Community health workers as cultural producers in addressing gender-based violence in rural South Africa

ABSTRACT

South Africa has been experiencing an epidemic of gender-based violence (GBV) for a long time and in some rural communities health workers, who are trained to care for those infected with HIV, are positioned at the forefront of addressing this problem, often without the necessary support. In this article, we pose the question: How might cultural production through media making with community health workers (CHWs) contribute to taking action to address GBV and contribute to social change in a rural community? This qualitative participatory arts-based study with five female CHWs working from a clinic in a rural district of South Africa is positioned as critical research, using photographs in the production of media posters. We offer a close reading of the data and its production and discuss three data moments: CHWs drawing on insider cultural knowledge; CHWs constructing messages; and CHWs taking action. In our discussion, we take up the issue of cultural production and then offer concluding thoughts on ‘beyond engagement’ when the researchers leave the community.

KEYWORDS:

• Community health workers
• cultural production
• gender-based violence
• rural community
• South Africa

ORCID

Naydene de Lange http://orcid.org/0000-0001-5660-6317

Claudia Mitchell http://orcid.org/0000-0002-9790-2486

Notes

1. In 2004 there were an estimated 40,000 lay health workers working in South Africa National Department of Health (NDoH) contributing to primary health care (Schneider et al., 2008). Schneider and Lehmann (2010) indicated that the NDoH estimated that the number of CHWs had risen to more than 65,000 in 2008. A new framework, Primary Healthcare Re-engineering Framework in South Africa proposes that each CHW would take responsibility for 250 households (Hospice Palliative Care Association of South Africa, 2012) – clearly a considerable workload.

2. Along with the rollout of antiretroviral (ARV) drugs in most segments of the country, new legislation and the Primary Healthcare Re-engineering Framework in South Africa (Paulus, 2013) have shifted CHWs’ work from offering palliative care to patients dying from AIDS to delivering frontline treatment (Storer, 2013).

3. A local teacher, a woman who had participated in our projects over several years, co-facilitated and translated the English for the CHWs, and the isiZulu for us.

4. We highlight this because of the types of criticisms that have been levelled against loveLife’s HIV and AIDS messages (Robbins, 2010) as being too urban and slick and often irrelevant to rural audiences.

Additional information

Funding

This work was supported by the South African National Research Foundation [grant number 78783].