1. Introduction
Women’s rights and freedom are always under discussion. Adding ethnical issues, marginalized groups such as women in ethnic minorities and lower class have raised their consciousnesses to pursue their identities and freedom. With the rise of postcolonial movement, literary writers put their efforts and energies into revealing the discrimination on African women. Carla Namwali Serpell, the Zambian writer and critic of contemporary, historical and science fictions, examined African people’s political, social, and environmental situations in her oeuvre. Her work, The Old Drift, narrates five generations’ life experiences and their struggles in Africa. The emergence of African women’s writing ranges between historical and science fiction. Exploding with class and race, various characters were afflicted with mythic stigmata so that The Old Drift is a testament and a meditation on the slow, grand passage of time.
Several perspectives in discussing this novel have been ticked off academically. Generally speaking, this novel is a literary heritage that reveals “the historical phenomenon of decolonization, which infused the novel with a sense of historical agency and a desire to contribute to the construction of viable postcolonial cultural identities for the new African nations” (Booker, 2009). From the angle of memory, The Old Drift “resorts to the discursive construction of the palimpsest as a way to address the distinct nature of diasporic memory” and shows (Monaco, 2020) “interconnectedness between people and places despite the differences they share” (Monaco, 2020). The mosquitoes in each chapter were manifestations of historical and collective memory, suggesting that “memory traces overlap, intersect and are transformed” (Silverman, 2013). In The Old Drift, the migrants’ trajectories are concerned with African habitants’ lives and memories. Till now, most researches mainly construct the main issues through the angles of family, gender, race, nation and so on. Therefore, other angles and approaches needed to be distributed in discussing this novel.
AIDS epidemic has become a major medical issue throughout the world. The Old Drift described that because of low economic, educational, and medical conditions, AIDS has become severe epidemic in Africa. For social and physical situations, African prostitutes are disproportionately affected by AIDS in many parts of the continent, and “are subjected to various human rights abuses because of their HIV status” (Kraus, 2007). The status and situation of prostitutes have not raised great attentions when discussing the marginalization of African women. Those women’s sexualities are stolen, commercialized and bartered by white males.
Medical ethic proclaims that medical testing, care and treatment should be in advocacy with no discrimination in facing epidemic. Everyone including prostitutes “shall be entitled to the right to liberty and security of person” (Durojaye, 2011). However, a certain group of people like prostitutes, who suffer from sexual and social margination and oppression, are targeted as objects to do vaccine testing in the novel, regardless of their human rights. Doctors, usually male, are authoritative figures that control others bodies as testing objects.
The novel described several special or marginalized women like the one with long hair, blind, full of tears and so on to show that they were under depression and exiled by male dominance. African female characters all suffer from the dumping from male characters, being exiled from the whole society. This article will argue the dehumanization on African prostitutes while doing HIV vaccine testing by adopting interdisciplinary approaches. Firstly, the investigation of the tension about the alienation of African Prostitutes’ bodies will be done. Then, prior to the illustration of medical ethic on vaccine testing in the third part, the discussion will be changed to the epidemic of AIDS in Africa. It privileges the use of multiperspectivity and multifocalization to explore the influence of AIDS epidemic and medical ethic principles on African prostitutes’ bodies in The Old Drift.
2. The Alienation on African Prostitutes’ Bodies
Human bodies are physical media and foundations of human lives, and they are theorized as “a fleshy organic entity and a natural symbol of society; the primordial basis of our being-in-the-world and the discursive product of disciplinary technologies of power/knowledge” (Williams & Bendelow, 1988). What’s more, the body is observed as not only “a material organism, but also a metaphor” (Turner, 1984). Though a body is a physical system, it is influenced by social conditions and can be “threatened by disease but also by social stigmatization” (Turner, 1984). What’s more, the body is also a place where all power struggles take place. Critics proclaim that “human bodies enter into the field that knowledge and power control” (Wang, 2022), in which people’s identities are under control. Female bodies are considered as inferior objects compared to male images in patriarchal values. They are stigmatized, subjugated and deprived of freedom and identity. In historiography, the objectification of female bodies has been multifold. Women are symbolized as corruption, impurity and imperfection. Their bodies are under male’s control.
