Theses and Dissertations (African Centre for Migration and Society)

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    Urban livelihoods and the risk of HIV infection: lived experiences of young migrant women in Havana informal settlements in Windhoek, Namibia
    (2014-10-22) Shinana, Eveline M
    Informal settlements are associated with higher prevalence of HIV. There is empirical evidence that HIV prevalence is higher in the North-Western suburbs (Katutura) of Windhoek which primarily consist of low-income housing and informal settlements. It is reported that a large proportion of young women in these suburbs who are 25 years and younger are HIV positive. This study sought to explore the linkage between urban livelihood strategies and the risk of acquiring HIV among young migrant women (aged 18 to 24) in Havana informal settlement in Katutura in Windhoek, Namibia. The study focuses on the lived experiences of internal young migrant women to explore the linkage between their livelihood strategies and the risks of acquiring HIV. A desk review was undertaken in order to analyse existing documents related to urban livelihoods and HIV from studies that have been conducted in the City of Windhoek. Semi-structured interviews and focus group discussions as research instruments were administered to collect primary data. Thematic analysis has been employed to analyse the data to help extract descriptive information concerning experiences of young migrant women in Katutura informal settlements and construct meanings in order to be able to understand how livelihood strategies of young internal migrant women in Havana relate to the risk of acquiring HIV. The study reveals that young migrant women in Havana informal settlement moved to Windhoek in order to have their livelihoods improved. Based on the data, income; education; employment and housing are some of the social and economic factors found to be affecting the livelihoods of the young migrant women. Furthermore, the study unveils that young migrant women engage in risky sexual behaviours such as low condom use, transactional sex and multiple concurrent partnerships as a strategy to earn livelihoods. Engaging in risky sexual behaviour such as transactional sex enhances the risk of acquiring HIV once they are exposed, as it influences their sexual decision making due to their dependency on men. The study concludes that there is a linkage between urban livelihoods and the risk of HIV infection. Therefore, exclusion of migrant communities from services as well as their limited access to sustainable livelihoods encourages young migrant women to engage in risky sexual behaviour. The findings of this study do not portray that all young women in Havana informal settlement engage in risky sexual behaviour because young migrant women are a heterogeneous group however, participants who took part in this study are a representative of all young migrant women (aged 18-24) in Havana. Therefore, their risky behaviour can be one of the major factors contributing to high prevalence of HIV among young women in Katutura. KEY WORDS: Migration, HIV, risky sexual behaviour, urbanisation, livelihoods, informal settlements, urban poverty, Havana, Katutura, Windhoek
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    Giving birth in a foreign land : maternal health-care experiences among Zimbabwean migrant women living in Johannesburg, South Africa.
    (2014-09-11) Makandwa, Tackson
    The republic of South Africa has a “health for all” policy, regardless of nationality and residence status. However, challenges still exist for non-nationals and little is known regarding migrants’ maternal healthcare experiences. This study explores the maternal healthcare experiences of migrant Zimbabwean women living in Johannesburg, South Africa. It focuses on the lived experiences of women aged 18years and above, who engaged with the public healthcare system in Johannesburg during pregnancy and childbirth. A desk review of the literature was undertaken. The theoretical framework in this study draws from three concepts (1) the Social determinants of health framework (WHO 2010), (2) the Access to healthcare framework (McIntyre, Thiede and Brich 2009) and (3) the “three-delays (Nour 2008). Primary data was collected through the use of open-ended semi-structured interviews with a sample of 15 migrant Zimbabwean women who have been in Johannesburg for a minimum of 2 years, and have attended and given birth or are currently attending antenatal care in inner city Johannesburg. Thematic content analysis was used to analyse data since it helps to extract descriptive information concerning the experiences of Zimbabwean women in Johannesburg and to construct meaning in order to understand their perceptions and opinions about the healthcare system in the city. Although the findings indicate that documentation status is not a key issue affecting access to healthcare during pregnancy and delivery, a range of other healthcare barriers were found to dominate, including the nature of their employment, power relations, language, and discrimination(generally) among others. Language was singled out as the major challenge that runs throughout the other barriers. More interestingly the participants raised their desire of returning home or changing facilities within the Public sector or to private institutions in case of any further pregnancy. This study concludes that the bone of contention is on belongingness, deservingness and not being able to speak any local language, that runs through the public health care institutions and this impact on professionalism and discharge of duties.
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    Memory and violence: Displaced Zimbabwean rural communities reliving the memories of the March 2008 political violence.
