Browsing by Author "Abrams, Amber"

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    Open Access
    An Inquiry Into the Diverse Modes of Caring in Khayelitsha Wetlands Parks World of Many Worlds
    (2023) Sibango, Asemahle; Solomon, Nikiwe; Abrams, Amber
    The management and governance of wetlands in Cape Town is largely informed by economic, techno-scientific, and engineering approaches which are deeply rooted in discourses of “Earth mastery”. Earth mastery aims to command, predict, and control the Earth's natural processes to access ecosystem services to benefit humans. When wetland management is solely informed by logics of domination and extraction for humans, then other ways of knowing, being, being with, and caring for spaces such as the Khayelitsha Wetlands Park (KWP) are often overlooked and overshadowed. Using Maria Puig de la Bellacasa's (2011:90) work on ‘Matters of Care in Technoscience' where the notion of care is viewed as “an affective state, a material vital doing, and an ethico-political obligation”, this thesis draws attention to meanings, practices, and enactment of care through thinking with people and the more-than-human worlds in the KWP. Based on eight months of research in the KWP which involved looking at this space's associated landscapes and multispecies communities, this thesis explores ways of living with and relating to the KWP in Cape Town, South Africa, which do not subscribe to logics of domination. This is done by highlighting the often overshadowed and taken for granted forms of care and reciprocity that do not fall into the realm of the “advanced”, “technical”, and “objective” approaches in techno-scientific and engineering practices. In this thesis, I argue that people who live with urban wetlands practise their more-than-techno-scientific approaches and versions of care in these spaces. The evidence basis for these more-than-techno-scientific and more-than-engineering approaches of care are drawn from firstly, people's stories and experiences of relating to and living with the KWP and secondly, an analysis of care, coexistence, and co-becoming among more-than-human species in KWP. This thesis then suggests the importance of deconstructing and queering the understandings of care practices in wetland spaces by arguing that the government and institutions responsible for wetlands could draw on decolonial approaches in managing and practising care in these spaces, shifting from logics of control and domination to relational and historicised interactions with wetlands to address environmental injustices of the past and of the present. Queer theory is often associated with gender and sexuality where it means diverging from what is normalised, for instance, understanding that there are other ways of being outside heteronormative binaries. For this thesis I conceive queering beyond the context of gender and sexuality, for instance, I suggest the importance of being aware that KWP and wetlands in general host multiple worlds. Thus, governmental approaches of managing and caring for these waterbodies should not only conform to the techno-scientific and engineering notions of care. I suggest that these governmental approaches should be democratized and open a space to be informed by citizen science as well. They should understand that their approaches should not be a “one size fits all” as modes of being and of living differ from space to space. This thesis therefore uses the concept of queering as a way to suggest that techno-scientific governmental approaches of caring for wetlands must recognize the efforts of care that are practised by people and multispecies who live with these waterbodies and to start co-existing with them instead of overlooking and overshadowing them. This thesis, drew from the environmental humanities, environmental anthropology, and queer conceptual and theoretical schools of thought to achieve its purpose. 
  • Thumbnail Image
    Item
    Open Access
    Engaging adolescents in TB and clinical trial research through drama
    (BioMed Central, 2016-04-01) Schmidt, Bey-Marrie
    Abstract Background: The South African Tuberculosis Vaccine Initiative is based in Worcester where tuberculosis (TB) is endemic, and incidence rates are amongst the highest nationally. In high TB burden settings after an early childhood peak, incidence rates start to rise again in adolescents, therefore they are an important target group for tuberculosis vaccine research. In 2012, learners from a local school developed a one-off theatrical production out of an educational comic book Carina’s Choice, developed by the South African Tuberculosis Vaccine Initiative in 2010. A Wellcome Trust International Engagement grant allowed for this one-off production to be further developed, with input from university students and staff, and rolled out to schools in the Worcester area as an engagement and education intervention. Methods: Focus group feedback was used to identify key messages and to develop the play’s script. Qualitative methods were used to collect and analyse relevant data. Interviews were conducted with learner-actors, pre- and post-focus group feedback was obtained from a sample of school-going adolescents, and pre- and post-questionnaires were administered to adolescent audience members. Results: From the pre-drama focus group discussions, topics such as TB symptoms, stigma and transmission were identified as areas that needed attention. After the performances, adolescents showed improved knowledge on the identified topics and they discussed TB prevention measures. They highlighted transmission of TB during pregnancy as a further topic to be addressed in future iterations of the drama. Although stigma is a difficult phenomenon to interpret, post-drama participants understood that TB transmission could occur in all individuals. Learner-actors agreed with focus group participants that the play could impact the wider community if it were rolled out. Feedback from the South African Tuberculosis Vaccine Initiative staff verified that recruitment for an upcoming trial was facilitated by the preparedness that the play provided in recruitment areas. The study showed that before and after evaluations provide data on the usefulness of the play as an education tool. Conclusions: Theatre, presented and motivated by adolescent peers, can raise awareness of TB, and assist clinical trial preparedness and further engagement between trial staff and their trial community.
