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Gregory Barz: Singing for Life:  HIV/AIDS and Music in Uganda

Review by Bernhard Bleibinger

New York:  Routledge/Tylor & Francis Group, 2006. 250 pp.
ISBN:  0-415-97289-2 (hardback), 0-415-97290-6 (softcover).
Includes a CD of musical examples.

Gregory Barz, who actually works as an associate professor of ethnomusicology and anthropology at Vanderbilt University, is already well known as a co-editor of Shadows in the Field: New Perspectives for Fieldwork in Ethnomusicology and Mashindano!  Competitive Music Performance in East Africa. He is also the author of Music in East Africa and Performing Religion: Negotiating Past and Present in Kwaya Music of Tanzania.

In his recent publication, Singing for Life:  HIV/AIDS and Music in Uganda (2006), he describes in a detailed way the experiences and results of his last fieldwork in Africa, where he did research on the local efforts and strategies against the spread of HIV. The book is not written exclusively for the ivory tower. Even though it includes scientific analyses, it is not directed only at an academic audience. In his skillful way, Barz gives HIV-positive people a face and a voice. Letting them tell their story, he outlines the daily life with the disease in rural African villages, combining personal experiences with scientific facts. The result is an ethnomusicological approach that can actually be experienced.

It was in the early 1980s when the Western world became aware of the cryptic and lethal disease later known as AIDS (i.e., the Acquired Immune Deficiency Syndrome), which is caused by HIV (i.e., the Human Immunodeficiency Virus). For decades, HIV/AIDS in sub-Saharan Africa has been considered above all as a concern of medicine, and the battle against it seemed to be an issue of modern pharmacology. In Singing for Life: HIV/AIDS and Music in Uganda, Gregory Barz offers other new ways of understanding AIDS, in its social contexts and as an illness that is treated by multiple medical techniques. with a general survey on the worldwide spread of AIDS, he centers his study on examining the link between the decline of the infection rate in Uganda and Uganda’s local grassroots efforts (i.e., its local groups that perform music and drama with the intention of leading people to behavioral change). The method that Uganda used should be convincing, as it equaled a vaccine of 80% efficacy, and at the moment it is more effective than pharmacology. The most significant factor is – as mentioned above – the behavioral change caused by direct contact with the performers of these educational campaigns, and not by the modern media. People may refuse to read flyers, but they can´t escape the power of culturally-embedded performance. That’s the secret behind music and drama, and it is the tenor of the book.

Singing for Life presents a series of case studies that explain AIDS from different points of view. It includes first-person reflections and personal field notes with the intention, as Barz writes, to „draw the reader deeper into the experiences of the social phenomena as others and I have experienced them“ (p. 36). For this reason he also provides English translations of excerpts taken from interviews, of quotations in preceding publications, and of transcriptions of dramatic texts. Experiences are therefore represented simultaneously in a direct and indirect way. One effect is the reduction both of the feeling of exoticism and of the distance between the Western reader of his book and his Ugandan sources, by giving the latter a voice. A further consequence is that the book is accessible to a multiple readership. Ultimately end, one can say that Barz provides a specialist’s knowledge based on the grounds of critical experience, ethnological ethics and facts, and of course, he does not withhold analytic and scientific conclusions from the reader.