Prostitution is one of the most oppressive phenomena that is originated from a long history with social stigma. The document states the feature of prostitution: “it is well paid despite being low skill, labor intensive, and, one might add, female dominated. Earnings even in the worst-paid type, streetwalking, may be several multiples of full-time earnings in professions with comparable skill requirements” (Edlund & Korn, 2002). Those women are trained to sell their bodies as flesh merchandise. Women sell their sex services to men, and “their sexualities are capable of being objectified in a way that men and their sexuality are not” (Overall, 1992). Most prostitutes have no legal status as common workers. Furthermore, they always own poor reputations because they are engaged in sexual intercourse for money. Their sexualities, rights and bodies are in dominant and institutionalized violence. The major reason for prostitution is associated with poverty being controlled by males. Prostitutes’ physical services are offered by material compensation.
African women face severe racial and sexual discrimination in sex industry. They are “victimized by their clients, who want to enact strange fantasies and fetishes perpetuated by society about black women” (Robinson, 2007). “Sexual health is a state of physical, emotional and social well-being in relation to sexuality” (Durojaye, Mukundi, & Ngwena, 2021). Sexual violence and abuse on prostitutes’ bodies hinder their physical safeties and rights. African women’s bodies rarely get compensation after male uses, and are exploited in poor conditions, disregarding for the well-being.
Women’s bodies are sellers while men are buyers. Prostitution is a patriarchally degrading because female labors are sex works and their bodies become “commodified and sex becomes the commodity, leading to her exploitation” (Robinson, 2007). Women sell their bodies in exchange of money at the will of men. Prostitutes are heterogeneous media and wanderers, “forming the city’s secret” (Wang, 2022). The salon in The Old Drift was actually a sexual industry providing Doctor Lee and other men with sexual commerce so that as an agency, it was a heaven for indoor prostitution. They are under abuse, abandonment, humiliation and detention, which are against basic ethical rights: “liberty, equality, transparency, accountability, dignity” (Erdman, 2015). They develop “distorted body images and become frustrated with not being able to obtain the ideal figure” (Molloy & Herzberger, 1998). Their physical safety cannot be guaranteed for the risk of disease transmission.
In the novel, Musadabwe, Doctor Lee’s medical partner proclaimed that prostitutes “had some natchuro immunities that made The Virus sustainabol. It was because they had a mutation on the respectacle that was preventing The Virus from attaching—” (Serpell, 2019). Women’s bodies are media of virus so that male doctors despise and take advantage of them. In the novel, prostitutes’ bodies are ideal receptors to culture diseases. Apart from as prostitution agency, the solon was also place where Doctor Lee can “scope out test subjects” (Serpell, 2019). It was actually an illegal clinic to do medical vaccine testing on prostitutes’ bodies without enough medical protection.
African female bodies are commonly used in medical field. Prostitutes’ bodies are controlled by medical power without human rights and dignities. In the novel, Doctor Lee and Musadabwe received a new report that “one very special woman had a second receptor as well. Zambia had a Lusaka Patient. It was indisputable: they had revolutionised the hunt for the Virus vaccine” (Serpell, 2019). They found that African prostitutes’ bodies are tagged as media in transmitting epidemic and storing antibiotics, which gave them inspirations to do vaccine testing on African prostitutes’ bodies. Throughout the whole novel, using men’s bodies had not been heard at all because in the medical discourse, only female bodies were perfect to breed virus and develop vaccines.
Scholars assert that prostitutes ought to have their sexual rights, and “she can use it on her own, apart from the relationship with the client, just as the domestic servant may cook for her family and clean her own house” (Nussbaum, 1999). The sexual contract relationship between female prostitutes and male clients is under the exploitation, oppression and commodification of female bodies. “The oppression paradigm, holds that sex work is a quintessential expression of patriarchal gender relations and male domination” (Weitzer, 2010). So as to the vaccine testing on African prostitutes’ bodies.
Body identity is a basic human right, and “core identity…and occurs lifelong, and is changeable, multiple, nonverbal, relational, situational and social” (Caldwell & Leighton, 2018). The body in oppression is in the statement that “white supremacy has divided us along the lines of bodies—black and brown bodies exploited, oppressed, and dominated by white bodies” (Caldwell & Leighton, 2018). In another sense, African prostitutes’ bodies become objects of medical experience with no identity and sense of self. Women’s inferiority and feebleness make women become docile under social oppression. This novel reveals issues on sexual minorities in Africa by addressing various representations of violence and claiming sexual minorities’ rights.
