Fault Lines of Care

Gender, HIV, and Global Health in Bolivia

By Carina Heckert

SERIES: Medical Anthropology

Rutgers University Press

The HIV epidemic in Bolivia has received little attention on a global scale in light of the country’s low HIV prevalence rate. However, by profiling the largest city in this land-locked Latin American country, Carina Heckert shows how global health-funded HIV care programs at times clash with local realities, which can have catastrophic effects for people living with HIV who must rely on global health resources to survive. These ethnographic insights, as a result, can be applied to AIDS programs across the globe.

In Fault Lines of Care, Heckert provides a detailed examination of the effects of global health and governmental policy decisions on the everyday lives of people living with HIV in Santa Cruz. She focuses on the gendered dynamics that play a role in the development and implementation of HIV care programs and shows how decisions made from above impact what happens on the ground.

Fault Lines of Care is a remarkable book of the type many of us strive for: a finely grained, moving ethnography that articulates the nature of the broad interactions among individual, community, state-level, and global dynamics in the domain of international HIV/AIDS care. Heckert is a lucid, evocative writer and frankly, I found the book hard to put down. Carole H. Browner, coauthor of Neurogenetic Diagnoses, the Power of Hope, and the Limits of Today’s Medicine

Carina Heckert’s evocative and wrenching ethnography, Fault Lines of Care, conveys the frustrating and at times deadly entanglements of global health agendas with the intimate lived experiences of people living with HIV/ AIDS in resource poor communities in Bolivia. Heckert invites readers on an emotionally-charged journey through her interlocutors’ intimate and social experiences of seeking care for HIV/AIDS and ultimately their struggles for survival. This ethnographically rich rendering is an important contribution to our understanding of how people’s experiences of chronic disease interact with the biopolitical contours of inequality and poverty, in Bolivia and globally. Nia Parson, author of Traumatic States: Gendered Violence, Suffering, and Care in Chile

Chronicle of Higher Education Weekly Book List,' by Nina C. Ayoub Chronicle of Higher Education

As a case study in global health strategy, [Bolivia] is a useful example because of the often unexpected ways in which local politics, societal structures, and culture interact to undermine efforts to combat the HIV epidemic. The Lancet

Heckert writes in an engaging and accessible style and clearly explains her theoretical approach to understanding her ethnographic data. She nicely balances her discussion of the historical, social, and political context of HIV care with case studies of HIV-positive people doing their best to navigate the healthcare system and make decisions about when and how to access care. American Journal of Human Biology

Comprehensive and impressively written. The Latin Americanist

Fault Lines of Care offers a thoughtful examination of an HIV epidemic....This book offers an excellent resource for undergraduate and graduate courses in medical anthropology and health sciences. It poses important questions for future researchers to consider, including why our stubborn reliance on metrics and disease-specific approaches to global health care persist. Medical Anthropology Quarterly

CARINA HECKERT is an assistant professor of anthropology at the University of Texas at El Paso.

1. Fault Lines
2. Decolonizing Bolivia
3. When Care is a “Systematic Route of Torture”
4. Aiding Women
5. Synergistic Silences
6. Blaming Machismo
7. The Biopolitical Drama of HIV Funding
8. Decolonizing Global Health
Bibliography
Notes
Index
Acknowledgments

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