At the beginning of the first chapter, the drama of AIDS in Africa is revealed statistically, before Barz consequently leads to the situation in Uganda by explaining President Yoweri Kaguta Museveni’s war against the disease, which is known as the ABC program (i.e., practice Abstinence, Be faithful, use Condoms), and the local campaigns: both intend to change people’s sexual behavior. Uganda is a unique example for its 70% decline in the prevalence of HIV since the early 1990s, which was a result of the educational work done on the Acquired Immune Deficiency Syndrome in Uganda’s social networks. All the more, Barz asks how those educational workings appear at the grassroots level and why they are so effective in comparison to some national and Western non-governmental campaigns, which use the most modern media, such as TV, radio, flyers, etc.  As he shows, many problems concerning the communication of information are related to poverty. Not everyone who lives in a rural region in Uganda has TV or radio, and even though some people might have them, they often do not have enough money for batteries to power them. Furthermore, many people simply don´t like to read flyers: they are not used to doing so. As a consequence, vital information doesn’t reach them. The efficacy of the social networks, on the other hand, lies in their specific qualities, such as in their direct contact with their audiences, their skillful combination of entertainment and education, and their utilization of cultural languages, or – as I dare to say  symbolism. In order to attract people and to explain in an adequate and effective way the cause of HIV and how AIDS is to be prevented, the contents must be communicated with appropriate and culturally-embedded symbols. Music and drama fulfill all of those demands, for they educate while entertaining and, rooted in local forms of expression, they establish direct contacts through live performance.
Barz does not simply drop those facts. From the very beginning of his book he familiarizes the reader with his sources, the performers (i.e., the members of women´s indemnity groups, choirs, youth groups, and even of the so-called ``witch doctors´´). But even though Barz is – as he states – personally involved with an underlying anthropologist’s responsibility, he does not do so by wagging his finger.Due to his anthropologist´s ethics, Barz narrates the subjects’ daily lives and, when he outlines the processes of fieldwork as well as those of educational campaigns, the reader also gets involved and becomes a participating observer in a field that can’t be reduced to one single region in a foreign country.
A short overview of the following chapters closes the first chapter.

The second chapter elaborates on the meaning of living positively, in the sense of living a positive life, rather than living while HIV positive. Barz discusses the role, the perception and the understanding of music in Uganda including the ``localized understandings of the power of music to heal and to persuade others to allow healing to occur´´ (p. 36). Music in this context means a bit more than just ``organized sound´´, our well-known Western concept, or the Kiswahili term muziki, which also often refers to Western musical performance. It is understood as a form of transactional communication, and in connection with AIDS campaigns, it functions as a medical intervention. As Barz´s sources state, music educates about the danger of AIDS and about how to protect the audience from HIV, as they are tired of ``sitting and learning´´ (p. 58), and they are more interested in music and drama. The last statement, in particular, reveals a central feature of music, namely its metalinguistic power, when we keep in mind that music itself already can be perceived as drama (i.e., by its dramatic text, the performance, etc.). Through music, messages are communicated in a dramatized way, and, as Barz illustrates through examples, its dramatization also means that musicians and singers intentionally evoke feelings (such as fear or anxiety) in their audiences. Many people in Uganda relate music with entertainment, and in regard to AIDS/HIV, music is a useful entertainment, and at the moment it seems to be the most efficient.
In the second chapter Barz furthermore introduces and defines the academic concept labeled ``medical ethnomusicology´´. One point is the idea of music as medical intervention or treatment, or even as medicine itself in indigenous or cultural understanding.  Whether music may cure or just support the process of healing, it is linked with strategies and practices developed by communities in order to respond to different types of desease, illness, health and healing, which are themselves culturally conceptualized. Medical ethnomusicology takes into account those conceptualizations, cultural understandings, and interpretations of disease, discussing them from differing transdisciplinary points of view. Focusing on the performative nature of treatment and healing, medical ethnomusicology seeks to gain a better understanding of – as Barz states, –  ``how disease is made meaningful´´ (p. 62).

In this spirit chapter 3 offers a gendered perspective, outlining the problems, strategies, and succesful work of the socially most vulnerable members of the communities, namely women. The spread of AIDS and the foundation of women’s groups necessarily led further to a new self-awareness, which scrutinizes traditional roles, interdependencies, and expectations, such as the cultural expectation for women to be submissive and dependent upon men. The examples quoted by Barz give evidence of an ongoing rethinking and re-discussing of those roles and expectations with the final aim of promoting behavioral change (i.e., proper condom use, faithfulness to partners, and sexual abstinence). The actual situation obliges the feeling of responsibility. In order to transmit their messages, women often draw on the traditional and the most effective forms of communication in Uganda: music, dance, and drama. But, as one of Barz´s sources states, they also induce fear among those who do not understand. Women’s groups often function as social networks and as contact points for counseling, care, and education. In some of their instructive lyrics they even give addresses where blood testing for HIV/AIDS can be done. For a better understanding of their role and their effectiveness, Barz contextualizes them through a survey of Ugandan history since 1962 and of the so-called Theatre For Development (TFD).

