AIDS, Intimacy and Care in Rural KwaZulu-Natal A U P Patricia C. Henderson A Kinship of Bones AIDS, Intimacy and Care in Rural KwaZulu-Natal CARE & WELFARE Care and welfare are changing rapidly in contemporary welfare states. The Care & Welfare series publishes studies on changing relationships between citizens and professionals, on care and welfare governance, on identity politics in the context of these welfare state transformations, and on ethical topics. It will inspire international academic and political de- bate by developing and reflecting upon theories of (health) care and wel- fare through detailed national case studies and/or international compar- isons. This series will offer new insights into the interdisciplinary theory of care and welfare and its practices. series editors Jan Willem Duyvendak, University of Amsterdam Trudie Knijn, Utrecht University Monique Kremer, Netherlands Scientific Council for Government Policy (Wetenschappelijke Raad voor het Regeringsbeleid – WRR) Margo Trappenburg, Utrecht University, Erasmus University Rotterdam previously published Jan Willem Duyvendak, Trudie Knijn and Monique Kremer (eds.): Policy, People, and the New Professional. De-professionalisation and Re-professio- nalisation in Care and Welfare , 2006 ISBN 978 90 5356 885 9 Ine Van Hoyweghen: Risks in the Making. Travels in Life Insurance and Genetics , 2007 ISBN 978 90 5356 927 6 Anne-Mei The: In Death ’ s Waiting Room. Living and Dying with Dementia in a Multicultural Society , 2008 ISBN 978 90 5356 077 8 Barbara Da Roit: Strategies of Care. Changing Elderly Care in Italy and the Netherlands , 2010 ISBN 978 90 8964 224 0 Janet Newman and Evelien Tonkens (eds.): Participation, Responsibility and Choice. Summoning the Active Citizen in Western European Welfare States , 2011 ISBN 978 90 8964 275 2 AIDS, Intimacy and Care in Rural KwaZulu-Natal A Kinship of Bones Patricia C. Henderson Cover photo: Odette Herbert Cover design: Sabine Mannel, NEON graphic design company, Amster- dam Lay-out: JAPES, Amsterdam ISBN 978 90 8964 359 9 e-ISBN 978 90 4851 497 7 NUR 759 © Patricia C. Henderson / Amsterdam University Press, Amsterdam 2011 All rights reserved. Without limiting the rights under copyright reserved above, no part of this book may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the written permission of both the copyright owner and the author of the book. For the late Pippa Stein and my parents Contents Acknowledgements 9 Preface 13 Introduction 17 1. The Vertiginous Body and Social Metamorphosis 41 The life and death of Nkosinathi Dladla 44 Symbolic investments in the body 51 Conclusion 56 2. Mortality and the Ethics of Ethnographic Research 59 In the presence of death 59 Theoretical pathways 64 Accompanying Mandla Shabalala in his illness 70 Conclusion 80 3. Children and Youth in Pursuit of Care 83 Introduction 83 The variable living circumstances of the children and youth of Amatikwe 87 The pain of mobility 95 Expressive genres 99 Conclusion 102 4. Healers Negotiating the Local and the Global 105 Exploring healer narratives: Ntuthuko Hadebe 108 Nonhlanhla Duma 113 Ties between the living and the dead, a conduit of knowledge 116 The politics of illness 119 Conclusion 125 5. Love in a Time of Adversity 127 Part one 129 Part two 144 Conclusion 150 6. On Accompanying the Ill 153 Zinhle Vilikazi 157 Life experience and philosophy in relation to becoming a volunteer 162 Home-based carers as brokers 167 7 The illegal sale of medication from a public health facility 170 Beginning a journey with antiretroviral therapies 172 Conclusion 176 Epilogue 181 Appendix: Interlocutors and Research Methods 187 Acronyms 193 Glossary 195 Notes 201 Bibliography 225 Index 243 8 aids, intimacy and care in rural kwazulu-natal Acknowledgements Having completed a doctorate in social anthropology and a post-doctoral fellowship at an American university, I returned to South Africa in 2002 hoping to find work in the field of HIV and AIDS. With its overwhelm- ing presence in southern Africa, the disease seemed to present one of the greatest challenges facing the newly formed South African demo- cratic state. Its effects added an especially cruel burden to the multiple social