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The gaps in the gaze in South African hospitals

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  • Gibson, Diana

Abstract

Analysis of health care systems, especially hospitals, could benefit from Foucault's description of the medical gaze and the panopticon. Foucault's perspective sheds new light on the South African transformation from an oppressive to a more democratic State and is played out in particular ways in hospital settings. Analyses of the South African health care system and its interface with patients in hospitals seldom draw on the work of Foucault, despite its pertinent description of the diffuse and insidious forms of social surveillance (the 'gaze') and processes of 'normalization' brought about in panoptical settings. The gaze has become a metaphor for the processes whereby disciplinary 'technologies', together with the emergence of a normative social science, discipline both the mind and body of the individual, as in my example of a medicalised institutional setting. Transformation from an oppressive State system to a democratic South Africa has impacted in particular ways on the hospital setting. Instead of being subject to the constant surveillance of the gaze of the State or of medicine, there are numerous instances where patients to all intents become 'invisible', and end up beyond its perimeters. In the hospital, as in the heterogeneous South African community, there is a continuous process of adjustment, with patients, services and staff being rotated in an attempt to provide redress and equal access to health services for all. A large, long-standing lack of funds forces the medical staff to make decisions as to who should get access to beds and to optimal care, and this permeates the everyday experience of institutionalisation and care-giving. It also militates against neutral policy objectives, consistent surveillance or a homogenised system of care.

Suggested Citation

  • Gibson, Diana, 2004. "The gaps in the gaze in South African hospitals," Social Science & Medicine, Elsevier, vol. 59(10), pages 2013-2024, November.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:10:p:2013-2024
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    Cited by:

    1. Gabriela Lotta & Roberto Pires & Michael Hill & Marie Ostergaard Møller, 2022. "Recontextualizing street‐level bureaucracy in the developing world," Public Administration & Development, Blackwell Publishing, vol. 42(1), pages 3-10, February.
    2. Evans, Joshua D. & Crooks, Valorie A. & Kingsbury, Paul T., 2009. "Theoretical injections: On the therapeutic aesthetics of medical spaces," Social Science & Medicine, Elsevier, vol. 69(5), pages 716-721, September.
    3. Deumert, Ana, 2010. "'It would be nice if they could give us more language' - Serving South Africa's multilingual patient base," Social Science & Medicine, Elsevier, vol. 71(1), pages 53-61, July.
    4. Sergio A. Campos & Rik Peeters, 2022. "Policy improvisation: How frontline workers cope with public service gaps in developing countries—The case of Mexico's Prospera program," Public Administration & Development, Blackwell Publishing, vol. 42(1), pages 22-32, February.
    5. Natasha Khamisa & Brian Oldenburg & Karl Peltzer & Dragan Ilic, 2015. "Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses," IJERPH, MDPI, vol. 12(1), pages 1-15, January.
    6. Kelly, Gabrielle, 2017. "Patient agency and contested notions of disability in social assistance applications in South Africa," Social Science & Medicine, Elsevier, vol. 175(C), pages 109-116.
    7. Sarah Shelmerdine, 2017. "Pathways to Inhumane Care: Masculinity and Violence in a South African Emergency Unit," SAGE Open, , vol. 7(3), pages 21582440177, September.
    8. d'Alessandro, Eugénie, 2015. "Human activities and microbial geographies. An anthropological approach to the risk of infections in West African hospitals," Social Science & Medicine, Elsevier, vol. 136, pages 64-72.

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