Chapter 4 relates to the aforementioned concepts by examining the ``languaging´´ of AIDS. There already existed a localized enculturation of the disease in the early 1980s before it was given its scientific name. A descriptive term such as ``silimu´´ (i.e., because those infected get slim in the end) is still in use today. Other ways of describing AIDS are rather metaphorical, for example as a ``worm´´ that eats a fruit, or as an animal in a saucepot, which represents a disease or virus in the genital areas (also as pars pro toto for the body). In order to illustrate the cultural experience of the musical performance of HIV/AIDS, Barz provides eleven categories of song lyrics followed by transcriptions of examples he recorded from different groups (including various youth groups, and of educational songs sung in schools). Every transcription includes a glossary of African words related to AIDS or its prevention, which shows how localized medical and health-related topics are made meaningful within musical performance.

The fifth chapter investigates how AIDS is handled in religious and faith-based communities. In some communities, AIDS has long been seen as a punishment or a curse from God, and this idea often led to the stigmatization and social isolation of those infected. Moreover, AIDS was not explicitly discussed in a clear manner. But this changed when influential members of church hierarchies dying from it. The churches have now addressed this issue and established drop-in centers.
An essential topic of this chapter is the use of multiple systems to promote health. For example, this means that Christians privately may contact traditional healers, and that traditional healers might refer patients to modern hospitals. In one of Barz´s examples, a traditional healer or ``witch doctor´´ worked in a modern hospital before he became a healer, so it means that other traditional doctors might also be acquainted with modern medicine and they might take it into account, even though they make their diagnoses in a traditional way (i.e., by means of music). Thus, the patient or client can be provided with specialists’ knowledge of different medical traditions. The role of churches and religious communities in this context can hardly be overlooked, for the performance of religion and medicine occupy influential social spheres. On one hand they may complement each other, while on the other they can fuel conflicts (for example, the case of prejudices against a health-care system or a religion). Nowadays, many Ugandans break the barrier between religion, medicine, and music, and it seems that it is the combination of multiple health promoting strategies– rather than their separation – that opens the door to better medical treatment. Also Western NGOs appreciate the interdisciplinary and crosscultural approach, for it minimizes old preexistent superstitions and optimizes the transactional transfer of knowledge.

Re-Memorying Memory is the central theme of the sixth chapter, which deals with the performance of memory through so-called Memory Books and musical performance.  Memorying in the context of musical performance is defined as a social activity that is able to manipulate, and is therefore an active process, rather than a sort of passive-collective memory. People in Uganda, as Barz explains, perceive themselves not only as bearers of memory, but they also contribute to the continuity of their communities by recalling and reshaping the past, and by this they are able to change the present and future. Above all, HIV-positive women play an influential and guiding role in contemporary traumatic memory work. Uganda is a drastic example, for memory work has to be done even in the absence of entire generations.

Barz´s Singing for Life gives a compact overview concerning strategies against AIDS, and reveals the importance of medical ethnomusicology, but it definitely doesn’t mark an end. Rather, it stands at the beginning of new studies to come. As he shows in the conclusion of chapter six, there are several works in progress on the same topic, namely a thesis of Abimbola Cole (UCLA), who concentrates on Botswana, and one of Kathleen Noss (UCLA), who is doing a research on HIV/AIDS and music in Kenya.

The current relevance of the role of music within medical interventions against AIDS couldn´t be explained in a more sober and convincing fashion.

Those who are interested in Singing for Life can get a further impression on the following website, which provides a description of Barz´s research on AIDS in Uganda ( The book includes a CD with musical examples.

Bernhard Bleibinger, Barcelona January 2007

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