and economic problems South Africa would have to confront. Through a series of serendipitous events, and in ways that suited my love of detailed anthropological and ethnographic research, I would in- deed begin to work with people living with and alongside HIV and AIDS. The years 2003 to 2007 marked a long and painful, yet rewarding journey in which I came to record individuals ’ experiences of living in the context of HIV and AIDS in Okhahlamba, a sub-district of KwaZulu- Natal in the region of the northern Drakensberg. The period began with three years of intensive ethnographic fieldwork, followed by two years of writing an ethnography. My profound gratitude and respect are due throughout to Eleanor Preston-Whyte, the head of the Social Science Re- search Unit at the Centre for HIV and AIDS Networking (HIVAN) at the University of KwaZulu-Natal, who graciously oversaw the work, giving me freedom to devise plans for fieldwork and to explore, think and write as I chose. At the commencement of the project, Sean Jones not only recommended that I be approached to do the work, but wrote and sub- mitted successful funding applications to the National Institutes of Health (NIH) and to the Rockefeller Brothers Fund, without which the research and the book would not have been possible. My heartfelt thanks are therefore also due to these funding bodies. With regard to time spent in Okhahlamba, I cannot thank enough the many people whom I met, some of whose ‘ stories ’ concerning illness and care appear in particular chapters in the book. Each person whom I came to know has enriched my life in enduring ways. Through our ex- changes in a time of AIDS, even in the midst of death and great sorrow, there was often a sense of beauty and human generosity: qualities that were interwoven with local cultural practice and ways-of-being. I do not mention the names of my friends in Okhahlamba in order to protect their identities. Yet I wish them to know that if I could, I would proclaim their names loudly. During my stay in Okhahlamba, several people I knew died of lesisifo (this illness, the local term most frequently used to refer to AIDS). What I have written is dedicated to their memory. 9 The body of research I came to complete encompassed my relation- ships with home-based carers who had received some training in pallia- tive care and who looked after the ill in their homesteads; with individ- uals suffering from HIV and AIDS and their families; a number of diviners and herbalists; and a group of young people from one settle- ment who had lost one or both parents through death. Without their acceptance and friendship, the work would not have been possible. In particular, I would like to thank the home-based carers whom I visited in their homes and whom I accompanied on visits to some of their patients. My gratitude and respect are due to the few people who allowed me to accompany them in their journeys with the illness. I thank the healers whom I met for their wide-ranging philosophical dis- cussions. The 31 ‘ Leaders of Tomorrow (LOT) ’ – young people whom I visited in their homes and at school in the community in which they lived – never failed to uplift me with their youthful exuberance. I thank them for their creativity, laughter, and performance, and for their playful description of anthropology as the exchange of unbounded ‘ stories about nothing ’ . I recall with happiness their accompanying me in walking the mountains to and from their homes. On my arrival in the region, personnel at the then uThukela District Child Survival Project (TDCSP), a non-governmental organization (NGO) in Bergville, welcomed me and facilitated my relationship with home-based carers and young people. Special thanks are due to Monica Holst for agreeing that TDCSP form a research partnership with my own organization, HIVAN. Claire Kerry, who straddled both organiza- tions, supported intervention efforts on the part of my research assis- tants and expressed frequent interest in the research. Undoubtedly a great debt of gratitude is due to Phumzile Ndlovu and Zanele Mchunu, community workers and project managers at TDCSP, who became my research assistants and companions in the field. With- out