Constructing loss : exploring the traumatic effects of bereavement due to HIV/AIDS and tuberculosis on aid workers in South Africa
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Date
02/07/2013Author
Ranjbar, Vania
Metadata
Abstract
This thesis aimed to investigate, first, the potentially traumatic effects of
AIDS-related bereavement on HIV/AIDS aid workers in South Africa; second, the
resources that aid workers utilise in order to cope with their work; and third,
differences in the experiences of local versus international aid workers. HIV/AIDS
work is associated with various stresses and burnout is commonly observed among
HIV/AIDS caregivers. Care of HIV/AIDS aid workers, however, has been largely
overlooked; research has typically focused on the experiences of professional health
workers, and often outside of an African setting. This present study, therefore,
addressed these limitations with the use of participant observation ethnography and
ethnographic interviewing.
A period of one year was spent with an organisation in South Africa that
provides care for vulnerable children in need and affected by HIV/AIDS. Openended
semi-structured interviews were conducted with 63 male and female local
and international staff and volunteers. The interviews were analysed using
discourse analysis (DA), a methodology novel within HIV/AIDS and trauma
research and particularly suitable for investigating language, social context and
interaction, and identities, which are factors found to be important in HIV/AIDS
work. Participants’ discourses were analysed to identify how they construct their
identities, concepts such as HIV/AIDS and tuberculosis, events they experienced,
and how they made sense of these phenomena.
The main finding of this study was that contemporary HIV/AIDS aid work
involves new challenges that have surpassed AIDS-related bereavement as the most
prominent concern. The main challenges reported by participants involved the
inability to control HIV/AIDS treatment and consequently inability to prevent, or
control, AIDS-related death as a result of patient non-compliance. Participants further constructed HIV contraction as controllable and, therefore, avoidable, and
used this micro discourse on control to counter HIV-related stigma, particularly
stigma they experienced as HIV/AIDS aid workers. This rhetorical technique,
however, rather maintains the macro discourse on HIV-related stigma by
maintaining the blame component of the disease. Two identity constructions
emerged in participants’ discourses. First, the characteristics inherent in the child
identity suggested that loss is not merely a matter of death but also sadness for and
on behalf of children for their various losses. Second, the caregiver identity
prescribed how ‘proper’ and ‘genuine’ HIV/AIDS caregivers are expected to behave.
The prescriptive nature of this identity can explain burnout among HIV/AIDS
caregivers. The rewards of caregiving, however, can act as a buffer against difficult
or traumatic experiences inherent in HIV/AIDS work. Managerial support and
global belief systems that allow finding meaning were further identified as
important coping resources for HIV/AIDS aid workers. Finally, differences between
local and international participants, in terms of how they conceptualise phenomena
and consequently have different needs, emphasise the role of culture in the
experiences of HIV/AIDS aid workers. In the thesis I further discuss these findings
in light of theories of social psychology, such as the Just World hypothesis,
Cognitive Dissonance, and Identity Control Theory and Self-Categorization Theory.
I conclude that although AIDS-related death no longer is a prominent issue,
care of HIV/AIDS aid workers should not be overlooked. Contemporary HIV/AIDS
work simply involves new challenges and traumas, and it is important that such
work is continuously researched to identify evolving needs.