AIDS Archives - Not Even Past

My Alternative PhD in History

A recent piece in The Economist claims that, “One thing many PhD students have in common is dissatisfaction. Seven-day weeks, ten-hour days, low pay and uncertain prospects are widespread. You know you are a graduate student, goes one quip, when your office is better decorated than your home and you have a favourite flavour of instant noodle.”

(via Pexels)

When I was considering enrolling in the University of Texas History PhD program, I heard similar sentiments from peers and discovered many analogous articles. Despite the deluge of criticism I found myself wading through during application season, stubbornness and ambition persevered, and I entered the program in August of 2013. I decided to get a PhD in History as training for pursuing a career in government policy making. Many people making policy decisions lack significant contextual knowledge about their fields, which has a negative impact on overall policy effectiveness. Nearly three and a half years later and having experienced many of the drawbacks associated with grad school, I am still content with my decision.

During my undergraduate years at UT, I took a course with the highly regarded historian Tony Hopkins. Though I often find myself remembering his stirring lectures and exceptional oration skills, one moment in the course especially resonated with my ambitions. One day, he mournfully stated that the last of the generation of economists who were well versed in history recently retired or passed away. His words deeply echoed my feelings about the profound lack of historical and cultural understanding among the vast majority of contemporary policymakers.

The distinguished economic historian A.G. “Tony” Hopkins taught at UT from 2002-2013 (via Wikimedia Commons).

I work on the history of sexual health politics during the colonial period in southern Africa with the goal of doing policy work for American HIV/AIDS relief efforts in the same areas. Historically, western medicine frequently has produced traumatic and violent experiences in African societies, where perspectives on sexual health and sexual education norms differ from western views and health relief campaigns have a history of becoming politicized within neo-colonial and nationalist power struggles, making American foreign health policy and its reception in Africa problematic. Many policymakers lack the historical background necessary to develop effective policy. For all the discourse on indigenous partnership that occurs as a part of American relief efforts in my focus regions, partnership occurs within the cultural and ideological framework of American public policy. For example, policymakers do not legitimately account for indigenous healing practices within their policy frameworks – either in discourse or practice – because the vast majority of policymakers fail to recognize just how much sociocultural value local medical practices hold while simultaneously overlooking the ways in which Western medicine possesses its own country specific cultural values. Americans have contributed to the tremendous progress made in fighting HIV/AIDS, but we could be doing better by integrating real historical training.

I have made this argument multiple times to potential employers as I look beyond my dissertation defense toward a career in policy making. My contentions have not fallen on deaf ears. Think tanks and other policy research institutes have indicated that my historical training really does bring valuable expertise to the table that few other candidates with other types of degrees possess.

030926-F-2828D-307 Washington, D.C. (Sept. 26, 2003) -- Aerial view of the Washington Monument with the Capitol in the background. DoD photo by Tech. Sgt. Andy Dunaway. (RELEASED)

Historical knowledge and training can inform policy from the local to the federal levels (via Wikimedia Commons).

When considering whether a PhD – and specifically one in History – is worth it, I would consider asking what such a degree can add both to one’s personal goals and to making one competitive on the professional job market. When I was thinking about graduate school, I reflected on Tony Hopkins’ words and realized that I could not, in good conscience, work in HIV/AIDS relief (something I have been passionate about for close to a decade) without acquiring the knowledge that was lacking in the field. I also believed that a PhD would enhance my employment prospects if I articulated the validity of my trajectory in the right way.

There is a tangible void in public policy and I firmly believe that history PhDs could have a critical role to play in filling that void in the coming years. To those who are skeptical of the decision to put so much time, money, and energy into a PhD education, I contend that the versatile PhD holds more weight now than at any other time in recent memory.

More by Ben Weiss on Not Even Past:

Slavoj Žižek and Violence.
The British Industrial Revolution in Global Perspective, by Robert C. Allen (2009).