them, much of the work would not have been possible. I thank them for their growing enthusiasm for ‘ ethnography ’ ; our often painful jour- neys together; and their hard work, unfailing support, and ingenuity in the face of many frustrations. Amagama abo adumile ! (Their names are well known!) Xolisile Zondo patiently transcribed tape-recorded inter- views in isiZulu and made excellent translations of them into English. Bernhard Gaede and Samantha Padayachee, friends and medical doctors in the region, sustained and stimulated me throughout my stay. Bern- hard read what I wrote, distributing draft papers amongst hospital per- sonnel. He kept me informed about developments at the regional hospi- tal in relation to planning for the antiretroviral (ARV) roll-out, and when it was operational, of its progress. His unfailing enthusiasm for and knowledge of the region and its challenges continues to inspire me. Deborah Heustice, who was our HIVAN project manager, visited Phumzile, Zanele, Xolisile and myself on numerous occasions, bringing her organizational skills and calm friendship to bear on the often painful 10 aids, intimacy and care in rural kwazulu-natal experience of fieldwork. She listened unflinchingly as we unburdened ourselves of what we had witnessed in the lives of our ill and dying friends. Diane Merchant and John Robertson of the HIVAN administra- tive staff in Durban provided unstinting and efficient logistical support. Friends who visited me in the field, or whom I in turn visited over weekends, mitigated the loneliness one sometimes feels when doing fieldwork and strengthened me in my purpose: they are Elizabeth Gun- ner, Jackie Chambers, Fiona Ross, Pamela Reynolds, Kelly Gillespie, Vi- vienne Bozalek, Abigail Baim-lance, the late Pippa Stein, Malcolm Pur- key, Lyn Middleton, Vernon Solomon, Sue Mathieson, Tessa Carlyle- Mitchell and Terence Wulfsohn. I remember with fondness the visit of my sister, Elizabeth Marshall. A number of people took care of me following a serious car accident in ‘ the berg ’ . I thank them all and in particular my indefatigable aunt, Shiela Henderson. She showed an unfailing interest in the work and frequently visited me in the ‘ hobbit ’ s hut ’ Having left Okhahlamba at the end of 2005, in 2006, a six-month research association with the Wits Institute of Social and Economic Re- search (WISER) enabled me to do some archival research and to write in a stimulating atmosphere. I thank Deborah Posel, and John Hyslop in this regard. A three-month summer residency at the Centro Incontro Humani in Ascona, Switzerland, provided a beautiful and peaceful set- ting in which to seriously write about the young people whom I came to know in the Drakensberg. I would like to thank Angela Hobart for her interest and generosity in hosting me, as well as Giovanni and Laura Simona for their assistance in Switzerland. In 2007, HIVAN, at the Uni- versity of KwaZulu-Natal, remained an ongoing home in which to com- plete the manuscript. Through their prolonged engagement with my work, Pamela Rey- nolds and Fiona Ross have offered intellectual companionship of a parti- cularly ‘ fecund ’ sort, and have read, in stages, the entire manuscript. In particular, Fiona Ross and I have shared our work over many years. My deep gratitude goes to her for the mutual delight we take in discussions around our work, for her meticulous reading of my own, and for our deep friendship. S ’ bongile Maimane of HIVAN ably assisted me in checking the spelling of words in isiZulu that appear in the manuscript. Ngiyabonga Ma ! (Thank you mother!) Apart from those already mentioned above, the following people read and commented on portions of the work at different times: the late Pippa Stein, James Williams, Aaron Goodfellow, Tamaryn Crankshaw, Claire Kerry, Fiona Scorgie, Helen Ibbitson, Beth Filiano, Deborah Posel, Lyn Middleton, Danilo Pedrelli, Tessa Carlyle-Mitchell, Sue Mathieson, Par- eskivi Stavrou, Elizabeth Marshall, Jennifer Crouch, Deborah Heustice, Lesley Green, Steve Robins, Nicoli Nattrass, and Olga Nieuwenhuijs. My research colleagues at HIVAN participated in lively and generous seminar discussions in response to the chapters of the book as they