(and especially Ugandan Christians) were being portrayed by the Western media. They have become, to use a phrase coined by the anthropologist Susan Harding, a “repugnant cultural other” in the eyes of a supposedly enlightened West.57 Their views on homosexuality have been dismissed as either grossly misguided, a symptom of their lingering “traditionalism,” or—worse yet—a reflection of their position as pawns of a sinister contingent of rogue Western conservative religious activists. Throughout my fieldwork I was struck by this persistent assumption: that Ugandan Christian social activism is pursued under the guidance of American Christians and conservative politicians and that the beliefs and interests of these two groups—American and Ugandan—were interchangeable. One of the main purposes of this book is to elucidate the ways this was often not the case. My intent is to reveal and explain something about the motivations and moral orientations of Ugandan Christians, highlighting their own agency and agenda in the social protests (for abstinence as an AIDS prevention method, and against homosexual rights) that have come to define them in recent years.
The Book’s Structure, and an Outline of the Chapters
This book is structured as an ethnographic study of a policy in that it considers, to quote Catrin Evans and Helen Lambert, “how interventions enter into existing life worlds and both shape and are shaped by them.”58 It is divided into three sections that lead the reader from the historical and political context that gave rise to PEPFAR’s origins, to an analysis of its impact within one Ugandan community, to the long-term effects or “wakes” that have remained in the years following its initial implementation. Part 1 draws on archival research, analysis of U.S. congressional records, and interviews with key figures in Uganda’s health and religious sectors involved in early AIDS prevention efforts. Part 2 is the ethnographic heart of the book, where Ugandan responses to and interpretations of PEPFAR’s policy are analyzed. Part 3 is also primarily ethnographic, focusing on the broader social and political effects of the policy in Uganda, especially in terms of attitudes surrounding gender and sexuality, including homosexuality.
Part 1, which outlines the context for the PEPFAR program, begins with a focus on the history of the PEPFAR policy itself and its initial implementation in Uganda. Chapter 1 explores the meaning of the idea of compassion in American politics and how it came to refigure international aid under the Bush administration. It provides a historical overview of AIDS prevention policy in Uganda and analyzes the role that born-again Christian activists have played in AIDS policy since 2004 in Kampala. It also sheds light on the motivations of the American politicians who crafted the policy and stipulated the controversial limits on how prevention programs would be funded. Chapter 2 provides historical background for the current political and religious climate in Uganda, its purpose being to focus a historical lens on the role that Christian churches have played in political and social struggles in Uganda over the course of the last century. The AIDS epidemic has heightened a sense of social instability, and in its wake there has been a proliferation of discourses that assert a return to the moral certainty promised by “traditional” gender relations, generational obligations, and modes of spiritual and social authority. This chapter explores how these arguments have been formed in dialogue with a much longer history of debates over changing household dynamics, women’s roles in society, and the place of ethnicity within the nation-state. Here I develop more fully what role so-called moral authority has played in the Ugandan political sphere and how contemporary discussions of morality are shaped by a decades-long history of the “moral reform” of the home.
Part 2 comprises chapters 3–5, which examine the meaning and practice of abstinence and faithfulness within a community of Ugandan born-again Christians. These chapters highlight how this message was refigured within Uganda to address the particular moral and spiritual struggles that young people encountered. Chapter 3 is the first of two chapters to examine the message of abstinence. The chapter focuses on how abstinence was framed as a certain type of (Christian, neoliberal) moral message and the ways it was compared and contrasted with other forms of sexual education in Uganda that emphasized different types of moral subjecthood. It includes an examination of how youth made sense of and resolved the moral disjunctures that abstinence created, and how such negotiations both established the strategy’s appeal and demarcated its limitations as a public health approach. Chapter 4 focuses specifically on how abstinence was evaluated in terms of Ugandan frameworks for health and healing. It explores how abstinence was a practice driven by forms of spirituality and experiences of embodiment that diverged from Euro-American and biomedical orientations to health. I suggest that the ability to reframe abstinence in terms of these local orientations to spirituality and embodiment played a large part in how and why this became a popular health message within the Ugandan born-again community.
Chapter 5 examines the message of faithfulness as a prevention strategy and interprets how a message about planning for marriage was shaped by intergenerational conflicts in contemporary Kampala. I highlight especially how these conflicts played off young men’s feelings of marginalization in the contemporary economy and how a message about AIDS prevention that asked them to withdraw from sexual relationships—usually a key measure of status for young men in Kampala—could succeed when paired with other neotraditional messages about gender relations and marital and household dynamics.
Part 3 begins with chapter 6, which serves as a coda for my ethnography of the church community as it focuses on the years after the end of the first phase of PEPFAR funding—a period when activism within the church expanded beyond AIDS prevention to address a wider array of concerns over sexual behavior. During this period members of UHC emerged as key participants in the antihomosexuality movement in Uganda, a series of protests that culminated in 2009 with the introduction in parliament of a bill that would radically intensify criminal punishments for men and women identified as homosexuals. This chapter analyzes the controversy over Uganda’s Anti-Homosexuality Bill as part of the longer struggle to manage sexuality and gender relations in the late twentieth and early twenty-first centuries in Kampala.59 In particular, it considers ideas about sexual personhood and sexual rights in Uganda today, and some of the problems faced by international and local groups that seek to protect gay Ugandans by building on rights-based arguments for sexual equality. Chapter 6 provides a window on how social activism within the church has changed in light of changing relationships with American Christians and a somewhat transformed political climate in the United States. Exploring the implications of accountability within other humanitarian endeavors, this chapter contributes a discussion of how efforts to extend the platform of human rights to include sexual minorities in Uganda has engaged and broadened many of the moral dilemmas I articulate earlier in the book.
Finally, this book’s epilogue revisits the concept of accountability as a key framework for global health projects. In the years following the end of PEPFAR’s initial grant period (2003–8), when abstinence and faithfulness fell out of favor as a dominant prevention strategy adopted by the U.S. government, members of UHC reflected on their role in a global AIDS prevention project. Their sense of frustration at the changing priorities of foreign funders revealed some of the limitations of global health partnerships that supposedly emphasize individual empowerment
