Patching Up a Community in Distress: HIV/AIDS and the Keiskamma Guernica
2015; UCLA James S. Coleman African Studies Center; Volume: 48; Issue: 4 Linguagem: Inglês
10.1162/afar_a_00250
ISSN1937-2108
Autores Tópico(s)HIV/AIDS Impact and Responses
Resumoall photos by Paul Mills, except where otherwise notedThe Keiskamma Art Project in Hamburg in the Eastern Cape of South Africa has become well known for making large-scale works, primarily in needlework but often incorporating other media, which rework iconic art objects from the West in such a way as to focus on local issues of concern. In this article I examine one such work. The Keiskamma Guernica (Fig. 1), begun late in 2009 and completed midway through 2010, is constituted from appliquéed textiles and includes embroidery as well as elements in wire, metal, and beadwork that have been collaged to its surface. An adaptation of Picasso's famous Guernica (1937; Fig. 2) which takes as its subject matter the horrific impact of the bombing of the historic town of Guernica in Spain by German forces working in cooperation with fascist leader Francisco Franco during the Spanish Civil War,1 the Keiskamma Art Project's version speaks of the devastating impact of HIV/AIDS on Hamburg and its surrounds.This was by no means the first time the Keiskamma Art Project had produced a work focused on HIV/AIDS. The project's Keiskamma Altarpiece (2005; Fig. 3) represented responses to the disease and the community's provision of support to the numerous youngsters whom AIDS had orphaned, by referring to the Isenheim Altarpiece (Fig. 4) which had been commissioned in the early sixteenth century by the religious order of St. Anthony, who cared for victims of ergotism, a devastating leprosy-like skin condition. Achieving particular notice through its exhibition at the Fowler Museum at UCLA in 2006 as well as its display at numerous churches in the United States, Canada, and the United Kingdom over a period of more than two years, the Keiskamma Altarpiece was also shown at various venues in South Africa and, in 2013, travelled to Germany.The Keiskamma Altarpiece was made shortly after Carol Hofmeyr, a medical doctor and artist who founded the Keiskamma Art Project in 2000, had secured private funding that enabled about eight people in the community to acquire antiretroviral treatment and simultaneously with the rollout of government-sponsored antiretroviral medication first reaching Hamburg. As I have observed previously (Schmahmann 2010), its message of hope would be especially apt as the work took shape while the health of people was improving dramatically and, it seemed, almost miraculously. I have also observed that this message of optimism would underpin smaller altarpieces referring to the impact of HIV/AIDS made immediately subsequent to the Keiskamma Altarpiece, in late 2005 and early 2006,2 as well as the project's large-scale Creation Altarpiece, which was completed in 2007.3 But, as I indicate in the present article, there is a distinct shift in the mood and tenor in the Keiskamma Guernica which, rather than being imbued with a spirt of positivity as well as confidence about the community's capacity to survive the onslaught of HIV/AIDS, suggests severe suffering and profound despair experienced in Hamburg and its surrounds. As the Keiskamma Art Project (2010a) observed, the work is “a lament for the dead, for the injustices of our health system and the staggering grief experienced in Eastern Cape villages today.”In interpreting meanings within the Keiskamma Guernica, one would want to consider the implications of using a well-known European artwork as its prototype and how this may affect a reading of its content. While being mindful of the fact that people in the Keiskamma Art Project, other than Hofmeyr and a handful of members with a tertiary education, probably have no knowledge of postmodernist theory, Linda Hutcheon's definition of parody as a genre which involves “repetition with critical distance which marks difference rather than similarity” (Hutcheon 1985:6) is nevertheless useful for suggesting something about the relationship between works by the project and the iconic artworks to which they refer. In the case of Keiskamma Guernica, for example, Hutcheon's definition suggests that qualities which the work has in common with Picasso's Guernica may actually emphasize the respects in which the South African work is different to its prototype. Apart from drawing attention to the fact that the Keiskamma Guernica is about circumstances particular to 2010 rather than 1937 and indeed about a devastating disease rather than about civil war, its reference to Picasso's work might be understood to emphasize respects in which it speaks of paradigms and frameworks of people in South Africa rather than those of a Spaniard living in France.Purchased by the Red Location Museum in the Eastern Cape city of Port Elizabeth shortly after it was unveiled at the National Arts Festival held in Grahamstown4 midway through 2010, the