The resurgence of tuberculosis in South Africa: an investigation into socio-economic aspects of the disease in a context of structural violence in Grahamstown, Eastern Cape

Erstad, I. (2007) The resurgence of tuberculosis in South Africa: an investigation into socio-economic aspects of the disease in a context of structural violence in Grahamstown, Eastern Cape. Masters thesis, Rhodes University.

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Abstract

This thesis is an investigation into the socio-economic constraints that influence the decisions of tuberculosis sufferers in the health seeking process and therapeutic management of tuberculosis in Grahamstown, the Eastern Cape. It is shown that structural violence influences experiences and perceptions of tuberculosis at all levels. Management of tuberculosis in the formal health sector is explored at local levels and related to national and global strategies of health care. The role of health workers, and particularly voluntary health workers, is explored and it is shown that they work within a context of growing burden of sickness and co-infections and a lack of government commitment to deal with increasing TB and HIV incidences. Kleinman’s notion of explanatory models is explored and it is evident that although knowledge of the aetiology of tuberculosis is well-known to patients and general members of the communities, they are nevertheless victims of increased stigmatisation and marginalisation as a result of illness. The importance of social support in curing tuberculosis is explored using Janzen’s concept of therapy managing groups. Social capital is a fundamental component in adhering to biomedical therapy, but is commonly weak among the structurally poor. The availability of temporary social grants for people living with TB influences health seeking behaviour. In a context of structural poverty the sick are faced with what Nattrass terms “perverse incentives”, having to choose between the right to health and the right to social security, both guaranteed in the South African Constitution, for him/herself and dependants. Although adherence to biomedical therapy is essential in curing tuberculosis, it is shown throughout this thesis that ignoring wider structural causes of disease limits the patient’s ability to get well. The ethnography shows that the right to health is a social and economic right which is not the reality for most South Africans.

Item Type:Thesis (Masters)
Additional Information:M.A. (Anthropology)
Uncontrolled Keywords:tuberculosis patients, tuberculosis treatment, community health services, role of health workers, medical anthropology, structural poverty, Grahamstown, South Africa
Subjects:Y Unknown > Subjects to be assigned
Divisions:Faculty > Faculty of Humanities > Anthropology
Supervisors:Bernard, P.S.
ID Code:882
Deposited By: Rhodes Library Archive Administrator
Deposited On:07 Dec 2007
Last Modified:06 Jan 2012 16:19
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