were acknowledgements 11 written. Apart from colleagues whose names have already been men- tioned, I would like to thank Gerry Coovadia, Steve Reid and Rob Patt- man for incisive comments in the seminars they attended. I am indebted to the inter-disciplinary Vimmin ’ s Writing Group (VWG) for their lively response to my writing, and in particular to Astrid von Kotze, Ingrid Winterbach, Alleyn Diesel and Cheryl Stobie. Yvonne Winters and Nellie Sommers of the Campbell Collections as- sisted me in tracing historical references to Okhahlamba. I owe thanks to the librarians of the Gubbins Africana Collection at the University of the Witwatersrand, and at the University of KwaZulu-Natal. At the Uni- versity of the Witwatersrand, Carolyn Hamilton generously made some of her personal library of rare historical works available to me. Thanks are also due to Trudie Knijn of the University of Utrecht and to others associated with the Amsterdam University Press, including Jaap Wagenaar, Saskia Gieling and Vivien Collingwood. Lastly I thank my deceased parents, Olive and Gordon Henderson, who bestowed upon me a love of words, storytelling, and a certain obdu- racy of application. Early versions of four Chapters of AIDS Intimacy and Care in Rural Kwa- Zulu-Natal: A Kinship of Bones appeared in the following publications and in the following order: For Chapter 1: 2004. The vertiginous body and social metamorphosis in a context of HIV and AIDS. Anthropology Southern Africa, 27 (1&2): 43- 53. For Chapter 2: 2005. Mortality and ethics of qualitative rural research in a context of HIV and AIDS. Anthropology Southern Africa, 28 (3&4): 78- 90. For Chapter 3: 2006. South African AIDS orphans: Examining as- sumptions around vulnerability from the perspective of rural children and youth. Childhood , 13 (3): 303-327. For Chapter 4: 2005. A gift without shortcomings: Healers negotiat- ing the intersection of the local and global in the context of HIV and AIDS. Social Dynamics: Special issue: AIDS and Healing Strategies in South Africa , 31 (2): 24-54. Patricia C. Henderson November 2011 12 aids, intimacy and care in rural kwazulu-natal Preface Isihloko senkondlo yami sithi Gciwane Ndodana kaNgculaza * The heading of my poem, it says ‘ Germ, son of AIDS ’ ** Trinity Njoko Busisiwe 8 August 2005, performance Philakahle Hall, Bergville NginguGciwane Indodana kaNgculaza. Iningi lenu liyangazi. Kepha laba abangaziyo abavumi ukuthi ngaziwe njengelunga lomndeni wabo. I am Germ, son of AIDS. There are many of you who know me. Yet those who know me do not agree that I be known as one among their relatives. Kunalokho bayateketisa. Bathi ubaba wami uyindoda yale, phesheya kwelase – Melika. Kanti qha! Akunjalo. Ngingu Gciwane, indodana kaNgculaza. Kubobonke laba abasho Njalo, akulutho. Mina, Ngiyafika kubona. Abanye baze bateketise ngayo. Yonke indlela abuze ukuthi ngabe ngiqhamuka kuliphi. Ngithi nginendawo yokuhlala. Ngihlala emzimbeni womuntu. Nginethezeke ehotela lami, okuyigazi. There are those who waver. They say my father is a man from over there, across [the seas] from America. But no! It is not like that. I am Germ, son of AIDS. There are those who always say, it is nothing. Yet, I arrive among them. Others waver. They ask in every way how it is that I have suddenly appeared. I say I have a place to stay. I stay in the body of a person. I am at ease at my hotel, the blood of a person. 13 Ingani ngibangisana nomakhelwane wami abambiza uMasotsha oMzimba. Phela, nginobhuti wami omcane. Abambiza uZifo zoCansi. Ingani uyena ongisizayo ukuba ngibhebhetheke. Ngigcwale izwe lonke Ngomzuz ’ owodwa. Ngihlasela ikhulu labantu It is because I contend with my neighbour whom they call, Soldiers-of-the-Body [the immune system]. Indeed, I have my younger brother. They call him Disease-of-the-Mat [of sex]. It is because he is the one who helps me so that I flare up.