3. The Anxiety of AIDS Epidemic in Africa
Generally, illness is not only a physical discomfort, but also “a metaphor for mortality, for human frailty and vulnerability” (Sontag, 1989). The metaphorical illness is dominated by main stream power. Illness stimulates people’s fear, and brings humiliation, marginalization, segregation and helplessness.
As one of the major chronic diseases, AIDS have become a central issue throughout the world. The definition of HIV/AIDS is “sexually transmitted infections, pelvic inflammatory disease” (Ditmore, 2006), which has risen a great concern and provide various prototypes such as “opportunistic infections and malignancies” (Sontag, 1989). According to Susan Sontag’s definition, AIDS:
…has a dual metaphoric genealogy. As a micro-process, it is described as cancer is: an invasion. When the focus is transmission of the disease, an older metaphor, reminiscent of syphilis, is invoked: pollution. (One gets it from the blood or sexual fluids of infected people or from contaminated blood products.) (Sontag, 1989)
AIDS has become a historically publicized concern because it affects world health. For HIV/AIDS, plenty scientists and physicians still have no clear knowledge and conclusion about the medical treatment. In the novel, the basic knowledge about The Virus is that “human immune cells have receptors that The Virus uses to enter and infect them—CD4, CCR5, CXCR4” (Serpell, 2019). The Doctor gave the definition about The Virus based on three molecules: CD4, CCR5, CXCR4, which were the basic components of AIDS. In the novel, Musadabwe pointed out severity of epidemic:
“But The Virus, it is velly movious, changing-changing all of the time. You cannot swove this problem just like that…No! It is a moving target!... The Virus used them like portals to break into the immune system and take over. If one receptor didn’t work, The Virus shifted to the next, like a general trying every gate of a walled castle.” (Serpell, 2019)
When discussing this disease, people bore in mind that “the Virus is getting worse with these viro multiplications…” (Serpell, 2019) and “has destroyed our country. Compretely and totally! Whole generations have been wiped down!” (Serpell, 2019). The disease spread significantly fast, and symptoms of this disease are: “The Virus had wrought an epidemic…That looped red ribbon icon was now scattered over pamphlets and walls like a plague of red eyes” (Serpell, 2019). This virus with high transmissibility soon became epidemic and fighting against the virus became an urgent task. The negative effects of AIDS toward catastrophe threaten most parts of the world, especially in Africa.
The epidemic spreads over African region. The study presents that “HIV transmission in Africa is mainly due to unprotected sexual intercourse (heterosexual and homosexual)” (Durojaye, 2021). Prostitutes, also called commercial sex workers, are in “complete sexual accessibility by many partners and at extreme risk of HIV” (Gorgendière, 2005). In many parts of Africa, “infection rates are high among female prostitutes and appear to be related only to sexual activity” (Kreiss, Koech, & Plummer et al., 1986). Prostitutes’ bodies maintain high risk of getting and transmitting HIV virus and they have been “viewed as the major reservoir of a variety of sexually transmitted diseases (STDs)” (Padian, 1988).
Because of unique symptom and transmission process, AIDS is often defined as plague that has been used “metaphorically as the highest standard of collective calamity, evil, scourge” (Sontag, 1989). This metaphor allows a person with this disease to be regarded as vulnerable others. In The Old Drift, HIV or AIDS still remains mystified. One of the reasons why African people did not accept the terrific influence of AIDS is concerned with the fear of stigma and discrimination. In the novel, Sylvia, the later prostitutes because of social conditions, got pregnant and fell victim of the AIDS epidemic eventually. The stigma of AIDS “not only undermines efforts at addressing the epidemic, but also infringes on the human rights of people infected and affected by HIV” (Durojaye, 2011). Being affected by this disease will be more harshly judged because AIDS “is understood as a disease not only of sexual excess but of perversity” (Sontag, 1989). Considering illness as a punishment, main stream discourse argues that it deserves noble medicine to save those patients.
