After about ten years of work experience in international development agencies, the author proposes a critical view on humanitarian aid in the post-Soviet Caucasus and Central Asia. Her approach is that of ‘networked ethnography’ and focuses on a typical institution, the ‘International Development Organisation’ (IDO) created just after WWII. The book aims at deciphering and analysing the contradictions in actions and reactions with respect to the application of development models, here applied to a global public health issue: the HIV/AIDS pandemic, a pathology which is politically highly sensitive and stigmatised in the post-Soviet space.
Even though HIV prevalence remains small in Central Asia and the Caucasus, compared with sub-Saharan Africa, the HIV infection may still become an important threat, because numerous risk factors for an epidemic prevail in these areas. The increasing poverty, the deteriorating health and social situation, the rapid increase in drug traffic in Central Asia due to the expansion of opium production in Afghanistan, corruption and authoritarianism are all potential factors for HIV spreading. The political authorities tend to negate the risks of infection. They neither provide accurate data nor develop appropriate prevention policies. The authorities tend to stigmatise high-risk groups, in particular homosexuals, following a long tradition prevailing during the Soviet era of applying coercive methods to groups labelled ‘deviant’ or ‘parasitic’. The official image of the system was supposed to not reveal any flaw, and this book underlines the reality of these operating processes, which considerably hamper the work of the non-governmental organisations.
The author underlines rightly the continuity of prevailing ideologies in this post-Soviet space, where the modes of functioning did not change with the end of the USSR. She shows the complexity of actions and reactions in relation with an IDO which wants to impose a new model of democracy, with all its underlying technical and theoretical paraphernalia. Likewise, from the local administrators’ viewpoint (Ministry of Health, Ministry of Interior, etc.), the work meetings as well as the quotes from the personnel show to which extent the IDO approach clashes head-on with them. Sometimes the NGOs may jostle the mind set of certain local actors who wish to acquire a new space for debate and action. However, this work is made difficult by the NGOs’ personnel itself, because they are not fully independent and because their action is finally inscribed within a foreign hierarchical and hegemonic system. These modes of functioning are illustrated by numerous interviews with institutional actors in Central Asia and the Caucasus. These interviews highlight the discussion between the various parties, and eventually translate the resistance of an ideology to another. Nevertheless, one could regret that only few interviews were conducted with the population directly concerned with the policies that the actors are willing to put in place for controlling the HIV epidemic, which would have increased the value of this study.
Lastly, this book emphasises the IDO strategies for raising the consciousness for HIV prevention. The political systems in place are still often very Soviet-oriented, individuals remaining reluctant to a holistic approach for controlling a disease that has kept a strong social connection, with high stigmatising power. The author focuses on the difficulties, the contradictions, and the misunderstandings from the various parties in place. Using as an example the HIV/AIDS epidemic, she shows how the functioning logics for action are deeply rooted in the past, and how Western paradigms remain poorly understood.