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This paper highlights the embeddedness of xenophobia in institutions through a theoretical but empirically under-researched concept of structural violence. Drawing on in-depth qualitative interview data with refugee women in Gauteng, South Africa, we explore the empirical utility of the concept of structural violence in shaping refugee women's everyday experiences of xenophobia through three analytical themes: (a) unequal access to resources (b) constrained agency and (c) dehumanization. While keeping an empirical grip on experiential narratives on xenophobia, we draw attention to three public institutions that enhance the vulnerability of those already vulnerable: The Department of Home Affairs, The South African Police Service and Public Hospitals. Our paper elucidates how refugee women experience xenophobia and how they manage their "everyday" in these circumstances- an aspect that remains underdeveloped in existing research. [ABSTRACT FROM AUTHOR]

The use of complementary and alternative medicine in the treatment of breast cancer is widely documented in low- and middle-income countries. However, there are limited data on the use of complementary and alternative medicine among breast cancer patients in South Africa. In this study, we examined the use of complementary medicine among a small sample of women attending a breast cancer clinic in a public health hospital in the Western Cape, South Africa; a context in which structural violence is rife. A convenience sample of 17 women participated in semi-structured interviews. We used an interpretative phenomenological analysis approach. We found that breast cancer patients’ use of complementary and alternative medicine was motivated by (1) pragmatic reasons related to health system delays in obtaining biopsy results, confirmation of diagnosis and between diagnosis and start of treatment, (2) psychological benefits, namely, enhancing holistic well-being and fostering a sense of hope and agency despite the physical disease, and (3) sociocultural influences. Such information was based on folk knowledge and cultural beliefs. Patient-centred care in this context may be enhanced by collaboration between biomedical and practitioners who provide complementary and alternative medicine to support transparency in patient treatment options, negotiate the various domains of patient care (physical, psychological, sociocultural) and contribute to earlier detection, diagnosis and better treatment outcomes. In addition, further research on the systemic complexities of structural violence and the way in which it shapes the illness experiences of women is necessary. [ABSTRACT FROM AUTHOR]

Introduction. South Africa has an enabling legislative and policy framework that promotes the protection of adolescents and young people's sexual and reproductive health and rights. Much of the literature in this field has identified discriminatory and hostile attitudes from healthcare workers as a major underlying factor to negative sexual and reproductive health outcomes for this age cohort. Not as well understood is the role of structural violence although this type of violence, through its structures of injustice and inequalities, is closely associated with stigma and discrimination. Data and sources. To contribute to closing this research gap, this paper draws on the findings of a larger qualitative study, specifically focus group discussions with young people aged 15–24 years. Results. The consequences of these attitudes within the structural violence framework are illuminated as are recommendations for enhancing access to sexual and reproductive health and services by adolescents and young people. Discussion and conclusion. Key among the latter is that young people's sexual and reproductive health needs and wellbeing should be pursued through a multisectoral approach that encompasses stigma reduction interventions involving the young people, families, and communities collaborating with healthcare workers. [ABSTRACT FROM AUTHOR]

This paper describes the potential that tourism encounters have in disrupting structural violence (conceptualized as silencing and invisibilization) in South Africa. Based on PhotoVoice research undertaken with a small number of residents of three Cape Town-area townships, we consider how residents' descriptions of their encounters with the tourists can be seen as helping to "polish the wounds of the past" as they shared a sense of being seen and heard. We apply the African philosophical lens of Ubuntu, described by one participant as "I am because we are," to consider the role of tourism in promoting peace simultaneously at the individual as well as the collective level. While far from unproblematic, this research finds hope in the ways township tourism is disrupting structural violence, thereby supporting the emancipatory aims of post-apartheid South Africa. [ABSTRACT FROM AUTHOR]

