Networks, NGOs and public health : responses to HIV/AIDS in the Cape Winelands

Ward, Vivienne (2007-03)

Thesis (MPhil)--University of Stellenbosch, 2007.

Thesis

ENGLISH ABSTRACT: This reflexive study of responses to the HIV/AIDS pandemic was set in Stellenbosch, a town in the Cape Winelands that, with its diverse but disjointed population, in many ways is a microcosm of South African society. My question was what happens when the experience of HIV/AIDS, with its personal impacts and global connections, reaches a particular locality in South Africa. I worked on the assumption that the reach of the disease in this specific locality reflects the disconnectedness of people through historical, political, social and economic processes, and that responses to the disease attempt to repair ruptures through integrating people into caring systems of support. By tracking and interrogating responses at public health and service organisation levels as a participant observer, I noted recurrent references to the importance of engaging patients in the treatment process. My observations revealed a transformation in the dyadic relationship between doctor and patient, as well as an embracing reach of networked service organisations, both initiatives striving to render more effective services. In the process relationships developed between patients and service providers at health and social levels, and between providers themselves. Much of the impetus for these local developments was derived from global inputs as local players draw down packaged practices and funds from the global assemblage that Nguyen refers to as the “AIDS industry” (2005a). Thus, I suggest that HIV/AIDS becomes a catalyst for local innovation within globally standardised structures, such innovation being driven principally by building social relationships.

AFRIKAANSE OPSOMMING: Hierdie reflektiewe studie aangaande die response tot die MIV/VIGS pandemie is in Stellenbosch, ‘n dorp in die Kaapse Wynlande, gedoen. Stellenbosch se diverse, maar tog onsamehangende, populasie is in verskeie maniere ‘n mikrokosmos van die Suid- Afrikaanse samelewing. My vraag het gevra wat gebeur as die ondervinding van MIV/VIGS, wat persoonlike impakte en globale konneksies insluit, ‘n spesifieke lokaliteit in Suid-Afrika bereik. Ek het gewerk volgens die aanname dat die omvang van die siekte in dié spesifieke lokaliteit die uitskakeling van mense deur historiese, politieke, sosiale en ekonomiese prosesse reflekteer, en dat response tot die siekte poog om ontwrigtings te herstel deur die integrasie van mense in versorgende ondersteunings sisteme. Deur response, op publieke gesondheid en dienslewerings organisasie vlak, as deelnemende waarnemer op te volg en te ondersoek, het ek herhaaldelike verwysings gekry na die noodsaaklikheid om pasiente te betrek in die behandelings proses. My observasies het ’n transformasie in die wederkerige verhouding tussen dokters en pasiente ontbloot, sowel as ’n omvattende omvang van netwerke van dienslewerings organisasies. Beide inisiatiewe streef daarna om meer effektiewe dienste te lewer. In die proses ontwikkel verhoudings tussen pasiente en diensverskaffers op gesondheids and sosiale vlakke, asook tussen diensverskaffers. ’n Groot gedeelte van die dryfkrag agter hierdie plaaslike ontwikkelings spruit uit globale insette namate plaaslike spelers verpakte praktyke en fondse ontvang/trek van die globale groep, wat Nguyen na verwys as die ’VIGS industrie’ (2005a). Daarvoor, stel ek voor dat HIV/VIGS ’n katalisator vir plaaslike innovasie binne globaal gestandardiseerde strukture word, en dat inovasies van die aard hoofsaaklik deur die bou van sosiale verhoudings gedryf word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/19890
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