    (2014-08-26) Mvundura, Wellington
    This thesis is premised on the argument that a distinct kind of narrative (‘truth’) about political violence, a narrative of the first-person experience, a narrative that is valued for its power to counter totalising historical narratives, is thought to reside in the subjective experience of each individual. Be that as it may, this study aimed to answer the question: What meanings do rural Zimbabweans who were internally displaced by the March 2008 state-sponsored political violence attach to this violence? In particular, the study investigated these meanings in a context where the victims remain(ed) in close proximity to the perpetrators during and after the violence. It also examined these meanings in an alleged silence by the state and local communities, and how these meanings have shaped the victims’ present socio-political identities. In order to answer the question, in-depth narrative interviews were conducted with purposively selected respondents. The study assumed a qualitative exploratory design which was underpinned by the phenomenological and constructionist theoretical approaches. It was concluded that the victims’ interpretation of the state-sponsored political violence is negotiated and mediated in the course of interaction. The personal narrative of the memory attains some latent political and redemptive value when it is interpreted in a social context. The meanings of the violence particularly assume a complex moral and ethical plane in a scenario where the perpetrator remains a permanent feature in the victim’s physical and social space, without any recourse. The complexity is imminent as the victim has to contend with the socio-psychological effects of the daily direct interface with their unpunished aggressor especially due to the communal nature of rural life. It was also concluded that the 2008 state-sponsored violence was increasingly interpreted as unfinished business by the victims. More so, it was also understood to be synonymous and complicit with silence at the communal and national level. Thus, the silence was synonymous with adaptation to power relations, cultural censorship, and liminality. In terms of identity, the victims suffer an identity crisis. They have developed personalities that have arguably, failed to internalise a sense of self as trusting and trustworthy. Last, the identification of the violence as unfinished business has also led to the reaffirmation of the victims’ spiritual identities as they have invoked bewitchment to avenge the death of their loved ones and in the process try to reconnect with them spiritually by invoking their spirits to seek revenge.
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    Seeking goals in the urban estuary : how a personal migrant subjectivity is reified into productive strategies and generative social effects.
    (2014-07-28) O'Keefe, Peter
    Using a micro-level frame of analysis, and working from in-depth interviews in Johannesburg's migrant-rich ‘urban estuaries,’ this research report considers participants’ personal, subjective, understanding of their own migrant-ness. The paper argues that theirs is a migrant subjectivity linked to the praxis of goal seeking, rather than the achievement of belonging. The goal seeking subjectivity is reified into pragmatic social strategies of network building, trust, and opportunity creation that undermine the concepts of generalized trust, communal social capital, and the host/migrant dichotomy. Personal subjectivies are rendered social. Denizens fill the social space with presentations and assessments of ‘mutual beneficence,’ and seek out demographically ambivalent networks of commonality.
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    Microfinance as a livelihood strategy: A case study of forced migrants in Johannesburg
    (2014-06-13) Kamugi, Watetu
    Microfinance as a tool for development has been used all over the world in combating poverty and improving livelihoods. It is described as the provision of savings, credit and insurance services to low income earners and the very poor in society through Microfinance Institutions (MFI). Additionally, MFI provide vocational training in various skills such as hand crafts, business and language skills. Livelihoods on the other hand constitute the ways in which people access and mobilise resources that enable them to increase their economic security thus reducing the vulnerability created and exacerbated by conflict, and how these resources help them pursue goals necessary for their survival. As a livelihoods strategy for refugees, the services of MFI have mainly been employed in camp settings, with few projects run for urban refugees. Many reasons arise for the difficulty in employing it as a livelihood strategy in urban settings, with the most common being the fluidity and mobility of urban refugees that renders them a risky group to lend money, grants or training to. This study explores the accessibility of microfinance to forced migrants and refugees living in the economic hub of Africa, Johannesburg. The findings suggest that refugees and other forced migrants receiving microfinance heard about the MFI in this particular study- Jesuit Refugee Services (JRS), from their social networks of family and friends while those who had never heard about JRS or any other organization offering microfinance services were in completely different social networks and were of different nationalities from the beneficiaries. As such, the question of accessibility to microfinance is linked to availability of information through social networks. Language also proved to influence the livelihood strategies adapted by the different refugees. Refugees who could speak English and other South African languages were in employment or in trade ventures as they could communicate with host nationals. This is unlike those refugees who only spoke French and Lingala, languages not spoken by South Africans. As such, they needed language training so as to enable them to communicate. The study also found that the main problems faced by refugees in Johannesburg are lack of employment, problems with accommodation, difficulty in enrolling children in public schools and raising the required school fees and difficulties in accessing social services. The research report concludes by recommending solutions to MFI and other organizations whose mandate is to assist refugees and other forced migrants to embrace all vulnerable refugees within the MFI in an effort to make MFI available to all who require their services.
