Department of Sociology and Social Anthropology

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Browsing Department of Sociology and Social Anthropology by browse.metadata.advisor "Du Plessis, Jacob"

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    Caregivers, care work and the limits of healthcare : an ethnographic exploration into practices of community-based HIV prevention, treatment and care in a resource-limited setting in South Africa
    (Stellenbosch : Stellenbosch University, 2016-03) Wademan, Dillon Timothy; Reynolds, Lindsey; Du Plessis, Jacob; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Sociology and Social Anthropology.
    ENGLISH ABSTRACT: In just over a decade the South African government's response to the HIV/AIDS epidemic has gone from a position that could be described as adversarial to rolling out and sustaining the largest antiretroviral treatment (ART) programme in the world (Simelela & Venter, 2014). With the latest recommendations from international organisations supporting immediate ART initiation for all people living with HIV/AIDS and ART for people at high risk for HIV infection (WHO, 2015), the number of people to be incorporated into the programme is likely to grow exponentially. One unfortunate effect of these shifts in healthcare provision is the enormous strain it places on an already ailing public health sector (Coovadia, Jewkes, Barron, Sanders & McIntyre, 2009). In order to cope with the growing pressures on the health system, the South African public health sector has increasingly relied on community- and home-based carers to carry out the everyday tasks of managing HIV-infected people's initiation on and adherence to ART. Despite their essential role in sustaining the health care system, little research has been done on the actual practices and experiences of community care workers in resource-poor settings (Zulliger, Moshabela, & Schneider, 2014). In this thesis I explore the care practices of two such groups of community- and home-based carers in one locality in the Western Cape. The first group are community care workers (CCWs) who work for non-governmental organisations in partnership with the public health sector. The second group, community HIV-care providers (or CHiPs), work for a population-based HIV treatment and prevention trial called HPTN 071 (or PopART). In addition, I engage with HIV-positive individuals introduced to me by the caregivers to draw out issues surrounding access to and provision of healthcare. In this context, CCWs are responsible for providing HIV-infected community members with treatment adherence and psychosocial support only once they have initiated ART. The CHiPs, on the other hand, are responsible for a range of HIV treatment and prevention practices including door-todoor voluntary HIV-counselling and testing. The PopART trial protocol describes the CHiPs’ work as delivering a “‘best practice’ public health intervention” and points out that their work should be “separate from the ‘research teams’” employed by the trial (Hayes & Fidler, 2012:33). However, at the same time as providing their clients with healthcare, both CCWs and CHiPs must also produce certain kinds of evidence of their care. Providing care while producing evidence often requires caregivers to adapt protocols and standard operating procedures, to ‘make do’ (Livingston, 2012), in order to meet their client’s healthcare needs. Further, everyday care work entails translating and negotiating between divergent and overlapping modes of healthcare and healing. This thesis explores how caregivers use their intimate knowledge of the challenges their clients face to help them navigate these complex layers of healthcare, knowledge and authority. Thus, rather than seen simply as intermediaries, I argue that caregivers should be seen as living in translation, as entangled in the everyday lives of their clients, tying together the loose ends of healthcare implementation in a resource limited setting.
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    Pumping iron at Frankie’s
    (Stellenbosch : Stellenbosch University, 2021-03) Punt, Jacques; Du Plessis, Jacob; Pattman, Robert; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Sociology and Social Anthropology.
    ENGLISH ABSTRACT: The events and analysis prompting this study play out in a weight training gym in the Rusthof neighbourhood in Strand, Western Cape. Itis called Frankie’s Gym and originated to help deal with social issues in the neighbourhood, especially because of gangs and gang-related activities that are high in this neighbourhood. Frankie’s Gym (FG) focuses on influencing young men so that they do not get involved with gangs. The main research questions that drove this study were how FG can deal with the challenges that face the Rusthof community; what community means in the social environment of FG; and, how people at FG identify and perform gender. This study looked specifically at theoretical concepts like the gym as a sports-based intervention, community building, and masculinity(-ies). At FG there is a complex interplay of construction of community and masculinity(-ies). These two concepts seem to work in tandem in order to construct a social network and community, based around helping and caring for one another. In this way, FG and the people involved in it can influence their clientele to live a life away from the “bad stuff” in the neighbourhood –like gangs. Critically however, there are limitations to this. For one, people drop out of the gym and may start engaging with drugs and gangs, possibly finding it difficult to maintain a commitment to FG. Additionally, the focus on weight lifting can contribute to a version of being male which idealises toughness over sensitivity, although many of the young men with whom I engaged seemed to be committed to an ethic of care which they learnt and was exemplified in the gym. Lastly, the effectiveness of the intervention seems to depend to some extent on the role Frankie plays as a model of a caring, sensitive, compassionate, sociable and creative man, and this raises the question of who can replace Frankie when he retires (he is currently in his 70s) and continue the work with FG in the community. This is an ethnographic study and participant observation was the main research method. This provided rich data that was supplemented by a semi-structured interview with the owner Frank Hendricks. Applied thematic analysis was used to analyse the data.