Keiskamma Guernica was shown briefly at the University of the Witwatersrand in Johannesburg in 2011, was included in the Venice Biennale in 2012, and travelled to the South African National Gallery in Cape Town in 2013. Small copies of the work were included in the Smithsonian Folklife Festival in Washington DC in 2012 as well as in the A.R.T. Show, curated by Carol Brown and David Gere, which opened in KZNSA Gallery in Durban in South Africa that same year, and details of the Keiskamma Guernica were constituted into a set of stamps to mark World AIDS Day in 2013.5 Despite this exposure, the Keiskamma Guernica has not been given the detailed engagement accorded the Keiskamma Altarpiece and has in fact been discussed only in reviews (see Anon. 2010, Markman 2010), engagements comprising just a few paragraphs (see, for example, Ravasio 2012), and a small pamphlet the project made available at the 2010 National Arts Festival (Keiskamma Art Project 2010a). In addressing this absence of in-depth discussion of the work, I hope to provide insights both about challenges in managing HIV/AIDS that arose subsequent to 2007 and how these difficulties had a bearing on the choice and treatment of subject matter in the Keiskamma Guernica.I begin with a contextualization of the work by offering some background on the project as well as a discussion of responses to HIV/AIDS in Hamburg. As I have previously examined the history of Hamburg as well as the circumstances which led to the founding of the Keiskamma Art Project (Schmahmann 2010:35–37), I provide only a summary of that information here. Relatedly, the emphasis in my discussion of HIV/AIDS is on events that had immediate impact on the content of the Keiskamma Guernica rather than on how the disease may have arrived in Hamburg and the general challenges it has posed (factors and issues which are examined in Schmahmann 2010:38–39). Following this engagement, I explore how the Keiskamma Guernica was made as well as possible meanings and implications of its imagery and form.Hamburg, located sixty miles southwest of East London, is a small town by the mouth of the Keiskamma River (Fig. 5). When she settled there in 2000, Hofmeyr was struck by the levels of poverty in the town and its surrounding villages and sought to establish an art project which might enable local people (almost all of whom are isiXhosa speakers) to earn an income. Along with making large-scale works which involve significant numbers of the approximately 130 people6 who are associated with the project (and who receive a salary during periods in which they are contracted to participate in the making of such works), the collective has been set up in such a way that it also enables members to make small-scale art objects individually. The latter are sold in a shop adjacent to its primary studio (Fig. 6) as well as via various retailers elsewhere in South Africa. While embroidery is a primary focus, the project has developed in such a way that it also involves work in other media, and—along with embroidered cushion covers and tote bags—the shop includes, for example, cards embellished with woodcut prints as well as objects in beadwork, felt, wire, and ceramic. The initiative has also widened to provide social support in a broad sense. The art project falls under the umbrella of the Keiskamma Trust, a community organization set up in 2004 which also has initiatives in health, music, and education.From the outset, Hofmeyr encouraged the development of art with content and iconography relevant to the community. Local histories would inform the project's first large-scale work, the Keiskamma Tapestry (2004), which comprises seventy-three panels of varied length and measures nearly 122 meters in total and is on permanent loan to Parliament in Cape Town. Invoking reference to the Bayeux Tapestry, which represented events leading up to the Battle of Hastings in England in 1066, the Keiskamma Tapestry accords primary attention to the Frontier Wars (1779–1878) between colonial forces and local people in South Africa. In the Keiskamma Altarpiece, which was made a year later, the project once again used an iconic artwork from the West as a prototype (in this instance the Isenheim Altarpiece), but this time to refer to a medical issue of crucial significance to the community: HIV/AIDS.The findings of the most recent comprehensive survey of HIV Prevalence in South Africa undertaken by the country's Human Sciences Research Council in 2012, and published in 2014, estimates that 12.2% of South Africans are HIV-positive (Shisana et al. 2014:xxiv)—a figure which points to the country's poor history of managing the disease and its impact. The National AIDS Coordinating Committee of South Africa, formed in 1992, envisaged a dedicated approach to tackling the disease and its social effects, but—possibly because it was presented with a host of other matters requiring urgent attention, such as lack of housing and inadequate educational structures, or perhaps because “AIDS warnings