The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS

332 Pages·2008·1.53 MB·English

by  Pisani

THE WISDOM OF WHORES
THE WISDOM OF WHORES
Bureaucrats, Brothels and the Business of AIDS
ELIZABETH PISANI
Granta Books
London
Granta Publications, 12 Addison Avenue, London W11 4QR
First published in Great Britain by Granta Books 2008
Copyright © Elizabeth Pisani, 2008
Elizabeth Pisani has asserted her moral right under the Copyright, Designs and Patents Act, 1988, to be
identified as the author of this work.
All rights reserved. No reproduction, copy or transmission of this publication may be made without written
permission.
No paragraph of this publication may be reproduced, copied or transmitted save with written permission or
in accordance with the provisions of the Copyright Act 1956 (as amended).
Any person who does any unauthorized act in relation to this publication may be liable to criminal
prosecution and civil claims for damages.
A CIP catalogue record for this book is available from the British Library.
ISBN: 978-0-39306889-4
William Clowes Ltd, Beccles, Suffolk
For Roger and Julie
CONTENTS
Map
Author’s Note
Acknowledgements
Preface: The Accidental Epidemiologist
1 Cooking Up an Epidemic
2 Landscapes of Desire
3 The Honesty Box
4 The Naked Truth
5 Sacred Cows
6 Articles of Faith
7 HIV Shoots Up
8 Ants in the Sugar-Bowl
9 Full Circle
Notes
Bibliography
Map
AUTHOR’S NOTE
This is a non-fiction book. The events and facts in it are recorded as faithfully as
my memory and written and electronic records allow. Most people appear under
their real names, or the names by which they introduced themselves to me.
Sometimes this is a first name only (indeed many people in Indonesia only use
one name).
Except where someone was speaking or writing on the public record, I have
tried to seek people’s permission to recount conversations we have held, or to
reproduce their e-mails or written comments. In the few cases where I have not
been able to trace people, I have generally changed their names.
Most of the documents referred to in the book, including the scientific
references, can be accessed using the links provided on the book’s website:
http://www.wisdomofwhores.com/references
The website also has illustrations, photos and my blog on topics that may be of
interest to readers of this book. Comments are welcomed.
Elizabeth Pisani
London, November 2007
ACKNOWLEDGEMENTS
The Wisdom of Whores is the product of over a decade of debate, passionate
disagreement, moments of enlightenment, misery and laughter shared with
people in many countries and from many walks of life. Some I am not able to
acknowledge by name, and some whose names I do mention will be
uncomfortable with many of the ideas expressed in the book. I thank them
nonetheless for contributing to my understanding and convictions.
My greatest debt of gratitude is to friends and colleagues in Indonesia–
people who led me through brothels and bureaucracies with patience and good
humour. They include Arizal Ahnaf, Ines Angela, Vidia Darmawi, Desi, Eris,
Mohammad Noor Farid, Frankie, Molly Gingerich, Happy Hardjo, Naning
Iswandono, Saiful Jazan, Balgis Koesnantah, Ratna Kurniawati, Lina, Ling Ling,
Nana, Nancy, Palani Narayanan, Kharisma Nugroho, Brad Otto, Joy Pollock,
Sigit Prihutomo, Chris Purdy, Haikin Rachmat, Resty, Made Setiawan, Fonny
Silfanus, Arwati Soepanto, Stephen, Lenny Sugiharto, Aang Sutrisna, Bhimanto
Suwastoyo, Wayne Wiebel and Dewa Wirawan. I learned much, too, from other
colleagues at the Indonesian Ministry of Health’s sub-Directorate of HIV/AIDS
and at Statistics Indonesia, as well as at Family Health International’s Indonesian
programme, ASA. Thanks are especially due to Steve Wignall who led ASA
with dedication, compassion and a healthy dose of ribald realism.
Besides making me laugh, Philippe Girault taught me a lot about the
vagaries of fieldwork; Elizabeth Donegan did too. The unflappable Hari
Purnomo was my guru for conflict resolution, and Penny Miller provided a
shining example of the importance of persistence and attention to detail in
turning good ideas into good programmes.
In Beijing, I was lucky to work with the epidemiology division of the
National Centre for HIV/AIDS/STD Control. Thanks to Lu Fan and his staff,
especially Chaganhuar and Wang Liyan who were always willing to burn the
midnight oil in the name of research. I’m also grateful to Cheng Feng, He
Jinglin, Bert Hoffman, Liu Qian, Meiling, Joel Rehnstrom, Wang Lixue, Wu
Zunyou and Zhong Li.
Some say it is more important to choose a good boss than to choose a good
job; I have been lucky to have both. Jeanine Bardon ran FHI in Asia with an
unbeatable mixture of good humour and steely determination to build
programmes that actually improve lives. She ran an organization stuffed with
wonderful people who taught me many things. Thanks to all of them, especially
Sara Hersey, Nancy Jamieson, Nigoon Jitthai, Mike Merrigan, Graham Neilsen,
Dimitri Prybylski, Boyet Roquero and Ganrawi Winnithana. Steve Mills and
Tobi Saidel were my first friends at FHI; they taught me about behavioural
surveillance and pulled me into the fold, and for that as well as good friendship I
thank them.
I’ve had many good bosses in my wanderings as a consultant: Ties Boerma,
Txema Calleja, Michel Carael, Peter Ghys, Rob Moodie and Bernhard
Schwartlander have all indulged my argumentative nature and defended my
plain prose against UN-creep. Other friends and colleagues in the AIDS mafia
include Andrew Ball, Chris Castle, Kevin De Cock, Don Des Jarlais, Isabelle de
Vincenzi, Geoff Garnett, Robin Gorna, Simon Gregson, Daniel Halperin,
Noerine Kaleeba, John Novak, Wiwat Peeratapanapokin, Cyril Pervilhac,
Deborah Rugg, Swarup Sarkar, Karen Stanecki, John Stover, Jim Todd, David
Wilson, Ray Yip and Basia Zaba. I have argued stubbornly with most of these
people over the years, and with some I still disagree on many points, but I have
always come off the wiser from our encounters. I’d especially like to thank Tim
Brown, who shares my brain, and Neff Walker, who simply makes the AIDS
field a more fun place to work.
It goes without saying that I thank everyone who appears in the book for
letting me tell their tales. First among equals is David Fox, who has been in
equal parts generous and courageous in allowing me to chronicle an unhappy
episode in our largely happy history.
Several people were kind enough to read and provide detailed comments on
drafts of all or parts of the book. Thanks to Chris Archibald, Peter Baldwin,
Andrew Ball, Jeanine Bardon, Julie Bates, Claire Berlinski, Karen Broughton,
Sophie Campbell, Michel Carael, Adrian Cox, Tim France, David Gordon,
Robin Gorna, John McGlynn, Jack Molyneaux, Palani Narayanan, Mead Over,
Sophie Pinwill, Gray Sattler, Nathalie Steiwer, Jonathan Swire, Robert Templer
and Jack Tenison. Sinead Worrall brought a whole new perspective to the book.
Keith Hansen spent untold hours pointing out logical fallacies, highlighting
clichés and suggesting improvements in content and structure. He managed to do
all of that while still being a fount of energizing encouragement. Jimmy
Whitworth has entrenched his position as the epidemiologist I most admire by
taking the time to read and comment thoughtfully and amusingly on every
chapter of this book. For that and for a decade of inspiration, many thanks. Chris
Green gets my vote for ‘world’s best activist’. Through careful readings and
forthright comments Chris has tried to keep me both honest and human. I