*** I have filled all the land in a single moment. I attack hundreds of people ikakhulukazi laba abazonda umalume wami uKhondomi. Kubona ngifika sengiphindaphindeka okwezinwele zomuntu. Phela! NginguGciwane, indodana kaNgcu- laza. with a vengeance, especially those who hate my maternal uncle, Condom. It is amongst them that I arrive to return and return again like the hairs [on the head] of a person. Truly! I am Germ, son of AIDS. Angikhathalele ukuthi umude noma ingabe umfushane, noma ingabe umuhle noma ingabe, umubi noma ingabe umnyama noma ingabe umhlophe, noma ingabe uyisigwili noma ingabe uyisichaka, noma ingabe uyisangoma, I am not concerned about whether you are tall or short, whether you are beautiful or ugly, whether you are black or white, whether you are prosperous or someone without money or livestock, **** whether you are a diviner, noma ingabe udokotela. Angikhathalele lutho. NginguGciwane, indodana kaNgculaza. whether you are a doctor. I am not at all concerned. I am Germ, son of AIDS. 14 aids, intimacy and care in rural kwazulu-natal Abanye baze bangakhela uhlelo beluthatha esilungwini. Onezinhlamvu ezithathu. Bathi kukhona uA. Bathi kukhona uB. Bathi kukhona uC. Bathi uA uthi hlala ungayi ocansini. Ulinde ukuthi uze ushade. Bathi uB uthi thembeka ube nomngane oyedwa. Bathi uC uthi faka ijazi lomkhwenyana, loyoke uKhondomi. Ingani ngiyazi ukuthi niyamzonda umalume wami uKhomdomi. Kulaba sengifike, qáthatha! Others have built a programme taken from the whites. It has three syllables, three seeds. They say there is A. They say there is B. They say there is C. They say A means stay without sex, without going to the mat. Wait until you are married. They say B means be trustworthy having only one sweetheart. They say C means put on the jacket of the son-in-law, the one who is Condom. It is because I know you hate my mother ’ s brother Condom. I have arrived amongst those. Qáthatha! ***** Angidlali. I do not play. Phela mina nginguGciwane, indodana kaNgculaza. He! He! Bamb ’ isandla sami, we maARVs. Sihambe mina nawe. Senza isethembiso, sami nawe singefezwe umuntu ngaphandle kwethu sobabili. Engikwaziyo ukuthi wena ungumsizi wami futhi ungumnyatheli, nomgxobi, nomcin- dezeli womntwana ongahlelelwe emhlabeni on- guGciwane Mina nawe esithembisweni sami sathi ebhuhleni nase bubini ... Siyofa silahlane. Sihlukaniswe ukufa, impilo yami yonke. Truly I am Germ, son of AIDS. He! He! Take my hand ARVs. You and I go together. We made a promise, mine and yours that no person can fulfil apart from the two of us. What I know is that you are my helper, also a stamper, a trampler, an oppressor of the unplanned child who is the virus. You and I, in my promise we have said through good and bad we will throw one another away [only] when we die. We will be separated by death, for my whole life. preface 15 Ngibonge kwabakwa Broad Reach ngokungi faka ohlelweni lwemishaguzo yama ARVs I thank those of Broad Reach who have placed me within the programme of ARV medicines. * Note that ingculaza , the Zulu word for AIDS, is also sometimes spelt with an ‘ i ’ as the last letter of the word. (See, for example, Roman Khumalo ’ s poem in Chapter Two.) ** In isiZulu, gciwane is the word used to translate the English word, germ. It is also the term used for the human immunodeficiency virus. Its every- day meaning is ‘ a small particle floating in the air ’ (Doke et al 1990: 236), or ‘ ash particles which rise when blowing fire ’ (Dent & Nyembezi 1969: 352). *** Ukubhebhetheke means ‘ to spread fiercely as a fire ’ (Dent & Nyembezi 1969: 311). **** (Dent & Nymbezi 1969: 323). ***** Qáthatha is an ideophone of arriving (Dent & Nyembezi 1969: 464), of ‘ lightly dropping or falling down ’ (Doke et al 1990: 690). Possible roots of the word ‘ ingculaza ’ : - ncu (adj.) very small, little; ( i ) ncu- lu (noun) one who eats very little food; laza (v) turn sour, scatter as clouds, pass season without being covered by a bull, spread out in the wind as something running or flying (Dent & Nyembezi 1969: 403). 