In the context of medical document, in the “1980s, with the licensing of the first Human Immuno-Deficiency Virus (HIV) antibody test, it became possible to identify individuals with HIV infection” (Zivi, 2005). Even through identifying AIDS is achievable, curing this disease still remains a big problem, especially in Africa. The person who dares to be involved in vaccine testing for fighting against AIDS virus will be viewed as hero by ordinary people. In the novel, Musadabwe praised that Lee “was a blirriant man” (Serpell, 2019). In the funeral of Lee, others also called Lee a great man for trying to healing them without even minding the cost of that.
For poor economic and medical conditions, lack of education and health care, together with low status of females, Africa is one of the most AIDS affected regions living with various virus and “prevalence of HIV is highest in central African countries” (Padian, 1988). The AIDS “has complicated attempts to alleviate poverty and achieve upward mobility” (Ditmore, 2006). Those infectious diseases, such as AIDS, are often appeared in the oppressed or marginalized groups such as the ethnical minorities or prostitutes. This land in the situation of epidemic suffers from poverty and deficiency of power.
The deficiency marked on African prostitutes’ bodies “(emptiness, impure fluids, broken) authorize men to associate women with disease, infection and contamination” (Almendros, 2017). The main stream discourse has not denied that prostitutes are blamed for the transmission and infection of AIDS and epidemics. Epidemic and other diseases are explained from the perspective of moral judgement. The poor and sick are under margination. In The Old Drift, The Doctors also hypothesized that “prostitutes have mutations in the genes for one or more of these receptors” (Serpell, 2019), so that these women might have a natural immunity to The Virus. Therefore, they chose prostitutes to do vaccine testing. However, the medical vaccine testing has raised several ethical problems.
4. The Medical Ethic on Vaccine Testing
Particular focus is given to face epidemics’ disproportionately affects. Vaccination is one of the solutions. There should be “available, safe, and effective vaccines” (Madara et al., 2015) to fight against diseases to become epidemic or pandemic, which will be taken a long-term process. According to The Doctor Lee in the novel, a vaccine “usually works by giving the body a tiny dose of an inactive virus” (Serpell, 2019). Based on this angle, Doctor Lee tried to open a new approach to cure others, so that he was tagged as hero. Since the vaccination on preventing AIDS has not been in a successful process at once, it is an international public health priority. According to professionally medial field, the medical testing of vaccines is in several processes:
Phase I trials are designed primarily to test the safety of the experimental vaccine in small numbers of healthy volunteers at low risk for acquiring HIV infection…. Phrase II will focus on safety and immunogenicity in larger numbers of healthy volunteers, including individuals at high risk for HIV infection. These trials provide the foundation for future field trials of vaccine efficacy and aim to identify the optimal dosage regimen for those trials…Finally, Phase Ⅲ trials will assess the efficacy of the experimental vaccine(s) in populations at high risk for HIV infection. (Porter, Glass, & Koff, 1989)
These processes offer considerations of medical ethic in doing vaccine testing. Doing human testing should be in reducing the possibility of becoming HIV-infected and should evaluate the vaccine’s safety and immunogenicity. Given the characteristics of diseases and individual differences in reactions, “physicians cannot be truly competent in the prescription of many, and probably most, of the drugs at their disposal” (Thompson & Temple, 2001). Therefore, a broad-based need on a wider sample of humans is necessary for the invention of a vaccine to get testified and long-time researches to “determine how the body functions as an integrated whole” (Thompson & Temple, 2001).
In the former phrase about vaccine testing, the test is on animals such as rats, rabbits, pigs. Testing on certain human bodies means that these people are equated with animals through decentralization. Testing models have targeted from experiments on animals to those on humans. Those people become objects and animals. The efforts to protect humans from the infection of diseases are at the cost of other people’s pains, suffering and death. In the novel, Doctor Lee and his partner took several phrases in order to use the vaccine on human bodies:
“We take their T-cells out, genetically modify them with CRISPR, and put them back in. The jargon tasted metallic in his mouth. ‘They don’t die, but I can see it in their skin, off-target symptoms from disabling the cells, black spots and patches from the mutagenesis. This is just what happens when we test it on animals. How could we use it on people?” (Serpell, 2019)
Prostitutes remain great importance in the prevalence of AIDS, because they “engage in unsafe sex practices” (Rosenberg & Weiner, 1988) so that AIDS facilitates transmission from prostitutes to others: “they have numerous partners, usually lack the ability to screen them, and may not use barrier methods of contraception” (Rosenberg & Weiner, 1988). Under this circumstance, testing on prostitutes will be a vital component. Medical institutes search prostitutes as objects to do medical tests to have more precise data and results.
