This article works with the assumption that Practical Theology requires involvement at grassroots level. The narrative approach to pastoral care offers certain possibilities, by means of Participatory Action Research, for setting foot on grassroots level together with research participants. In this case, the research participants are children infected or affected by HIV / AIDS. Initial expectations were that children infected or affected by HIV / AIDS would be particularly defenceless against violence. The research in two comparative, traditional black suburbs confirms that it is not HIV / AIDS, in the first place, but poverty, which leaves children defenceless against various forms of violence. Proposals are made about taking a stance and about the role of the church as an alternative community.
Black women in previously disadvantaged communities in South Africa carry the burden of triple oppression: (a) the social engineering policies synonymous with apartheid have marginalised women economically and socially; (b) patriarchy, embedded in cultural and religious discourses, has rendered women voiceless and powerless and (c) HIV/AIDS targets the most vulnerable: women and children. The authors describe a research experience in Atteridgeville, a historically disadvantaged community in South Africa, with a family of women infected and/or affected by HIV/AIDS, about their experiences of care and or the lack thereof. A narrative approach offers useful ideas to facilitate a process in which African women in historically challenged communities can speak out about their experiences of care and or the lack of care.
To describe the spectrum of primary immunodeficiency diseases (PIDs) diagnosed at Red Cross War Memorial Children's Hospital.Retrospective, descriptive study.Tertiary, referral hospital.All patients investigated by the immunology service because of suspected PIDs, between January 1983 and December 1996.Review of immunology service database and hospital case records.During the 14-year review period, 515 patients were investigated, a mean of 36.8 new patients per annum. Ninety-three patients with PIDs were diagnosed, a mean of 6.6 new patients per annum. The spectrum of PIDs was similar to that reported in developed countries. As in other series, antibody deficiencies predominated, accounting for 56% (52/93) of diagnoses. The male/female ratio was 1.5:1; 73% (62/85) came from the Western Cape, the remaining 27% (23/85) resided in five other provinces. Eighty per cent (70/87) presented with recurrent or atypical infection, with or without failure to thrive. Sinopulmonary infections (80%), diarrhoeal disease (19%) and candidiasis (18%) were the most common preceding infections. By the age of 5 years, only 60% had been diagnosed, compared with about 80% in developed countries. During the study period, 20% (19/93) were known to have died.The results show a pattern of PIDs incidence similar to that in developed countries. Diagnosis was delayed in many patients, which probably contributed to morbidity. To facilitate earlier diagnosis and to improve outcome, children should be considered for an immunological assessment if they exhibit increased susceptibility to infection.
Black women in previously disadvantaged communities
in South Africa carry the burden of triple oppression: (a)
the social engineering policies synonymous with apartheid
have marginalised women economically and socially;
(b) patriarchy, embedded in cultural and religious
discourses, has rendered women voiceless and powerless
and (c) HIV / AIDS targets the most vulnerable:
women and children. Not only are women carrying the
brunt of HIV infections, but they also carry the extra
burden of caring for the sick and the orphaned. The writer wants to ensure that she does not victimise
the family of women in her research experience in any
way, compounding their burdens. It is paramount for the
writer that ethical considerations should be at the core of
research with African women in previously disadvantaged
communities, infected and / or affected by HIV / AIDS. The writer discusses some of the ethical elements of the
theology and research methodology within which she
positions herself. As a narrative researcher, she argues
positions herself. As a narrative researcher, she argues
that the regulative principles that apply to traditional
research methods are limited when applied to narrative
research. She then proceeds with a description of her
research experience in a day with the Ubisi family, a
family of women infected and affected by AIDS. She
continues by writing from this experience, sharing a few
of the ethical dilemmas that she had faced during that
day and how she came to terms with them.
The COVID-19 pandemic and responses by governments, including lockdowns, have had various consequences for lives and livelihoods. South Africa (SA) was one of the countries that implemented severely restrictive lockdowns to reduce transmission and limit the number of patients requiring hospitalisation. These interventions have had mixed consequences for routine health services.To assess the impact of COVID-19 and restrictions imposed to limit viral transmission on routine health services in SA.Data routinely collected via the District Health Information System in 2019 and 2020 were analysed to assess the impact of the COVID-19 pandemic.Access to public health services between March 2020 and December 2020 was limited in all provinces. However, this was not linear, i.e. not all services in all provinces were similarly affected. Services most severely affected were antenatal visits before 20 weeks, access to contraceptives, and HIV and TB testing. The impact on outcomes was also noticeable, with a measurable effect on maternal and neonatal mortality.The responses to the COVID-19 pandemic, including different levels of lockdowns, the limitation of health services, lack of staff as a result of COVID-19 infection, and fear and stigma, resulted in a reduction in access to routine health services. However, the picture varies by type of service, province and district, with some faring worse than others. It is important to ensure that routine services are not significantly affected during future COVID-19 waves. This will require careful planning on the part of service providers and optimal communication with patients and communities.
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