3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Building a culture of research in clinical medicine: an ethnography of professional aspiration, privilege and crisis at the intersection of hospital and University in South Africa(2019) Van Der Wiel, ReneeThis thesis is an ethnography of a group of medical doctors in South Africa who produce clinical research based on their patient practice. These clinician-researchers are scarce around the globe but praised as contributing indispensable clinical insights to research in an aim to improve healthcare. In South Africa government and professional bodies recently took action to expand and racially transform this elite of knowledge producers with the aim of remedying the country’s healthcare, perceived as being in crisis. My ethnography centres on the University of the Witwatersrand (Wits), specifically its School of Clinical Medicine, its associated teaching hospitals, and its attempts to grow a so-called culture of research among doctors. It is a reflection on the relationship between clinical practice and knowledge production at the intersection of resource-insecure public hospital and research-intensive university — both powerful state institutions with competing demands for doctors. Drawing on interviews and participant-observation I describe and analyse the aspiration, contestation, contingency, and actual work of research production among local clinicians. Overall this thesis indicates that the resource-insecure context in which clinicians produce knowledge creates the opportunity for and the value of their research. But this context simultaneously limits the scale, translation, and social good of their research, undermines the valour and expertise of clinician-researchers, and in cases bifurcates their knowledge production from their clinical experiences. This undercuts the pervasive imaginary of doctors’ clinical insights as fundamentally valuable to clinical research; and the potential of their research to improve healthcare for a population with a unique demographic and epidemiology by providing locally-embedded evidence for best practice, rather than relying on research from the global north. My evidence also indicates that publicly claimed professional aspiration to create a more inclusive democratic scientific community of doctors sits in tension with the often unacknowledged professional privilege many doctors have in the dispersed labour of research and does not fully reflect the unequal professional experiences and engagement that research doctors have in relation to gender, race, language, and locality. I argue that attempts to build a culture of research in clinical medicine sit uneasily within its larger institutional structures and historical context. My ethnography of “studying up” is relatively uncommon in South African anthropology. But I demonstrate that profession is a useful lens through which to study the relationship between power, knowledge, and human suffering, including the brutalisation of professionals, in post-apartheid institutional life. The thesis also highlights the personal and epistemological challenges of doing interpretivist research among a professionally-privileged, research-literate community that places great value on instrumental knowledge production.Item Policing sex an ethnographic study of the policing of sex workers in Johannesburg(2017) Thusi, I IndiaBy adopting a legal ethnographic methodology, this dissertation examines the everyday policing of sex work in Johannesburg, South Africa. Sex work is difficult to regulate and is at the literal and figurative margins of proper society, where legality and illegality often blur into one another. The policing of sex work in Johannesburg, South Africa, straddles the line between formal and informal. On the streets, police often appear to be acting in an informal and ad hoc manner. However, high-level organisational directives intended to regulate the police’s obligations and duties toward sex workers also influence police action, and tilt the exercise of discretion to the formal. These obligations themselves reflect the tension between the law and human rights: police must respect the human rights of sex workers, but they also must enforce the laws of the country. Sex work is illegal, but it is also time-consuming to regulate and difficult to prove that a sex work transaction has occurred. Sex work involves activity that occurs in private transactions in spaces that are ordinarily private in nature. But the illegality of sex work make it a matter of public concern. Meanwhile, discourses and attitudes about sex workers themselves inform how the law is interpreted and enforced, reflecting the fluidity between the formal and informal, and the legal and social. Popular discourses about sex workers’ hygiene, impact on public health, and proclivities to upset public order all inform how the police approach them. In this liminal space, this study considers how sex work is policed and how it should be policed. How do discourses about sexuality and gender informally police sex workers, and in turn inform how they are formally policed by the police organization? What is the current relationship between the police organization and sex workers in Johannesburg? These two ethnographic questions about the nature of sex work provide the foundation for determining how sex work should be policed. This study reveals that there is the possibility of negotiation between police and sex workers, which can provide provisional security for sex workers through police protection, and this relationship is often formulated in a human rights language, adopting legal language and terms. However, it is never a lasting security because it is unregulated, and police ‘greed,’ the structural effect of working for an institution that is perceived to be underfunded, can tilt things very quickly. Thus, the law is not the primary issue in the policing of sex workers; these other practices which remain despite changes in the law and are informed by popular discourses and competing rationales, constitute the everyday practices, norms, and understandings that influence the policing of sex workers.Item Sandton: a linguistic ethnography of small stories in a site of luxury(2018) Kelleher, WilliamThis is a linguistic ethnography that focuses on small stories (Bamberg and Georgakopoulou 2008, De Fina 2009, De Fina and Georgakopoulou 2015, Georgakopoulou 2006a and 2006b, 2008, 2014) within Bucholtz and Hall’s (2005) approach to identity and interaction. These two intersecting theoretical scaffoldings are completed by a geosemiotic approach (Scollon and Scollon 2003) to the discursive environment. The research therefore studies narrative interactions within communities of practice (Eckert and McConnell-Ginet 1992, 2007) across the spaces and fields of the research site of Sandton, Johannesburg; investigating both participant behaviour and discursive environment, in particular with respect to the semiotic landscape. It is a ‘new’ ethnography in that its aim is to better understand the new spaces of South Africa’s cities (Duff 2014). Methodologically the narrative interactions of participants are plotted onto the space of Sandton using GIS technology. This allows attention to be brought to the trajectories of participants and thus to change in interactive style, role and behaviour as participants enter, remain within and leave the site. Three principles of identity and interaction are explored and unpacked in depth for this linguistic ethnography: emergence, positionality and relationality. In addition to a focus on the site itself and its socio-historic processes, this thesis examines the trajectories across the space of the site, institutional discourse and practice through four emblematic companies and, finally, the ‘Born Free’ or ‘millenial’ participants. Through the different participants the research seeks to give an account of the subjectivities and understandings that will be relevant to the present, and future, of the site, and of the country. Axes of investigation are emergence of identity work, masculinity, religion, modernity, codeswitching, positionality with respect to macro, meso and micro discourses and interaction, and tactics of intersubjectivity (Bucholtz and Hall 2004b).