Human trials on medical testing will come eventually. In the novel, Joseph, the son of Doctor Lee, “felt sorry for the Lusaka Patient and the other women like her” (Serpell, 2019). Because sacrificing certain group of people also meant ruining great amount of family, the vaccine testing raised great quarrel among Joseph, Jacob and Naila. Naila, the daughter of Sylvia, believed that doctors just treat those women like lab rat to do medical testing. Medical safeguarding on patients’ health is doctor’s ethical responsibility to prevent infectious diseases. In the novel, Doctor Lee only cared about the results of vaccine testing rather than experimental objects’ health.
Facing severe epidemic, others seem to have no agency so that Doctor Lee had no partners but only Musadabwe, who “was the first person Lee had met who both felt the urgency of the problem and had the ambition to pursue a solution into the shadiest corners of Zambian society” (Serpell, 2019). They had no financial, medical, official and national supports, just like being abandoned by mainstream authority. They only worked in a small clinic, Lee “began a side project of his own, an experiment of sorts, based on a hunch. Musadabwe ran some tests and after a year of sorting the data and sending samples to their collaborators in Kenya and South Africa” (Serpell, 2019). They did those tests without any helps because people who suffered from AIDS are marginalized and discriminated.
In the novel, for lack of methods or medical instruments, the testing was always lack of proper procedures in Africa. Though The Virus had become epidemic, it still was a taboo so that Doctor Lee had to remain anonymity and did not convince not so many people to try experimental therapies. The vaccine testing in Africa indicates national and racial discrimination:
AIDS did not become so famous just because it afflicts whites too, as some Africans bitterly assert. But it is certainly true that were AIDS only an African disease, however many millions were dying, few outside of Africa would be concerned with it. It would be one of those “natural” events, like famines, which periodically ravage poor, overpopulated countries and about which people in rich countries feel quite helpless. Because it is a world event—that is, because it affects the West—it is regarded as not just a natural disaster. (Sontag, 1989)
Medical testing on African women’s bodies has been a long-established situation during colonial and postcolonial period. Ethical principles should be considered as vital component in vaccine testing on prostitutes’ bodies. Several principles are highlighted: “respect for persons (autonomy), beneficence, and justice” (Porter, Glass, & Koff, 1989). One of essential principles of medical testing is that the targets should “give valid consent to any treatment” (Durojaye, 2011). The complexities of medical testing on African prostitutes impose various ethical dilemmas. It addresses the issue of sexual oppression and exploitation of marginalized women such as women of colors, which raises medical and social injustices.
Doctors are major medical workers, who are symbolized as science, authority, knowledge for the sake of human health. They refer to middle and high class in dominating patients and the weak. Doctors and other medical workers should promote people’s health, and should “know what new therapeutic developments might benefit those in their care and still not subject them to undue risk” (Lewis & Tamparo, 2007). The medical ethic principles undertake that physician should inform “samples” the concerns with vaccine testing because they easily get access to those particular epidemical diseases. Medical humanity calls for the humanistic care of science. In The Old Drift, clinical workers like Doctor Lee used sex workers (prostitutes) to test vaccines and treatments. They often seek out those marginalized minorities and take advantage of their vulnerability to get satisfied testing results without being questioned and accused. Those prostitutes are sufferers and scapegoats that are sacrificed by medical authorities.
HIV testing is conducted when the patients agree to do that with great autonomy, however, the objects of vaccine testing are under oppression in this novel. These processes indicate important ethical dilemmas. First is the recruitment of testing volunteers, who commonly have sexual history with high possibilities to access risk of AIDS infection. In the novel, Lee noted that in order to develop different kind of vaccines, they “have been looking instead into some promising studies about a group of sex workers in Nairobi” because “these women are obviously highly exposed to The Virus, and they test positive for it. But for some reason, it has not blossomed into the full-blown disease in this small population” (Serpell, 2019). Those targeted African prostitutes are judged and evaluated as Others and commodities: “where our physical form is commoditized, our appearance is driven by consumer culture” (Caldwell & Leighton, 2018). Therefore, prostitutes are ideal targets for their needs of money and low social status. The selection of objects raises the paradox about the relationship between the transferring burdens of risks to prostitutes and the benefits from the development of effective vaccines:
Lee Banda was not a man to be swayed by visions. He needed subjects for his lab and Sylvia would give him access—her salon was clearly a front for a brothel. These were precisely the women who might have the genetic mutation he sought. As he courted her, he took samples from her and her girls, and sent them off to be tested. (Serpell, 2019)
Women are always victims of male’s sexual desire and use so that they never have freedom to process their bodies. Prostitutes’ ruined bodies associated with malignancy are the targets of medical testing with social oppression. The jurisprudence of human rights on bodies proclaims that “all people…are entitled the protection provided for by international human rights law, including the rights to life, security of person and privacy, non-discrimination” (Durojaye, Mukundi, & Ngwena, 2021). Vaccine testing on prostitutes regardless of their health rights violates medical ethic principles.