How to Survive a Plague: The Inside Story of How Citizens and Science Tamed AIDS, by David France (2016)

By John Carranza

In the 1980s, the United States experienced a new disease that seemed to target young, gay men living in New York City and San Francisco. From the beginning, those doctors and scientists willing to treat members of the gay community remained perplexed as to why these men, their ages ranging from their early twenties to their thirties, were falling ill with rare diseases that would not ordinarily affect someone their age. The earliest name given to this new epidemic was gay related immune deficiency (GRID) before it took the name acquired immune deficiency syndrome (AIDS), which was caused by the human immunodeficiency virus (HIV). The push for scientific advancement and treatment was not readily available to these young men, and many government officials at the state and national levels refused to acknowledge the epidemic that soon spread across the United States and affected groups other than gay men.

David France’s How to Survive a Plague: The Inside Story of How Citizens and Science Tamed AIDS is a complementary work of history to the 2012 documentary of the same name that documented the early years of the AIDS epidemic to the successful discovery a decade later of combination drug therapies that brought people with AIDS from the brink of death back to life. The main actors in France’s sweeping narrative are a group of men and women who formed the AIDS Coalition to Unleash Power, or ACT-UP, devoted to demanding action from the government and pharmaceutical companies for treatment. Their initiatives were influential in saving thousands of lives by the early 1990s.

ACT-UP buttons from the 1980s (via Wikimedia Commons).

ACT-UP began as an informal group of gay men who were dying of opportunistic infections related to the compromised immune systems associated with AIDS. However, as time went on, the epidemic took more lives and the government remained silent, so they took it upon themselves to learn about their illnesses in order to demand government intervention and the development of medical treatments. In this way, many of them became citizen-scientists. They compiled the scientific data made available to them by competing scientists and used it to educate one another and the government officials that they lobbied. They pushed for medications that would treat their opportunistic infections, as well as the virus that causes AIDS once it was discovered. They were also first in realizing the safe sex might lessen the chances a person had for catching this new and mysterious disease.

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AIDS activists in the 1980s (Curve Magazine via the Odyssey Online).

France recounts the activism necessary to win visibility not just for gays, but also for other populations who became affected, such as intravenous drug users and women. ACT-UP’s activism undertook public demonstrations as a means of demanding more scientific research, access to drugs, and lower prices for those drugs once they were identified as possible treatments. In its earliest years of activism, the group modeled itself on the Civil Rights movement of the 1960s by practicing nonviolent civil disobedience and going into traditionally conservative parts of the United States to educate people. ACT-UP petitioned members of Congress for AIDS funding for research, fought with the Food and Drug Administration (FDA) to allow lifesaving drugs onto the market faster, set up needle exchanges for intravenous drug users, and protested on Wall Street. The early stages of ACT-UP’s activism included using the infamous symbol of the pink triangle with SILENCE = DEATH written beneath it, which was made into bumper stickers and posters that could be plastered all over the city, as well as hats and T-shirts. One of the enduring symbols of their activism is the AIDS Memorial Quilt, which was created in San Francisco to remember the lives lost in the epidemic. It made its first appearance on the National Mall in Washington, D.C. in the fall of 1987 when it included more than 1,900 panels.

The AIDS Quilt on the National Mall in 2011 (via Wikimedia Commons).

David France’s book is a great achievement in that he details the events and lives of the people who lived through the AIDS epidemic over the course of approximately thirteen years. France achieves this not simply as a researcher with an eye for historical detail, but also as a person who lived through those events as a journalist. His ability to document the AIDS epidemic in the 1980s resulted in the ability to keenly observe developments while still keeping a certain level of objectivity. France uses extensive archival research, including the papers of the most visible activists and he draws on his own experience. Where possible, France conducted oral interviews with members of ACT-UP who are still alive today. France captures the emotion and frustration of the members of ACT-UP who pushed for access to life saving drugs while negotiating alliances and feuds among members of the group and the scientific community. How to Survive a Plague is essential reading, not only for members of the LGBTQ community, but for everyone who may have been too young or not have been alive during the 1980s and early 1990s when the fight for visibility and medication was still happening. How to Survive a Plague is an excellent example for understanding how activism works, how advocacy for those marginal members of society can be effective, and to show government and public health officials how not to handle a plague.