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    Effects of perceptions and negotiation of decision making on gender relations, masculinity and contested patriachy among immigrant-South African households in Johannesburg, South Africa
    (2014-01-31) Aaca, Lisa Rebecca
    The study aimed at understanding how immigrant men and South African women in heterosexual relationships perceive and negotiate gender relations arising from household decision-making; and the effects these have on notions of masculinity among couples living in Johannesburg, South Africa. In order to investigate the research question, I used qualitative descriptive approaches with a poststructuralist perspective. The study drew on Foucault’s conceptualization of power and identified eight (8) immigrant men originating from other African countries and eight (8) South African women using purposive and snowball sampling. All individuals recruited were of at least eighteen years of age and had lived with their partners for at least two years. I perceived a minimum of two years of living together as adequate for differences in culture and socialization of people in immigrant-South African relationships to manifest in the performance of gender; and to equip participants with different constructions of decision-making, gender relations and masculinity. I selected men from other African countries because of the exclusionary discourses surrounding them in South Africa. Data was collected using face-to-face in-depth semi structured interviews with open-ended questions. Data analysis was undertaken using both thematic and discourse analysis. In doing the thematic analysis, work by Braun and Clarke (2006) was drawn on while work by Parker (1994, 1997 and 2005) was focused on for the discourse analysis. The study found that immigration and difference in nationality shape the different perceptions that determine decisions on formation of immigrant-South African relationships; affect income inequalities and decisions on expenditures; as well as decisions related to children in immigrant-South African households; and that these affect gender relations and notions of masculinity. The study further found that there are contradiction between gender equality and traditionally acceptable gender roles; as well as patriarchal and anti-patriarchal socializations by immigrant men and South African women. It also found that immigrant men and South African women use similar strategies in reviving and silencing of transgressed masculinity.
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    Towards understanding the experiences of accessing antiretroviral treatment services among Congolese men at clinics in Yeoville, Johannesburg
    (2014-01-30) Swamba, Adrien Bazolakio
    Little is known about the experiences of Congolese men receiving antiretroviral therapy (ART) services in the urban areas of South Africa. Johannesburg is home to many non-citizens who left their home country because of political or human rights reasons and in search of better economic opportunities in South Africa. In South Africa, adult HIV prevalence is highest in urban areas: 9% in formal urban areas and 18% in informal urban (Shisana et al., 2005). South Africa has one of the highest rates of HIV infection and has the largest public sector antiretroviral programme with the health system enrolling a great number of people living with HIV for antiretroviral therapy (Boulle et al., 2008). Non-citizens have the same rights as South African citizens to access free ART services; however, challenges in access antiretroviral treatment for non-citizens have been documented (McCarthy et al., 2009). This research project explores the following question: What are the treatment experiences of Congolese men who are currently well and receiving ART services at a government and at a non-government clinic in Yeoville Johannesburg? The study involves interviewing six Congolese men receiving antiretroviral therapy services and twelve healthcare providers at a government, the primary healthcare clinic and at a non-government clinic, Nazareth HIV clinic. Understanding the experiences of Congolese men and non-citizens is valuable to contribute to the literature on the role of male health seeking behaviour, access to healthcare, and treatment experiences in Johannesburg inner city. The primary objective of this study is to explore the treatment experiences of Congolese men receiving ART services at a government and at a non-government clinic in Yeoville. The study takes a qualitative approach and collects data in the Yeoville clinic (a government primary healthcare clinic) and in Nazareth House HIV clinic (a non-governmental clinic) in the Yeoville suburb of Johannesburg inner-city. Findings from this research reveal different treatment experiences with respect to access - opening and closing hours, documentation, services available; other factors - including support networks, secrecy and stigma; and, survivalist livelihoods that affect access dimensions of Congolese men on ART at the two clinics. Recommendations are made on access dimensions: Extending opening and closing hours of the clinic, giving the training to frontline healthcare providers on the rights of migrants on access to healthcare services including antiretroviral therapy services, and extending number of staff members. On other factors: Providing soup kitchen, shelters and extended campaigns on HIV related services to non-citizen patients on antiretroviral therapy services at the clinic, are ways to solve some challenges face by beneficiaries who access to antiretroviral therapy in both government clinic and non-government clinic in Yeoville, Johannesburg.
