Images of Palliative Care in Tanzania – A Hospital-Ethnography in a Cancer Clinic in Dar es Salaam
Through rapid demographic transition NCDs have recently received attention in Sub-Saharan Africa. Among those cancer stands out with the highest mortality and fastest deterioration of patients, especially where screening examinations are scarce and the diagnosis is often only made in advanced stages. Unlike most studies about cancer prevention and disease control, this PhD research project focuses on what comes beyond all that, where cure is no longer an option. What are the Tanzanian concepts of end-of-life care for cancer patients and how is it provided and performed?
The ethnographic study took place in Tanzania’s only specialized cancer hospital and its patients’ urban homes in Dar es Salaam, for a total of twelve months between 2012 and 2015. It depicts the role of end-of-life care in a hospital environment where cure and prevention is the first and almost only priority. PC seems a luxury as most of the patients are dying anyway and financial and human resources are needed elsewhere. The research project is intended to show how and in what extent professional and private care is provided and realized – in the hospital and also at home. Since cancer doesn’t particularly affect the weak or old, but also hits businessmen, or women who make their families living on the fields, it severely affects whole families all over the country. Long distances between most family homes and the cancer hospital enhances special role and necessity of professional care givers, because of the absence of relatives. Hence, all aspects of PC as a holistic care approach for patients and their relatives, including different kinds of physical, emotional, spiritual and geographical requirements, are part of this consideration. The research study tries to capture individual stories of cancer patients and to embed them in a broader context of Palliative Care and cancer treatment in Tanzania.
Andrea Buhl is PhD student at the Institute of Social Anthropology and part of the Medical Anthropology Research Group (MARG) at the University of Basel. Since 2012 she is working on her PhD project, supervised by Prof. Brigit Obrist since 2013. In 2013 she was part of the PhD program in International Health at Ludwig-Maximilians University (LMU) in Munich, Germany. Andrea studied Social and Cultural Anthropology, Intercultural Communication and Sociology (M.A. 2012) at LMU. With her PhD project she is also attached to the Interdisciplinary Center for Palliative Care in Munich. Andrea is working as an assistant in the Sustainable Development at University Program at the University of Basel and MARG coordinator. Her PhD is currently funded by the University of Basel Forschungsfond.