Sub-Saharan Africa is one of the regions most affected by the AIDS/HIV pandemic in the world. Nearly 70 per cent of people living with AIDS/HIV globally are local to sub-Saharan Africa, with two-thirds of new infections occurring in the region despite increasing efforts around prevention and treatment. Women are disproportionally affected by AIDS/HIV, yet the risk factors and mechanisms of infection in relation to gender inequality are poorly understood. The 2017 film Pili, directed by Leanne Welham and produced by Sophie Harman, provides profound insight into the everyday cultural, social, economic and political effects that further influence the gender disparity of AIDS/HIV. Pili visualizes the physical and emotional toll of living with AIDS/HIV while being constrained by the socio-political and socio-economic structures that define everyday life. Shot on location in the Pwani region of Tanzania, the film's narrative is based on insights derived from 85 interviews with local women. The audience follows central protagonist Pili (Bello Rashid) as she navigates difficult circumstances over four days. When Pili is given the opportunity to rent a market stall—a highly prized alternative to her labour in the field for less than US$1 a day—she struggles to come up with the deposit while trying to keep her HIV status secret from her community. Pressured by kiosk owner Mahera (Nkwabi Elias Ng'angasamala) to come up with the money or risk losing the rare chance to run a market stall, Pili must undertake desperate measures to secure her tenancy. As time passes, Pili faces an increasingly stark choice between her health and the future financial security of her family. From the opening credits score of insects and nature, tension is built incrementally throughout the film, which helps constantly remind the audience of their anxiety about Pili's situation and isolation. Gender is a significant theme in Pili, and explicitly intersects with structures of inequality arising from uneven development. Pili herself is a farm labourer, and like many women in her community in Miono, she is a single parent. She is responsible for earning an income, maintaining her household and caregiving—leaving few opportunities for education in order to transition to a better life. To finance her deposit for the market stall, Pili approaches the Village Community Bank (VICOBA) which is run by a board of women from Miono. Here we see the intersection of gender inequality and development: micro-lending institutions such as the VICOBA reinscribe a monetary set of relationships that commodify pre-existing social relations and can reinforce poverty by subsidizing individuals through accrued debt. VICOBAs often rely on peer pressure and social constructions of shame to ensure debt repayment, which is brilliantly visualized in the film through the ongoing debates between VICOBA members as to whether Pili should be able to apply for a loan. The absence of men in the Miono VICOBA signifies, again, the individual becoming tied to a global economy of debt: microfinance institutions are predominantly founded by and for women precisely because the international organizations that fund them rely on existing social customs to enforce payments on the larger group debt. Yet husbands can use their position to compel their wives to take on a VICOBA loan, which further reinforces the power imbalance of the domestic household. Problems of development and gender inequality in relation to AIDS/HIV are also visualized in key scenes where Pili visits care and treatment clinics (CTCs). Many CTCs are understaffed, lack essential equipment and at times are unable to provide medicine to patients. These CTCs and other health services rely heavily on external funding due to the wide-spread dismantling of government services in the 1980s following structural adjustment policies. These policies have resulted in inadequate care and insufficient education about the spread of AIDS/HIV, which in turn reinforces the stigma surrounding the disease—another significant inhibitor to seeking help. As Pili says, ‘I've been hiding for a long time. I didn't want anyone to know’. When the pharmacy price for anti-retrovirals increases, Pili sources her medication from a CTC in another village to avoid being seen at her local AIDS/HIV clinic by members of her community. When pressed by her friend Cecilia (Sesilia Florian Kilimila) about the relief she would feel if she were open about her status, Pili remains silent. Having control over how one is seen by others in the community is a risk factor that is often overlooked in examinations of the spread of AIDS/HIV. Pili is an aesthetically powerful film that offers an important contribution to the study of visual politics, global health and international relations. The film makes a path-breaking academic contribution to debates on AIDS/HIV prevention and treatment: it visually demonstrates the role of structures of gender inequality and development in exacerbating the AIDS/HIV pandemic, furthering our understandings of the possible political responses to alleviating such crises. © The Author(s) 2018. Published by Oxford University Press on behalf of The Royal Institute of International Affairs. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
International Affairs – Oxford University Press
Published: Mar 1, 2018
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