Between policy and patients : protocols and practice in HIV/AIDS treatment
Date
2008-12
Authors
Human, Oliver
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
In recent years the World Heath Organisation (WHO) has recomended standardising
HIV/AIDS treatment. Standardisation is based upon a particular model of what occurs
within the relationship between a doctor and a patient and is propogated through the
application of protocols. This thesis aims to illustrate how a doctor deals with a
protocol in the face of contexts over-laden with contingency and excess which the
protocol does not account for and which standardisation excludes. In other words, it
explores how doctors deal with the failures and restrictions of standardised medicine.
The central question this thesis aims to answer is: How do doctors on the ground deal
with the standardising demands of global, as well as national, institutions in the face
of highly contingent daily realities?
I aim to answer this question by critically analysing the relationship between global
institutions and the effects of their policies on the ground level. I argue that global
organisation such as the WHO attempt to limit the particularities and contingency of
local contexts in order to ensure the internal coherence of their own policies. This is
made possible through ‘interpretive communities’ of experts, as well as, the relative
opacity of ground level actions. However, I also illustrate how doctors applying these
protocols are not merely pawns in the state’s and global health organisations schemes
but rather depend upon the opacity at ground level in order to ensure the well-being of
those marginalised by protocols.
Description
Thesis (MA (Sociology and Social Anthropology))--Stellenbosch University, 2008.
Keywords
HIV, Protocols, Doctors practice, ARV distribution, Dissertations -- Sociology and social anthropology, Theses -- Sociology and social anthropology