and the message of safer sex were not subjects congenial to those savouring the euphoria of freedom” (Van der Vliet 2004:54)—efforts to manage the disease were in fact put on the back burner during Nelson Mandela's term in office. This situation deteriorated further when Thabo Mbeki came to power in June 1999 and appointed Manto Tshabalala-Msimang as his health minister. The former president and his health minister, influenced by dissident scientists who questioned the link between AIDS and the HIV virus and persuaded by theories that AIDS was a hoax, stalled in introducing antiretroviral treatment, suggesting instead that the disease might be treated exclusively through vitamins and nutrition, most notably a diet rich in beetroot, lemons, garlic, and African potatoes. It was only through the extensive pressure exerted by the Treatment Action Campaign, a nongovernment organization formed in 1998, and other agencies that government-sponsored antiretroviral rollout programs were finally approved late in 2003. Although Jacob Zuma (who assumed power in April 2009) and his health minister, Aaron Motsoalodi, prioritized making available antiretroviral treatment, only 55% of adults and 36% of children who were eligible for HIV medication were in fact receiving it by the end of 2010 (Simelela 2014:250). Also, while Zuma has not supported the AIDS denialism operative during Mbeki's presidency, he has nevertheless been an especially poor role model in regard to addressing unequal relations of power between men and women involved in the spread of the disease.7Carol Hofmeyr, while trained as a medical doctor, had not practiced medicine for many years when she moved to the Eastern Cape. Although she had worked with embroidery groups on an HIV/AIDS awareness program entitled Paper Prayers in 1998, this was as an art trainer rather than in a medical capacity. (See Schmahmann 2010:39–40 for discussion of the Paper Prayers initiative and for an engagement with how other embroidery projects in South Africa began to focus on HIV/AIDS in the late 1990s.) But in the context of Hamburg and its surrounds, where there were escalating levels of HIV infection as well as an overall scenario in which people were dying through lack of speedy access to medical care or interventions, it seemed insufficient to focus only on establishing an art project. She consequently began working in various rural clinics in 2002 as well as collaborating with Eunice Mangwane, an AIDS counselor who had settled in Hamburg at the end of 2001. Prior to government-sponsored antiretroviral treatment reaching Hamburg, Hofmeyr obtained sponsorship to source antiretroviral medication privately, enabling about eight people to receive treatment in the second half of 2004. The health of those people had improved visibly by early 2005, providing the community with evidence that it was in fact possible to live a full and productive life while HIV-positive. During the first half of 2005, while the Keiskamma Altarpiece was being made, government-sponsored antiretroviral treatment finally reached Hamburg, and Hofmeyr was also able to establish a facility which enabled personalized care to be offered to HIV-positive patients—the Umtha Welanga (meaning “Rays of Sun”) Treatment Centre.These events seemed to bode well for managing the disease and ensuring the increased wellbeing of the Hamburg community. But difficulties would in fact arise subsequently. In 2009, largely because of financial contingencies, the Keiskamma Trust was obliged to phase out its activities of disseminating antiretroviral treatment and offering hospitalization to the very ill at the Umtha Welanga Treatment Centre. HIV patients were instead required to seek out medication and, where necessary, hospitalization, from Nompumelelo Hospital in Peddie (over twenty-five miles away from Hamburg) or from Cecilia Makiwane Hospital in Madantsane township (fourteen miles from the center of East London and over sixty-seven miles from Hamburg). The building which had formerly served as the Umtha Welanga Treatment Centre would instead become the center for the Keiskamma Health Program, which focuses its energies on, for example, training and supporting community health workers, providing psychosocial support to the ill and their caregivers and families, running awareness campaigns, and providing the community with nutritional support. Hofmeyr remained involved in work at local clinics until 2013, when she resumed focusing full-time on the art project.Besides presenting challenges to people who often lacked funding to spend on transport, the new arrangements appear to have divested residents of Hamburg and surrounding villages of proper care. While the treatment center did not have advanced medical equipment at its disposal, and hospitalization would therefore have been essential for those requiring operations or access to specialists and specialist facilities, it had enjoyed enormous success in enabling the recovery of AIDS sufferers. This was not, however, true of