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    Managing the final journey home: exploring perceptions, experiences and responses to death among Congolese migrants in Johannesburg
    (2014-01-22) Kwigomba, Darius
    The study explores perceptions and responses of Congolese migrants when they experience the death of other migrants. The study takes an ethnographic qualitative approach and gathers data from three Congolese ethnic groups living in Johannesburg. This is done by observing and participating in their funeral ceremonies as well as interviewing community members. The primary objective of this study is to understand the cultural changes migrants experience as a result of migration by exploring social, economic and cultural challenges migrants encounter when experiencing death of a fellow migrant. Findings of this study indicate migrants strive to observe their home culture in the hosting country. Marginalisation is the acculturation strategy that explains their ways of dealing with death in South Africa. Results further indicate migrants’ perceptions of experiences and ways of dealing with death out of their places of origin are negatively annotated. This is due to difficulties in recreating elements of their own culture as well as the absence of people who are traditionally responsible for dealing with death among the migrant community. Lastly some causes of death, such as HIV/AIDS, are highly stigmatized. This study contributes to the scarce literature existent on the topic of perceptions and responses to death among migrants.
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    Treatment experiences of HIV positive temporary cross-border migrants in Johannesburg : access, treatment continuity and support networks.
    (2013-10-03) Hwati, Roseline
    As the economic hub of South Africa, Johannesburg attracts cross-border migrants in search of improved livelihoods; over half the population of some of its inner-city suburbs are made up of cross border migrants. Globally as well as locally, foreigners have been blamed for the spread of diseases such as HIV. As a result, they have suffered challenges in accessing public healthcare, particularly antiretroviral treatment (ART) for HIV. Studies have shown that despite these challenges - foreigners experienced better ART outcomes than nationals. There is a need to explore the ways in which cross border migrants use to access and to stay on treatment, given the wide-range of challenges that they face during their stay in Johannesburg. Semi-structured interviews with five nurses and ten cross-border migrants currently receiving ART, along with non-participant observations, were used to collect data from two public clinics in inner-city Johannesburg. Analysis suggests that the family network in the country of origin remains critical, as cross border migrants are not disclosing their status in the city in which they live, but do so to their families in their countries of origin. Data shows that when it comes to accessing and staying on treatment, cross-border migrants go to the clinic every month as do nationals; ask for more treatment from nurses when going home temporarily; eat healthily; but hide when taking medication, and negotiate confidentiality and trust within their families in countries of origin. Some are found to access treatment in their countries of origin while staying in Johannesburg. Despite the lack of social networks in the inner city, this data suggests that cross-border migrants are successful in accessing and continuing with ART. There is need for future research to look at social networks for internal migrants, so as to compare results.
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    Authority, trust and accountability : regulation of pharmaceutical drug trade practices in Yeoville.
    (2013-09-27) Cossa, Ema Euclesia
    The increase in use and distribution of pharmaceuticals on a global scale has caused pharmaceuticals to play an integral role in the notions of quality of health. This study is concerned with how Western medication is transacted and interpreted in explicit and implicit contrast to the other context. I observe the commercial trade of medicines, specifically the effects of regulation of pharmaceutical drug trade in a suburb of Johannesburg (Yeoville) a low income area where many migrant groups have found long and short term refuge. A Policing and Mobility Project (Hornberger & Cossa 2010) centred on tracing paths of medication and the level of policing thereof in Johannesburg revealed that clandestine sale of medication occurs in the suburb’s local market. This prompted a comparison between the formal and informal pharmaceutical trade spaces. Simon (a pharmacist) and Teresa (a former nurse turned market trader) sell pharmaceutical drugs in seemingly contrasting contexts. Despite their expertise in health care, Simon and Teresa were flung to opposite ends of the trade spectrum by regulation. In the weeks I spent with Teresa and Simon it became abundantly clear that the spaces which had been initially presented as the opposite of one another may have had a few layers of common ground. At first it seems as though only regulation has the ability to produce authority, trust and accountability. But later it becomes evident that such aspects can be reproduced through manipulation of everyday practices. Roger Cotterrell’s (1999) interpretation of Emile Durkheim’s view of the law as a ‘Social Fact’ (1999:9), demonstrates how the collective experience of regulation (an aspect of the law) affects the individual. But De Certeau (1984) claims that the same individual can tacitly undermine this collective experience (the dominant form) through everyday practices. The findings suggest that the assumed roles of regulated and unregulated pharmaceutical trading spaces are not as static as they appear. The study concluded that authority, trust and accountability can be reproduced outside of regulation. And secondly thus the formal and informal trade of pharmaceuticals in Yeoville have more in common than perceived since both Simon and Teresa, had authority in health, their customer’s trust and loyalty and were accountable within the trade.