  • Thumbnail Image
    Item
    Open Access
    From care inside the laboratory to the world beyond it: a multispecies ethnography of TB science towards growing a decolonised science in South Africa
    (2022) Shain, Chloë-Sarah; Abrams, Amber; Macdonald, Helen
    This anthropological research began with curiosity about human relationships with microbes. Inside the contained environment of a Biosafety Level 3 laboratory at a South African university-based tuberculosis research division, the fieldwork focused on the relationships between scientists and Mycobacterium tuberculosis − the pathogenic bacterium that causes the disease tuberculosis (TB). These deadly bacteria were cared for and nurtured by women scientists. This care extended to the cells and various species with which they worked. Moreover, this care moved beyond the scope of their immediate scientific research projects and well beyond the laboratory. Care was also central to how the participants conducted their scientific research and themselves in the world. This long-term, qualitative ethnographic research weaves together many layers of care in biomedical scientific research, highlighting that scientific research is a deeply personal, caring and subjective practice. The natural and the social are not − and can never be − mutually exclusive. Boundaries between mind/body, subject/object, human/nonhuman, researcher/researched, subjectivity/objectivity and science/society are porous. Acutely aware of the socio-political moment in which this research was embedded, these findings are put into conversation with South African student calls to decolonise science that emerged alongside the #RhodesMustFall student movement. In particular, the focus is on a 2016 meeting about decolonising science at the University of Cape Town where students argued for connection between the university and the community, science and society and the world of academia and the world of Africans. Implicit was the need for science to be relevant to Africans and deeply complex African social formations and problems. The care by women scientists that was observed inside the laboratory and beyond it speaks volumes to cultivating a more caring science and caring institutions of science that connect the laboratory to the world in which it exists in meaningful, relevant and impactful ways. I demonstrate how the participants embodied a decolonised science, and that what they cared about and how they acted upon those cares could serve as important guides for decolonising science and scientific institutions. This research provides important contributions to the field of science and technology studies (STS), to anthropological research on TB and to the conversation on decolonising science in South Africa.
  • Thumbnail Image
    Item
    Open Access
    National stakeholders’ perceptions of the processes that inform the development of national clinical practice guidelines for primary healthcare in South Africa
    (BioMed Central, 2018-07-31) Kredo, Tamara; Cooper, Sara; Abrams, Amber; Daniels, Karen; Volmink, Jimmy; Atkins, Salla
    Background There is increased international focus on improving the rigour of clinical practice guideline (CPG) development practices. However, few empirical studies on CPG development have been conducted in low- and middle-income countries. This paper explores national stakeholders’ perceptions of processes informing CPG development for primary healthcare in South Africa, focusing on both their aspirations and views of what is actually occurring. Methods A qualitative study design was employed including individual interviews with 37 South African primary care CPG development role-players. Participants represented various disciplines, sectors and provinces. The data were analysed through thematic analysis and an interpretivist conceptual framework. Results Strongly reflecting current international standards, participants identified six ‘aspirational’ processes that they thought should inform South African CPG development, as follows: (1) evidence; (2) stakeholder consultation; (3) transparency; (4) management of interests; (5) communication/co-ordination between CPG development groups; and (6) fit-for-context. While perceptions of a transition towards more robust processes was common, CPG development was seen to face ongoing challenges with regards to all six aspirational processes. Many challenges were attributed to inadequate financial and human resources, which were perceived to hinder capacity to undertake the necessary methodological work, respond to stakeholders’ feedback, and document and share decision-making processes. Challenges were also linked to a complex web of politics, power and interests. The CPG development arena was described as saturated with personal and financial interests, groups competing for authority over specific territories and unequal power dynamics which favour those with the time, resources and authority to make contributions. These were all perceived to affect efforts for transparency, collaboration and inclusivity in CPG development. Conclusion While there is strong commitment amongst national stakeholders to advance CPG development processes, a mix of values, politics, power and capacity constraints pose significant challenges. Contrasting perspectives regarding managing interests and how best to adapt to within-country contexts requires further exploration. Dedicated resources for CPG development, standardised systems for managing conflicting interests, and the development of a political environment that fosters collaboration and more equitable inclusion within and between CPG development groups are needed. These initiatives may enhance CPG quality and acceptability, with associated positive impact on patient care.