Eastern Cape hospitals. Mavis Zita (née Maroyi), a registered nursing sister with the Keiskamma Health Trust, explains that public hospitals often failed to treat HIV-positive people with the sensitivity that staff at the Umtha Welanga Treatment Centre had accorded them:She observes also: “There are no people to counsel them in hospital. There are no people to [enable AIDS sufferers to] … feel wanted and accepted. Here we had people—counsellors alongside those of us giving the nursing care—going around their beds and counselling them.”9Hofmeyr observes that there have been a number of incidents in which local people suffering from AIDS-related illnesses actually died through incompetent and neglectful treatment when they were hospitalized. Although the Department of Health had committed itself to ensuring that all the people of South Africa had opportunities to receive treatment, this “didn't change the way patients were treated in clinics and hospitals” in the Eastern Cape, Hofmeyr observes. “The staff don't investigate them properly and—mostly, in general—don't give them the level of care they require,” she indicates.10 As one example, she cites the case of a woman from Hamburg who, suffering from tuberculosis and in a partially conscious state, suffocated to death while in hospital because her medication was syringed into her mouth rather than via a nasogastric tube. She provides as another example the case of a young girl suffering from ascending paralysis who died because she was not put on a respirator.11There are also structural difficulties and legislation associated with poverty that sometimes lead people to take health risks—ones which proved difficult to control after the Keiskamma Health Trust had ceased handling the dissemination of antiretroviral treatment. In Hamburg, as in numerous other villages where people lack employment opportunities, a key form of income for many families is social grants. Eunice Mangwane notes that people incapacitated through AIDS-related illnesses were afforded a disability grant for a six-month period, but this grant would not be renewed once their CD4 count had improved. In order to try to overcome this obstacle, people in desperate economic circumstances would sometimes stop taking their treatment. Such defaulting could be curtailed when people were receiving their treatment from Umtha Welanga, she explains: “We were in contact with them the whole day. We would watch and look in on them, and we gave direct treatment.” But village health workers could more easily be fooled: “It may be 9 or 10 am [when the monitor arrives], and the person says ‘I have taken the treatment already'. … [The patient knew] the monitor would do a pill count, so he or she would remove the amount of tablets that he or she would be taking for that particular day.”12There are also numerous long-term difficulties associated with managing HIV/AIDS that are not necessarily the result of the closure of the Umtha Welanga Treatment Centre and people's dependence on hospitals and clinics where they may receive less than optimal care. Although it has become possible for people in Hamburg and surrounding villages to receive their treatment at a local clinic rather than travelling to Nompumelelo Hospital in Peddie, defaulting has unfortunately remained increasingly common. While some may perhaps still deliberately seek to lower their CD4 counts to become eligible for the renewal of their disability grants, Magda Greyling, an artist and social worker employed by the program to offer psychosocial support to vulnerable children in Hamburg and surrounding villages, says that others indicate—genuinely—that “I can't take my medication because I don't have food to eat.” She observes that the health program is also “finding more and more people are just getting tired of taking ARVs and they just stop or they say ‘it makes me sick I am going to stop'”—defaulting that, tragically, sometimes extends to their HIV-positive children.13I have noted elsewhere that women are not only those confronting the burden of caring for the sick or looking after orphans, but are also the gender biologically most vulnerable to infection—a susceptibility complicated through women being in relationships in which they are unable to insist on condom use as well as their facing social and domestic pressure to become mothers (Schmahmann 2010:39). Additionally, it seems, some villages in the area—concerned about escalating rates of infection—have begun resorting to virginity testing, perceiving that policing girls through this practice may have a prophylactic effect. Zita mentioned the following to me:Sadly, such activities actually potentially increase female susceptibility to both infection and violence. Commenting on instances of virginity testing in KwaZulu-Natal, Quarraisha Abdool Karim (2005:258) observes that such practices may not only “reinforce gender inequality by placing the burden of responsibility on females,” but that they “may also [in fact] increase their vulnerability