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The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre
This is an ethnographic study which seeks to understand the functioning of a Western Cape primary health care facility, the Hanover Park Community Health Centre, in terms of the space it occupies, transforms and utilises. The study aims to demonstrate that space as an object of inquiry may provide v...
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| Format: | Thesis |
| Language: | English |
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Department of Psychology
2023
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| _version_ | 1867613286018580480 |
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| access_status_str | Open Access |
| author | Muller, Lauren Elizabeth |
| author2 | Swartz, Sally |
| author_browse | Muller, Lauren Elizabeth Swartz, Sally |
| author_facet | Swartz, Sally Muller, Lauren Elizabeth |
| author_sort | Muller, Lauren Elizabeth |
| collection | Thesis |
| description | This is an ethnographic study which seeks to understand the functioning of a Western Cape primary health care facility, the Hanover Park Community Health Centre, in terms of the space it occupies, transforms and utilises. The study aims to demonstrate that space as an object of inquiry may provide valuable insights into the structuring and interpreting of clinical activity and identity. Fieldwork was undertaken at the community health centre and varied forms of data gathering were used to reflexively observe the manner in which the CHC's space was planned, used and interpreted by staff, and to a lesser extent, patients. Space was understood and examined in the following ways: a) Disciplined and ordered space as an intrinsic component of modem biomedical functioning; b) The role and interpretation of multiple spaces within the staff's cultural construction of the clinic, c) The orthodox and unorthodox use of space as a strategic resource in a context of gang violence and health service crisis. The architectural design of the clinic was analysed in terms of the international criteria and logic for PHC facility design. Unique local features were understood as socially and political contingent. Spatial disorder and insecurity was demonstrated to impact directly upon clinical functioning and social identity. Current changes in health policy, service deterioration and community conflict have amplified staff's anxieties regarding real and metaphoric clinic boundaries and integrity. Staff and patients sought to appropriate and reinterpret spaces as a strategy of power and authority. The Trauma Unit was examined as a particularly vulnerable site where unorthodox forms of power were taken up by staff and patients in a performance facilitated by the uniquely public and chaotic nature of this clinical space. The study concludes practically by stressing the necessity of ·a spatial understanding in health service management and policy development. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/38451 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:43.673Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Department of Psychology |
| publisherStr | Department of Psychology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/38451 The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre Muller, Lauren Elizabeth Swartz, Sally Clinical Psychology This is an ethnographic study which seeks to understand the functioning of a Western Cape primary health care facility, the Hanover Park Community Health Centre, in terms of the space it occupies, transforms and utilises. The study aims to demonstrate that space as an object of inquiry may provide valuable insights into the structuring and interpreting of clinical activity and identity. Fieldwork was undertaken at the community health centre and varied forms of data gathering were used to reflexively observe the manner in which the CHC's space was planned, used and interpreted by staff, and to a lesser extent, patients. Space was understood and examined in the following ways: a) Disciplined and ordered space as an intrinsic component of modem biomedical functioning; b) The role and interpretation of multiple spaces within the staff's cultural construction of the clinic, c) The orthodox and unorthodox use of space as a strategic resource in a context of gang violence and health service crisis. The architectural design of the clinic was analysed in terms of the international criteria and logic for PHC facility design. Unique local features were understood as socially and political contingent. Spatial disorder and insecurity was demonstrated to impact directly upon clinical functioning and social identity. Current changes in health policy, service deterioration and community conflict have amplified staff's anxieties regarding real and metaphoric clinic boundaries and integrity. Staff and patients sought to appropriate and reinterpret spaces as a strategy of power and authority. The Trauma Unit was examined as a particularly vulnerable site where unorthodox forms of power were taken up by staff and patients in a performance facilitated by the uniquely public and chaotic nature of this clinical space. The study concludes practically by stressing the necessity of ·a spatial understanding in health service management and policy development. 2023-09-07T17:57:19Z 2023-09-07T17:57:19Z 1999 2023-09-07T17:56:58Z Master Thesis Masters MA http://hdl.handle.net/11427/38451 eng application/pdf Department of Psychology Faculty of Humanities |
| spellingShingle | Clinical Psychology Muller, Lauren Elizabeth The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre |
| thesis_degree_str | Master's |
| title | The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre |
| title_full | The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre |
| title_fullStr | The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre |
| title_full_unstemmed | The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre |
| title_short | The geography of the clinic: spatial form, meaning and practice at a Western Cape community health centre |
| title_sort | geography of the clinic spatial form meaning and practice at a western cape community health centre |
| topic | Clinical Psychology |
| url | http://hdl.handle.net/11427/38451 |
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