16 aids, intimacy and care in rural kwazulu-natal Introduction From March 2003 to February 2006, I lived in Okhahlamba, a portion of the uThukela District in the South African province of KwaZulu-Natal. I had come to this mountainous region abutting the northern Drakens- berg (Dragon ’ s Mountain) to record the experiences of people living in a context of HIV and AIDS among African communities in the Ngwane and Zizi chieftaincies, and adjoining African freehold settlements. I hoped that whatever I came to write would reflect the concerns of rural people and would pay close attention to local ways in which the illness, through time, was folded into everyday life, as well as how people used language to reflect upon its devastating presence. My aim was to provide an ethnographic record of a particular period in which suffering from the illness was acute, and where, prior to readily available antiretroviral treatment, death was inevitable. In particular, I wished to trace reper- toires of care outside of the formal institutional domains of hospitals and clinics, in order to show what people in limited circumstances brought to bear on the illness when there was little assistance forthcom- ing from the state. As it happens, the book spans a period in which anti- retrovirals were initially unavailable, and moves on to a time when treat- ment became accessible in various ways. It therefore begins with the presence of overwhelming death and mourning, after which hope gradu- ally became manifest in the recovery of a number of people through anti- retroviral therapies and ‘ the return ’ of bodies they could recognize as their own – bodies that had recovered from a state of emaciation. 1 Notwithstanding the ‘ crisis of representation ’ that has unsettled anthropology over the last 25 years by overturning the discipline ’ s for- mer claims to objective ‘ truth ’ (see Clifford 1988, Clifford & Marcus 1986), I uphold the value of ethnographic study both as a research meth- odology and as an art of writing. In so far as ethnographic research im- plies protracted interaction with people over time, where an attempt is made to reflect a range of local views and practices pertaining to interlo- cutors ‘ in the field ’ , it provides important records of and insights into the unfolding textures of everyday life (Fabian 1983). These are textures that include the presence of the anthropologist, a presence that has its ef- fects. In writing an ethnographic account of individuals ’ lives at a time of AIDS, I draw for inspiration on several ethnographies that in their diversity, attention to detail, styles of writing, and patient and subtle ex- egesis approach themes similar to those that appear in my own work. They are the themes of suffering, social and structural inequality, illness, violence, mourning, sensibility and intimacy (see Biehl 2005; Das & 17 Poole 2004; Csordas 2002; Petryna 2002; Das et al 2001, 2000, 1997; Davis 2000; Desjarlais 1997; Nadia Seremetakis 1996, 1991 and Klein- man 1995, 1988). What I have written clearly reflects my own ‘ literary ’ style. Yet, in true empirical fashion, I have sought to record what was ‘ out there ’ , as I encountered it, while at the same time acknowledging the shifting nature of the everyday. To my mind, far too little time is given to conducting rigorous research in dialogue with research partici- pants across differing sectors of society in South Africa. The above omis- sion comes to limit our understanding of political and ethical engage- ment with the world and its diversities. What ’ s in a name? I begin the book with a brief exploration of a particular metaphor at- tached to the ways in which people living in Okhahlamba often spoke. It has to do with the increasing visibility of the outline of a person ’ s bones as HIV and AIDS takes its alarming course. The title of the book draws upon a mother ’ s account of the death of her daughter, and the textured implications of human bones within a living world, where care is brought to bear on the intrusion of illness, death and mourning. Having lived in Okhahlamba for a period of three years and having visited it intermittently for one year thereafter, a consideration of bones has come to hold for me a multivalent cluster of ‘ feeling-tones ’ related to sociality, relationship and intimacy, to the paring away of flesh, and to loss, mourning and death. Yet bones are also linked to the emergence of sur- prising strength. With their durability, they evoke memory, history and the endurance of people who have been dispossessed over protracted periods of time. All of the above thematic elements form ongoing ‘ threads ’ that weave their way through what I have written. They are the conduits through which