African prostitutes still sell their bodies in vaccine testing at the will of white men. In the novel, the doctor needed to “find a different kind of Virus patient–sexually active, asymptomatic, and willing to undertake great risk for money” (Serpell, 2019). Sylvia’s salon was Lee’s base camp for recruiting young girls in vaccine testing. The daily procedure included: “Lee took samples from her and all of her ‘salon girls’ and followed their leads to other casual sex workers in the community” (Serpell, 2019). For African prostitutes, money is the motivating factor to sell their bodies, so that they also have no choice but to commercialize their bodies for exchanging vaccine testing. Therefore, prostitutes are perfect experimental targets who are suitable for all conditions.
In vaccine testing process, prostitutes’ bodies are still commodities with designated marginality. Michel Foucault demonstrates that “repression operated as a sentence to disappear, but also as an injunction to silence, an affirmation of nonexistence” (Foucault, 1990). African prostitutes are seen as nobody with silence so that doctors can use them to do medical testing without being accused. Because in their eyes, prostitutes are not regarded as real human beings so that doctors can commit repression on them.
Doctor Lee chose African prostitutes as testing objects and experimental mice to prove his result’s right. The marginalization of African women is manifested by being forced into prostitution and suffering from AIDS. A vaccine developed with foreign money is being tested on unwitting Zambians. Naila also claimed that “black people have always made great guinea pigs” (Serpell, 2019) for vaccine testing. When a vaccine became available, the white population rejected it, fearing it may turn their pale skins dark—something worse than death. Last chapters of this novel featured the proliferation of “Beads”, technological devices embedded in human hands that can transmit an experimental HIV vaccine on them. This dystopian narration criticized colonial power on African people with racial discrimination. Even in African continent, ethnical and social discrimination and oppression still existed.
In the novel, Serpell wants to reveal that racial discrimination is more malicious that epidemic. “Lee was too pragmatic to weep for dying Zambians, and he was far more interested in the biology and epidemiology than the sociology of the disease” (Serpell, 2019). Even being a doctor who ought to treat all people equally, Lee still held his discrimination and indifference towards Zambians. Medical ethic is adopted to examine African people’s bodies and racial issues in the novel. The novel focuses on African prostitutes’ lives and social positions to destabilize gender, race and class discrimination in Africa.
5. Conclusion
African women face both racial and gender discriminations without rights to claim their autonomy and self-ownership. African prostitutes’ bodies are used as testing rats by medical authorities. Serpell based her ideas on this novel in the outcry against white male’s dominance by exposing medical hypocrisy and control over African female bodies. There is a cry that a woman, no matter she is from ethnic minority groups or lower class, should have rights to control her body.
The emergence of prostitutes’ medical rights presents the new approach to call for the protection for these colored sexual minorities. Doctors do medical experiments on marginalized people’s bodies in the name of science and authority by exploiting their health rights. Medical ethical principles claim the equal right on medical treatment with no discrimination. What’s more, the selection of certain groups on vaccine testing should be based on ethic principles to pursue social justice.
Serpell embodied the idea of the family as a site of solidarity that resists social marginalization and gender discrimination. This article was in engagement in medical ethic, aiming to argue against racial and sexual discrimination and alienation on African women in the name of AIDS transmission and vaccine testing, increasing medical and humanistic awareness about health risks, and developing African prostitutes’ ethic rights. With the help of interdisciplinary methods, this paper has provided a different angle for the follow-up study of postcolonial texts, so as to pay attention to the gender, race and ethical demands of postcolonial novels.