CHRONIC ILLNESS AND THE URBAN HEALTHWORLD: A SOWETAN CASE STUDY

The sociology of health and illness recognises that illness is both a biological and a social phenomenon, requiring both technically competent healthcare as well as social and interpersonal meaning. The dual nature of illness is thought to underlie the observed phenomena of the combined use of different healthcare practices that develop illness narratives as well as treat the illness. In this article we describe the social nature of chronic illness and healthcare access by narrative enquiry and healthworld explication. We explore the narratives of 12 women with chronic illness residing in Soweto, South Africa, employing a qualitative methodology with serial interviews. The interviews focus on concepts of disease causation, treatment and coping. The findings describe a complex pattern of encountering chronic illness and accessing healthcare. Individual, familial, and social relations, including relations with Western biomedical healthcare, were intertwined in narrations regarding the development of chronic illness. The examination of diseased conditions by means of the healthworld locates the experience of disease within a social and autobiographical context, and focuses on the interaction between participants and healthcare systems. Narratives preserve biographical continuity in the face of biographical disruptions such as chronic illness, suggesting that a complete definition of healthcare access must address the concomitant search for meaning by individuals with chronic illness.