I explore the overall theme of the book. They encompass the ambivalence of care that is both proffered and withheld in relations of intimacy, kinship and neighbourliness. Turning to the mother ’ s story of her daughter ’ s death: in August 2003, on the day that she died of lesisifo (the name that is commonly given to HIV and AIDS in Okhahlamba), sensing that death was near, the daugh- ter of a home-based carer thanked her mother, as she expressed it, for having ‘ touched [her] bones ’ while nursing her ( ‘ Ngiyabonga ukungithin- ta amathambo ’ ; ‘ Thank you for touching my bones ’ ). The daughter in- sisted that if she had gone to a hospital to die, she would not have been touched in the same way. In ‘ touching her bones ’ , her mother showed a love that neither quailed in the face of her emaciation, nor ignored it, but rather encompassed it through the movements of her hands. Her mother washed, cleaned and caressed her, giving shape to her daughter ’ s suffering through feeling the outline of her bones, their density beneath her skin. It was an act that upheld the daughter ’ s humanity and the va- 18 aids, intimacy and care in rural kwazulu-natal lued threads of interconnection between herself and her mother in the face of death. Luce Irigaray (1986) conveys the importance of touch that, although addressed to a body replete with flesh, is apposite in reflecting on the young woman ’ s reciprocation and acknowledgement of her mother ’ s love. In her words, touch becomes a medium of recognition, an act of giving that underscores social being as predicated on exchange: Before orality comes to be, touch is already in existence. No nourishment can compensate for the grace, or the work, of touching. Touch makes it pos- sible to wait, to gather strength, so that the other will return to caress and reshape, from within and from without, flesh that is given back to itself in the gestures of love. The most subtly necessary guardian of my life being the other ’ s flesh. Approaching and speaking to me with [her] hands. Bringing me back to life more intimately than any regenerative nourishment, the other ’ s hands, these palms with which [she] approaches without going through me, give me back the borders of my body and call me back to the remembrance of the most profound intimacy. ( Ibid : 232-233) At her own insistence some weeks before her death, the young woman asked her mother to accompany her in various tasks. In order to accom- plish them, her mother carried her on her back like an infant to board a minibus taxi to travel to Johannesburg where the daughter had worked. Her mother then carried her through the streets of that city to the place where she had lived to recoup her possessions and important docu- ments. On their return to Okhahlamba, her mother carried her to the relevant state department to secure the birth certificates of her children, documents that would be needed to obtain state grants for her children after her death. 2 Through her actions, the mother re-enacted a tender and practical ges- ture related to childhood in most parts of the African continent, one in which a child is comforted, and in which the bearer ’ s hands are freed for everyday tasks. The infant is cradled with a cloth against the back of the person carrying it, held with the front of its body against the warmth of an older person, its legs and arms embracing the contours of the car- rier ’ s body. In evoking the dependence of a child through the use of the word ‘ teta ’ , yet using it in relation to her adult daughter who could no longer walk, the mother expressed how the act of bearing her child had become one imbued with sorrow. Instead of presaging a future of in- creasing capabilities, it pointed towards the ending of her daughter ’ s life. The work taken up by the mother in relation to her daughter consti- tuted their mutual attempt at ordering life in preparation for death. 3 One social meaning of the mother ’ s actions in touching her daughter indicates that although the flesh of a person undergoing AIDS falls away, the body ’ s frame, the skeleton, with each bone linked to another, be- comes a metaphor for the insistence on a certain coherence of person- introduction 19