A stroke of misfortune: Cultural interpretations of aphasia in South Africa

Abstract

Background: Cultural perspectives about illness influence the experience of illness and disability, shaping the nature of both formal and lay care. However, very little has been written about cultural understandings of aphasia despite a renewed focus on contextual influences. Methods from anthropology have the potential to improve our understanding of this condition.

Aims: In this paper we explore understandings of stroke and aphasia in a South African township. We describe how stroke and aphasia is presented and understood by people living in this community, particularly those living with aphasia, their family members, and healthcare workers, and provide examples of how these individuals account for the sudden and long term consequences of stroke.

Methods & Procedures: Data are drawn from a broader ethnographic study of the social and cultural experience of aphasia in South Africa that involved a 3-year period of intermittent fieldwork in a township community on the outskirts of Cape Town. Participant observation of the everyday life of a group of five adults living with aphasia and interviews with participants, kin, and healthcare workers was carried out in various settings including homes, clinics, and an adult day care centre.

Results & Outcomes: The main result of this study was that causation emerged as an important discussion topic for people living with aphasia as well as for carers and health workers. These discussions were not limited to the search for a biomedical understanding, but reflected multifactorial understandings that were linked to cultural frameworks as well as daily circumstances and social realities.

Conclusions: Aphasia is experienced in a sociocultural context. Thus there is theoretical and clinical relevance in using anthropology to explore the world of the adult living with aphasia.

Keywords:

• Aphasia
• Cultural interpretations
• South Africa