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Joseph Parrott reviews The Lavender Scare: The Cold War Persecution of Gays and Lesbians in the Federal Government by David K. Johnson (2006).
Chris Babits explores the Dallas Gay Historic Archives.
Blake Scott reviews AIDS & Accusation: Haiti and the Geography of Blame by Paul Farmer (1992).

AIDS & Accusation: Haiti and the Geography of Blame by Paul Farmer (1992)

by Blake Scott

In 1983, the Center for Disease Control in Atlanta, Georgia announced that there were four major risk groups for AIDS in the United States – homosexuals, hemophiliacs, heroin-users, and Haitians. The report acknowledged that each of the four groups – widely known as the “Four-H Club” – contained many individuals who were not at risk for AIDS. In the early years of the epidemic, however, those exceptions meant little to the public. AIDS was a new, mysterious disease and these people were its supposed carriers. The warning, in the end, may have caused more harm than good, intensifying paranoia and discrimination.

While all four groups experienced the stigma of accusation, there was something particularly arbitrary about the ‘Haitian’ risk pool. It was the only risk group based on nationality rather than specific behavioral factors. Why were all the citizens of Haiti included in the CDC warning? In his well-crafted book, Paul Farmer takes “a geographically broad and historically deep” approach to explain the roots of the AIDS accusation afflicting the Haitian community.

Leading up to the official warning, the media and a handful of prominent scientists in the U.S. had erroneously concluded that Haiti was the original source of AIDS in the Americas. As Farmer convincingly argues, though, the Haitian origin theory represented a “systematic misreading” of both epidemiology and history. The false accusations that swirled around the Haitian community, he explains, drew on a long history of racism and ethnocentrism.

Over the course of the 1980s, Farmer, a medical doctor and anthropologist at Harvard University, carried out extensive ethnographic fieldwork in Haiti, while at the same time, offering medical services to rural communities. In his writings, Farmer combines medical and anthropological knowledge to explain how both international and local forces shaped disparate responses to the epidemic.

U.S. troops marching during the occupation of Haiti, 1915, via Wikimedia Commons.

The book is made up of highly readable essays that allow the reader to approach the story from several angles – from Haitian community dynamics to larger medical debates to transnational economic and political issues. In one essay, for example, Farmer narrates the local history of the village of Do Kay to illuminate how poverty and cultural beliefs, such as sorcery, helped to direct responses to the disease. In another section, he explores the intersections between epidemiology and history to explain how HIV most likely arrived to Haiti via North American tourists. The arrival of AIDS, he concludes, was linked to Haiti’s historical and continually evolving role in a regional economy dominated by the United States.

Haiti after the earthquake. Photograph by Eva Hershaw.

Farmer offers a compelling argument for why medical professionals need to better understand the histories and cultural practices of the people they hope to help, at home and abroad. Haitian counter-theories, which vehemently blamed North American imperialism for the arrival of AIDS, originally baffled U.S. medical doctors and scientists. A greater awareness of the history of U.S.-Haitian relations would have led to a more sympathetic and likely, a more effective medical response. In short, anyone interested in learning how history and culture affect societal responses to disease will find Dr. Farmer’s book well worth their time.

For those interested in learning more:

The Agronomist. In this documentary, award-winning director Jonathan Demme profiles the life of Haitian journalist and radio pioneer Jean Dominique. Through the life of Dominique and his family, The Agronomist offers a compelling portrait of Haiti in the second half century of the twentieth-century.

Paul Farmer’s Haiti After the Earthquake. Dr. Farmer offers an on-the-ground account of the most recent earthquake in Haiti, discussing its aftermath and recovery projects, past, present, and future.

Mary A. Renda’s Taking Haiti: Military Occupation and the Culture of U.S. Imperialism, 1915-1940. Professor Renda explores the cultural dimensions of U.S. contact with Haiti during the 1915 intervention and its aftermath. She shows that what Americans thought and wrote about Haiti during those years contributed in crucial and unexpected ways to an emerging culture of U.S. imperialism.

Laurent Dubois, Avengers of the New World: The Story of the Haitian Revolution. Professor Dubois weaves the stories of slaves, free people of African descent, wealthy whites, and French administrators to explain how the Haitian Revolution became a foundational moment in the history of democracy and human rights.

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