to disease, as girls identified as virgins become prey for sexual assault.”Although it was Carol Hofmeyr who devised the idea of making a work referring to concerns about HIV/AIDS modelled on Picasso's Guernica, the act of making the Keiskamma Guernica did not simply involve project members realizing a fully developed concept. Rather, as project member Nokupiwa Gedze explains, Hofmeyr said,Besides involving different authors in devising the initial design, the subsequent process of making the work provided opportunities for input and ideas from the various members of the group. Greyling explains this as follows:Even before any drawing was done, members of the project engaged with the implications of the subject matter. Florence Danais, manager at the project, indicates that Port Elizabeth-based artist Greg Kerr gave a talk on Picasso's Guernica. Recalling that the talk was extremely well attended and that it included embroiderers and those working in other media as well as those responsible for drawing, she remembers also that Kerr focused on formal qualities of the Guernica. Revealing how somber tonalities may have invoked a mood of gloom, Kerr also suggested how sharp shapes in the composition conveyed a sense of suffering and pain.17 Additional engagement with the content of Picasso's work occurred through a series of drawing workshops run by Greyling and a visitor from the United Kingdom, Irene Neilson, in late 2009. Focusing on a group of first-time embroiderers who were new to the project, the pair asked participants to engage with Picasso's various images of weeping women. But rather than asking women to simply copy the European prototypes, they invited participants to focus on their own perceptions about mourning and loss. As Greyling explains:While not actually incorporated into the Keiskamma Guernica, these drawings (Fig. 7) enabled project members to glean a richer understanding of the subject matter.Gedze oversaw the process of structuring the work in such a way that it was of the same scale and dimensions as the Picasso prototype. Coordinating the making of drawings, Gedze also produced some of the drawings herself—notably, the group of mourning women on the lower right side of the work (see Fig. 1), based on a photograph of women at the funeral of Dumile Paliso, whose death was narrated in the predella of the Keiskamma Altarpiece. Nombuyiselo Malumbeza worked with Gedze in devising the design for the wounded bull at the center of the work while also designing the images of weeping women which form a backdrop to that motif. Nozeti Makubalo drew the woman with an adult child on her lap, which is on the left, and a woman with upraised arms in the midst of dead and dying people, on the right. Cebo Mvubu drew the large head of a bull on the left of the work, while Thobisa Nkani drew the sun motif (top, left of the center). Nomfusi Nkani oversaw the preparation of text for the small metal panels arranged across the base of the work which record the names (normally the first name and the initial of the surname because of matters of confidentiality) as well as the birth and death dates of people who died of AIDS-related illnesses.Different groups of embroiderers—each including about a dozen women—were able to work on the Keiskamma Guernica simultaneously, as the work was divided into different sections. Malumbeza supervised a group of embroiderers working in the project's studio in the adjacent village of Bodium, for example, while other groups worked in Hamburg. Contributions were also made by the wirework studio, where Thobisa Nkani produced figures in rusted metal and wire—described by Hofmeyr as images of Adam and Eve19—that were attached on either side of the work. The stretcher and construction of the work was made by Hofmeyr's husband, Justus.Unlike previous works, which were made from specifically purchased material, much of the Keiskamma Guernica was fashioned to include “found” textiles and objects. Including blankets that were retrieved from the Umtha Welanga Treatment Centre after it closed down, the work also incorporates old skirts in cloth colored with natural clay dye. Even the sun was fashioned from a found item—overalls that Hofmeyr spotted Thobisa Nkani wearing and requested he donate to the work.20 Whereas the Keiskamma Tapestry and Keiskamma Altarpiece had involved a group of beadworkers in the nearby village of Ntlini devising beadwork specifically for those works, in this instance beaded AIDS ribbons left over from a past initiative were collected and sewn on to the work (just above and below the metal panels).The Keiskamma Guernica is a self-contained work but, when first exhibited as part of the National Arts Festival, it was constituted as part of an installation which incorporated works in other media made by the project and which also responded to concerns with HIV/AIDS. Placed immediately in front of the work (Figs. 8–9) was a kraal—that is, an enclosure constructed from acacia bushes of the type customarily used for cattle (Fig. 10)—within which were displayed a series of pots made by the ceramics studio of the Keiskamma Art Project, established in March 2009 under the leadership of Cebo Mvubu (Keiskamma Art Project 2010b). Including large ceramics made by Mvubu and Thobisa Nkani, it also featured the output of workshops in which people who had lost family members produced small pots in their memory. Also exhibited were pillowcases embroidered with images of weeping women derived from drawings made at the workshop run by Neilsen and Greyling. Each was embroidered with the name of a local person who had died of AIDS-related complications (abbreviated—as with the names on the Keiskamma Guernica itself—to sustain confidentiality) as well as his or her date of birth and death and, in the manner of a package, enclosed the medical records of the individual it commemorated. A series of panels produced by the group at Bodium were also on display (Fig. 11). Reworking various motifs from Picasso's Guernica, they were constituted from felt appliquéed on cotton fabric, which was embellished further with embroidery. And in a locked glass case, Hofmeyr included notebooks with her own medical records from the treatment center, which were wrapped in felt covers that had been produced in a workshop run by a visitor to Hamburg, Liz Velz, and her daughter, Cathy.The decimation of the town of Guernica during the Spanish Civil War was the first instance of a systematic dropping of bombs on a civilian settlement by a military air force, and Picasso's visual language in his painting speaks of suffering wrought on ordinary people going about their day-to-day business on market day (see Fig. 2). On the left, a woman with a dead baby in her lap cries in shock and emotional pain, while on the far right—with arms outstretched above her head in the manner of a crucified Christ—a terrified woman falls from a burning house. Beneath her, on the right at the bottom, a female appears to stumble and fall to her knees. Immediately to the left of the woman with outstretched arms, a female leans out of a window, holding out a light, as if to try to make sense of the horror that confronts her. This motif resonates against the eye-like sun overhead. Including an image of a bulb inside it, it perhaps alludes to bursts of harsh light—like the flashes of a switch being turned on and off—in a town immolated through descending bombs.Picasso also invoked the horror of the bombing of Guernica through allusions to the language and practices of the bullfight, with some motifs simultaneously referring to the Crucifixion. It was common practice for elderly workhorses to be purchased for a nominal price and sent blindfolded into the bullfight ring to be gored by an angry bull (see Russell 1980:44). Picasso's hapless horse stabbed with a spear who cries out in agony, which constitutes a central motif in his painting, is readily interpreted as an analogy for the townsfolk of Guernica caught unawares by the bombs descending on them. At the same time, the animal alludes implicitly to a crucified Christ, and in that sense parallels the image of the woman with upraised arms on its right. The bull itself is depicted on the far left. A curiously impassive onlooker, the animal's meaning in regard to the topic of the painting—the bombing of Guernica—has been interpreted variously. For example, while Picasso once indicated that the bull stood for “brutality and darkness,” on another occasion he indicated that both the bull and the horse are “massacred animals” (Russell 1980:56)—that is, victims of a situation rather than culpable for it. A figure on the bottom left of the painting lies fallen, with his mouth open and his amputated arm still holding a lance. This seemingly dead bullfighter may be the picador whose role it is to test the bull's strength with the aid of a lance. But, as Russell (1980:22) suggests, the figure also might be read as a fusion of Christ following the Deposition with St. Longinus, the Roman soldier who belatedly endeavoured to administer a type of coup de grace to the crucified Christ by piercing his side.The Keiskamma Art Project commented, in the pamphlet produced to accompany the inaugural exhibition of the work at the National Arts Festival, that, unlike Picasso's painting, the Keiskamma Guernica “depicts not an instant of horror but rather a slow eating away at the whole fabric of a community” (2010a). However, Gedze suggests that the representation of the sudden devastation experienced through the bombing of Guernica could in fact be understood as analogous to the dramatic impact of HIV/AIDS on Hamburg: “You know the outbreak of HIV/AIDS came as a shock to everyone. It came like a bomb to everyone: it blasted and people died from HIV/AIDS. So it was similar to Picasso's Guernica which represented people bombed in the town.”21 Hofmeyr indicates, additionally, that it was people's lack of agency in Hamburg and its surroundings that made the Picasso pain
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