Global HIV Interventions and Technocratic Racism in a West Papuan NGO.

In the era of scale up, global donor-driven HIV activities are transforming NGO work by demanding administrative, technical, and data-oriented activities. Drawing on interviews and participant observation in an NGO in the West Papuan city of Manokwari between 2011 and 2014, I attempt to understand why Indigenous Papuan NGO employees were steadily replaced by non-Indigenous migrant settlers, mainly of Javanese heritage, to deliver HIV services. I show that new rivalries, technical roles, performance targets and efficiency rhetoric intersected with existing racialization to produce a preference for Javanese employees, who were assumed to be more compliant and professional than their Papuan counterparts and to operate more easily within the technocratic regime imposed by donor expectations. I use the term technocratic racism to describe the way that global HIV rationalities intersect with ethnic stereotypes and gendered racial ideas to make possible certain HIV workers and not others. I contribute to anthropological literature on the delivery of HIV services by showing how a technocratic approach to HIV/AIDS intervention intersects with a settler-colonial context to gradually exclude Indigenous employees. Approaches that allow for relational, independent and flexible services would assist to decolonize HIV responses in West Papua.

Service delivery under translation: multi-stakeholder accountability in the non-profit community sector in New Zealand.

This paper addresses the challenge reported in the research literature of providing adequate accounts of service quality and value to multiple stakeholders. Rather than starting with a particular accountability practice, we examine the accounts of complex service delivery and results from the perspective of five key stakeholder groups. The case study at the empirical centre of this research is a small New Zealand non-profit organisation that provides community-based wraparound casework to young people, and their families, with multiple and complex needs. This paper reports on data collected during 2009-2012 through interviews with five key stakeholders of this service: the young people, the caseworkers, the co-providers, the managers and the funders. Drawing on translation theory, the different points of reference and the consequential shifts in focus, content and meaning within the multiple stakeholder accounts are traced. The findings show that while each stakeholder group brings a unique point of reference to the service delivery, there are degrees of overlap in the focus and content of the accounts. This is particularly evident in the 'relationship' dimension. While overlaps may exist, points of invisibility are also revealed. Accountability tensions can be traced directly to these points of invisibility. As a result of this analysis, it is argued that more explicit attention to the impact of multiple stakeholders at the level of epistemology provides a mechanism for addressing some of the tensions routinely raised.

(Not) getting political: indigenous women and preventing mother-to-child transmission of HIV in West Papua.

This paper builds on critiques that call for a more nuanced and contextualised understanding of conditions that affect HIV prevention by looking at West Papuan women's experiences of prevention of mother-to-child transmission services. Drawing on qualitative, ethnographic research with indigenous women and health workers, the paper demonstrates that women experience poor-quality HIV education and counselling, and that indigenous practices and concerns are largely not addressed by HIV services. We attribute this to a combination of national anti-indigenous and anti-separatist political concerns with donor-led interventions that result in limited localisation and reduced effectiveness of HIV prevention measures. In West Papua, services are needed that enhance cooperation and shared commitment, and that acknowledge and work to overcome existing inequalities, ethnic tensions and discrimination in the health system. Beyond Indonesia, donor-led HIV programmes and interventions need to balance avoidance of politically sensitive issues with complicity in perpetuating health inequalities. Translating global health interventions and donor priorities into locally compelling HIV prevention activities involves more than navigating local cultural and religious beliefs. Programme development and implementation strategies that entail confronting structural questions as well as social hierarchies, cleavages and silences are needed to render more effective services; strategies that are inherently political.

Inclusion and exclusion in mid-life lesbians' experiences of the Pap test.

Lesbians are said to feel excluded by sexual health messages that presume heterosexuality, a finding linked to lower levels of Papanicolaou (Pap) testing. This paper discusses a small, focused qualitative study based in Calgary, Canada that illuminated mid-life lesbians' experiences and perceptions of Pap testing and health. Participants indicated that they felt compelled and invited to access Pap testing by an inclusive discourse - that of 'mid-life', a period associated with an increased need for body surveillance. They also reflected upon aging as an experience of liberation, increased confidence and a time when they could 'catch up' on health and sexuality issues denied them in their younger days. On the other hand, there was significant uncertainty about Pap testing, human papillomavirus (HPV), cervical cancer and what kind of sexual healthcare is necessary for lesbians, which was reinforced by physician messages suggesting a reduced need for Pap testing when lesbian sexual identity was disclosed. In approaching mid-life lesbian healthcare, we suggest that greater analytical attention should be paid to the ways in which lesbian women are included, as much as excluded, in dominant sexual health scripts particularly by health providers who need to attend to women's diverse experiences and needs.

Rebel girls? Unplanned pregnancy and colonialism in highlands Papua, Indonesia.

In highlands Papua, Indonesia, rapid social change under a colonial system of governance has created novel sexual opportunities for young indigenous women. Recent scholarship has viewed similar youthful sexual practices that challenge the status quo as expressions of personal agency. By looking at how young women and their families cope with unplanned pregnancies, we suggest that a more viable analytic approach would be to view sexuality, pregnancy and childbirth as a single unit of analysis. From this perspective, young women's experiences are primarily ones of constraint. Case studies offer insights into the ways a political context of colonial domination limits options and choices for young women who have children born out of wedlock. In particular, this paper describes how the 'settler gaze' - omnipresent colonial norms and judgments - creates regulatory effects in the realm of reproduction.

Border testimonials: patterns of AIDS awareness across the island of New Guinea.

This paper compares and contrasts two similar sets of data about AIDS (acquired immune deficiency syndrome) and AIDS awareness from the island of New Guinea. The goal of this comparison is to show that state policies and values can dramatically affect personal knowledge about safer sexual practices. One set was collected in 2001 in the Indonesian province of Papua, which is home to indigenous Papuans and many inmigrating Indonesians. The second set was collected in 1991-1992 in the independent state of Papua New Guinea (PNG). Papuans and Papua New Guineans share many sexual beliefs and cultural practices and have experienced similar effects of modernization, but we show that there are marked differences in public knowledge about AIDS and condoms. In general, Papuan respondents know less about condoms and use them less frequently than their PNG counterparts. We argue that a colonial form of government in Papua makes it more difficult to design culturally appropriate and effective programs.