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1.
Am Ethnol ; 49(3): 413-426, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36583129

ABSTRACT

In South Africa the racialized contours of economic life powerfully shape the distribution of who owns poultry enterprises, who is employed to labor in them, who consumes poultry products, and in which way. When, in late 2017, an outbreak of highly pathogenic avian influenza (H5N8) decimated the South African poultry sector, it revealed the ontological transformations of industrial egg-laying poultry into "cull birds" and then into imileqwa, the quintessential rural chicken. It thus showed how distinct regimes of value "articulate," blurring infectious and noninfectious concerns as new chains of conversion were inaugurated across domestic and global economies. Thanks to the mediations performed by the network of egg-laying chickens, (White) farmers, (Black African) consumers, and state veterinarians, translations of value take place in which industrialized egg-layer chickens turn into socially enlivened beings. Such beings sustain and nurture social reproduction in South Africa's postapartheid cities and beyond. [zoonosis, value, human-animal relations, global health, one health, race, urbanism, South Africa].

2.
J Med Humanit ; 43(1): 43-54, 2022 Mar.
Article in English | MEDLINE | ID: mdl-31478127

ABSTRACT

In this article we examine the figure of the doctor in animated debates around public sector medicine in contemporary South Africa. The loss of health professionals from the South African public system is a key contributor to the present healthcare crisis. South African medical schools have revised curricula to engage trainee doctors with a broader set of social concerns, but the disjunctures between training, health systems failures, and a high disease burden call into question whether junior doctors are adequately prepared or whether conditions of care extend beyond medical training. A concern with 'resilience' suggests a correct ethical relation to a putative obligation to provide care in a struggling system. By examining the ways in which trainee doctors are expected to 'cope' with the demands of medical practice, to adopt the correct moral posture in relation to the urgency of care, and to enact a desirable ethical relation to the broader social and political context of medical practice, we examine the picture of humanist concern that animates the subjectivities and techniques of the self called for by this training, and advocate for endurance as an alternative framework for understanding the political and ethical relations between doctors, patients and health systems.


Subject(s)
Physicians , Delivery of Health Care , Health Personnel , Humans , Schools, Medical , South Africa
4.
Med Humanit ; 44(4): 221-229, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30482814

ABSTRACT

In this article, the authors make a case for the 'humanisation' and 'decolonisation' of health sciences curricula in South Africa, using integration as a guiding framework. Integration refers to an education that is built on a consolidated conceptual framework that includes and equally values the natural or biomedical sciences as well as the humanities, arts and social sciences, respecting that all of this knowledge has value for the practice of healthcare. An integrated curriculum goes beyond add-on or elective courses in the humanities and social sciences. It is a curriculum that includes previously marginalised sources of knowledge (challenging knowledge hierarchies and decolonising curricula); addresses an appropriate intellectual self-image in health sciences education (challenging the image of the health professional); promotes understanding of history and social context, centring issues of inclusion, access and social justice (cultivating a social ethic) and finally, focuses on care and relatedness as an essential aspect of clinical work (embedding relatedness in practice) The article offers a brief historical overview of challenges in health and health sciences education in South Africa since 1994, followed by a discussion of contemporary developments in critical health sciences pedagogies and the medical and health humanities in South Africa. It then draws on examples from South Africa to outline how these four critical orientations or competencies might be applied in practice, to educate health professionals that can meet the challenges of health and healthcare in contemporary South Africa.


Subject(s)
Curriculum , Education, Medical, Undergraduate , Health Occupations/education , Humanities , Interdisciplinary Communication , Attitude of Health Personnel , Delivery of Health Care , Empathy , History , Humans , Personhood , Philosophy, Medical , Physicians , Politics , Social Environment , Social Justice , South Africa
5.
Med Anthropol ; 35(5): 433-46, 2016.
Article in English | MEDLINE | ID: mdl-26794259

ABSTRACT

How might we understand and respond to the new forms of hunger that arise with the massive rollout of antiretroviral therapy (ART) for HIV in southern Africa? Rather than 'merely' a technical problem of measurement, medicine or infrastructure, I suggest that a philosophical question arises concerning the relationship between the experience of hunger, the utterances that communicate that experience, and the bodily regimes of well-being and ill-being indexed by such utterances. Taking the gut as a particular kind of mediator of experience, I draw on ethnographic fieldwork conducted in KwaZulu-Natal, South Africa to open up a set of questions on acknowledgment and avoidance. The central question concerns the divergent concepts of 'grammar' that confront the relationship between hunger and ART.


Subject(s)
Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , HIV Infections/ethnology , Hunger/ethnology , Nutrition Disorders/ethnology , Anthropology, Medical , Health Services Accessibility , Humans , Politics , South Africa
6.
Soc Sci Med ; 77: 118-25, 2013 Jan.
Article in English | MEDLINE | ID: mdl-23219165

ABSTRACT

In the context of low rates of participation in a prospective, population-based HIV surveillance programme, researchers at a surveillance site in rural KwaZulu-Natal, South Africa, conducted an operational study from January 2009 to February 2010, with the aim of improving participation rates, particularly in the provision of dried blood spots for the surveillance. Findings suggest, firstly, that consent to participation in the HIV surveillance is informed by the dynamics of relationality in the HIV surveillance "consent encounter." Secondly, it emerged that both fieldworkers and participants found it difficult to differentiate between HIV surveillance and HIV testing in the surveillance procedure, and tended to understand and explain giving blood under the aegis of the surveillance as an HIV test. The conflation of surveillance and testing, we argue, is not merely a semantic confusion, but reveals an important tension inherent to global health research between individual risks and benefits and collective good, or between private morality and public good. Because of these structural tensions, we suggest, the HIV surveillance consent encounter activates multiple gift economies in the collection of blood samples. Thinking beyond the complex ethical dimensions provoked by new forms of long-term surveillance and health research, we therefore suggest that deepening relations between scientists, fieldworkers, and study participants in locality deserve more careful methodological consideration and descriptive attention.


Subject(s)
HIV Infections/epidemiology , Informed Consent/statistics & numerical data , Population Surveillance , Rural Population/statistics & numerical data , Treatment Refusal/statistics & numerical data , Adolescent , Adult , Female , Health Services Research , Humans , Male , Middle Aged , Population Surveillance/methods , Prospective Studies , Qualitative Research , South Africa/epidemiology , Young Adult
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