Family Solidarity and Place as Components of Hospital Provision in Istanbul: The Dependence of Public Healthcare on Culture and the Local Economy

Abstract

In Istanbul, public university hospitals exemplify the importance of urban social networks in the structuring of economic activity. The involvement of patients' families in care-giving on hospital premises is essential to the efficient functioning of the health service. This paper illustrates the vital role of cultural and social factors, especially kinship relations and informal networks, in shaping the urban built environment at the local level. The paper shows how family solidarity is a precondition for the successful functioning of a major city hospital in Istanbul, and how this affects the economic character of the built environment around the hospital. The paper employs a relational approach to highlight to key processes at work.

Acknowledgements

The authors would like to thank to Georges Prevelakis and John Lovering for encouragement with their extensive and constructive remarks on this paper. They also extend their appreciation to Betul Sengezer and Kemal Hepgul for their guiding remarks and to Graeme Mutlu Smith who spent time and effort on improving the linguistic quality of the earlier version of this paper.

Notes

These observations constitute a part of an ongoing research that was started in May 2000.

Women are primarily responsible for care-giving. Yet age, gender, job, marital status, degree of kinship and breastfeeding can affect the division of labour, so male relatives sometimes take the main role. Gender-based differentiation becomes more obvious in the fulfilment of the care-giving duty because, even when care-giving is completely taken over by a male family member, some tasks like cooking, bathing the patient, and doing laundry are still done by female family members.

The daughter of Patient-P was, by tradition, the person primarily responsible for care-giving. Since she was unable to do so, her husband (P's son-in-law) replaced her as long as the care-giving job consisted of errands.

When Patient-P was transferred to the ward it was impossible for the son-in-law to carry on because that location required more ‘female’ tasks like bathing the patient and so forth. The fact that Patient-P had to share the same room with other female patients also necessitated a female caregiver.

This is calculated on responses from 21 firms.