  • Thumbnail Image
    Item
    Open Access
    Perceptual change through transnational experience : American exchange students and HIV/AIDS
    (2008) Abrams, Amber; Levine, Susan
    This thesis considers the power of United States popular media to construct both conceptions of "Africa" and knowledge of HN / AIDS among exchange students in Cape Town, South Africa. Arguing that the reification of myths about Africa influenced respondents' arrival stories and initial experiences, I exhibit how being in South Africa produced very different associations, particularly with regard to intimate relationships. Drawing on theoretical work that looks at the tendency to imagine disease as a product of "foreign" or "other" people, and building on respondents' imaginary Africa, the conceptual linking of Africa to AIDS is highlighted in their discussions of expectations. The linking of HN / AIDS to Africa affects respondents decision to study in South Africa, as well as their initial interactions; highlighting the tendency of respondents to describe their motivation for studying in South Africa a result of a sense of "responsibility" they feel to "save" Africans from AIDS. Respondents' urge to "save" is in tension with their initial tendency to distance themselves from HIV / AIDS in Africa through an imaginary matrix of immunity exhibited through rhetorics of difference. Evolving from respondents' motivation to "save," a discussion of "moral tourism" and ''voluntouring'' is explored. The thesis argues that the combination of voluntary services and living in Cape Town has the ability to change perceptions that were previously used as explanation for high levels of contraction rates of HIV / AIDS on the African continent and particularly in sub-Saharan Africa.
  • Thumbnail Image
    Item
    Open Access
    The adverse health effects associated with drought in Africa: working towards developing a vulnerability index
    (2020) Asmall, Taherah; Dalvie, Aqiel; Abrams, Amber
    Africa is uniquely vulnerable to the occurrence of drought. A rise in temperatures over Southern Africa occurs at almost twice that of the global rate. South Africa has begun to experience an increase in the frequency of drought, particularly in the Western and Eastern Cape. Droughts are associated with several health effects. The direct and indirect risks of climate change to human health have become a global concern. The most recent systematic review available on the adverse health effects associated with drought was published in 2013, and as such, an up-to-date review focusing on Africa is needed to inform a Cape Town specific health vulnerability index. This study aims to provide a review of available research exploring the association between drought and adverse health effects in Africa. The rationale for this study is to provide a solid research foundation from which a drought-specific health vulnerability index for Cape Town can be developed. A narrative review of original studies and published reviews was conducted. An extensive electronic literature search was performed using a combination of keywords, Medical Subject Heading (MeSH) terms and free text words. The Critical Appraisal Toolkit (CAT) was used to assess the quality of included studies. A total of 1922 publications were identified, of which twenty-four articles were included in this review. The main drought-related health effects that emerged were divided into 4 main categories: (1) drought and nutritional health including malnutrition, poor childhood health outcomes (wasting, stunting and underweight), mortality, anaemia, and nutritionrelated disability; (2) drought and food consumption including micronutrient deficiencies and motor neuron diseases; (3) drought and water-borne, water-washed and water- related diseases including cholera outbreaks, diarrhoeal diseases, protozoa parasite transmission, scabies outbreaks, trachoma, vector-borne disease outbreaks and malaria-related mortality; and (4) drought and health behaviours including health perceptions and health-seeking behaviours, HIV prevention and care behaviours and family planning practices. There was generally limited evidence in all health categories with several limitations. These limitations include studies with methodological weaknesses (e.g. a lack of comparison to a non-drought period), the singularity of published studies on health effects associated with drought and studies which did not account for potential confounders. While the evidence from the included studies is limited, this study highlights gaps in literature to encourage further research into understanding the direct and indirect impacts of drought on health, particularly in vulnerable groups. Furthermore, the results of this study emphasized the contextual factors which lower an individual's adaptive capacity and identified key indicators that can be used to begin to develop a broad framework for a vulnerability index
  • Thumbnail Image
    Item
    Open Access
    The Impact of Extreme Weather Events on Mental Health in Africa: A Mixed-Methods Systematic Review
    (2022) Deglon, Michaele; Dalvie, Mohamed Aqiel; Abrams, Amber
    Introduction: The psychosocial impacts of extreme weather events are contributing to the burden of mental illness, exacerbated by pre-existing vulnerabilities. Despite an emerging global interest in this association, Africa remains poorly represented in the literature. Methods: A mixed-methods systematic review of peer-reviewed studies was conducted to determine the adverse mental health outcomes associated with extreme weather events in Africa (2008-2021). The review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: A total of 12 204 peer-reviewed articles were identified of which 12 were retained for analysis. These studies were all conducted in 8 countries in Sub-Saharan Africa. Adverse mental health outcomes were identified resulting from flood (n=4), drought (n=4), extreme heat (n=1), bushfire (n=1), and multiple events (n=2). Findings included pathological outcomes with predictable symptomatology including mood disorders; trauma- and stressor-related disorders; and suicide. Additionally, conditions indicating psychological distress which were below the pathological threshold including emotion regulation difficulties, disturbed sleep, alcohol use, stress, and anxiety. The quantitative evidence for the association between extreme weather events and mental health was limited primarily by a lack of longitudinal data, exposure gradient, and comparison to an unaffected group, as well as a failure to provide an objective exposure measure. The qualitative evidence for this association was complimentary but without sufficient clinical measurement these outcomes cannot be verified as psychological morbidities. In addition, this review provided insight into the mental health of vulnerable communities affected by extreme weather events including those living in poverty, farmers, pastoralists, women, and children. Conclusion: This review provided some preliminary evidence for the association between extreme weather events and adverse mental health outcomes for populations in Africa. The review also provides insight to vulnerable populations affected by extreme weather events. Future research with stronger designs and methodologies are recommended.