The ways in which rural women living with and/or affected by HIV are portrayed in films can potentially influence how social transformation is imagined, including the extent to which the women can be involved in problem-solving processes. This is because, in addition to conceptualising the problem, such representations often place women in a certain position in relation to, or within, the problematic situation, which in turn influences how solutions are framed. This paper uses a discursive approach to explore the portrayal of South African rural women living with and/or affected by HIV in Darrell Roodt's film, Yesterday (2004), which is set in rural KwaZulu-Natal. It considers how the film deals with the tension between structural violence and rural women's agency in grappling with HIV. Structural violence has a significant impact on the experiences of rural women and, hence, their health outcomes. However, when representing rural women, too heavy an emphasis on structural violence runs the risk of portraying them as passive or helpless victims, thus severely limiting their agency. [ABSTRACT FROM AUTHOR]

An interview with Heidi Grunebaum a scholar, activist, and poet, on her views on identity and citizenship in a global world that is increasingly reproducing systems of violence that it was assumed belonged to humanity's past. Researching the answer of why that is, Grunebaum shares the lessons learned from her personal identity and work moving between Germany, South Africa, and Palestine-Israel. [ABSTRACT FROM AUTHOR]

In 1998, Speak Out on Poverty held hearings across South Africa shortly after the Truth and Reconciliation Commission (TRC) completed eighteen months of highly publicized, nationwide hearings at which victims testified. Speak Out challenged the TRC's focus on overt political violations, seen to occlude forms of structural violence central to apartheid's policy and practice, as well as longer legacies of colonialism. Reading Speak Out alongside the TRC puts pressure on supposed differences between official truth commissions or tribunals and those run by civil society. Discussing Speak Out in relation to the TRC signaled more than a set of comparisons. In a time of transition, Speak Out spoke from within and against the noise of the TRC. It aimed to make poverty and inequality the nation's priority rather than reconciliation, or at least to challenge notions of reconciliation that did not have inequity and poverty at its center. This intention failed to come to fruition, and Speak Out seemed paradoxically inaudible in public debate. In exploring this conundrum, this article considers particular strategic and organizational choices by Speak Out. These shaped the discursive terrain of operations and subjectivities in ways that unintentionally enabled inaudibility and constrained the organizers' transformative intentions. [ABSTRACT FROM AUTHOR]

Abstract: This mixed method study aimed to gather a contextual understanding of the perspectives of young girls in South Africa with regard to transactional sexual interactions between older men and young girls. Two major narratives of the “sugar daddy” phenomenon have dominated the public discourse on the topic. One emphasises the girls' vulnerability and experience of victimisation, whereas the other highlights their role as social agents with control in such interactions. In this study, the participants acknowledged the heterogeneity among partners in such interactions, which suggests that the phenomenon of “sugar daddies” cannot be explained by a simple narrative. The girls' experiences form a continuum based on the degree of their individual control and the extent of their vulnerability in such an interaction. Contextual factors and social norms influence decisions and experiences in these interactions. The study concludes that these relationships form part of the girls' daily experiences of structural violence as well as gender inequality and can be regarded as a symptom of broader societal structures and norms. Quantitative data investigate the mental health status of the participants, whereas an essentialist/realist thematic analysis of qualitative data explores experiences and perceptions of the girls. [ABSTRACT FROM AUTHOR]

In Johannesburg, a city with the largest proportion of South Africa's migrant population, women who sell sex face multiple vulnerabilities including discrimination, criminalisation, and many levels of violence, directed particularly at non-nationals. Drawing from interviews with non-national or cross-border migrant women who sell sex on a regular basis, this paper explores experiences of selling sex, motherhood and 'keeping well' through the lens of the city. Noting that violence against sex workers is often identified at an inter-personal and behavioural level (attacks and abuse from clients, the police and the public), this paper seeks to make more visible the unjust and violent structures and practices of the inner-city, which impact upon and negatively shape the everyday experiences and well-being of migrant women as they sell sex. These include difficulties in accessing basic services such as healthcare and childcare, encountering widespread stigmatisation and the misrepresentation or silencing of certain voices within the sex worker movement. Therefore, questioning the ways in which the city is experienced, and in turn how practices of the city have failed migrant women who sell sex, the paper argues for a broader approach, an approach that recognises the complexities and ambiguities inherent in the lived experiences and multiple identities of migrant women themselves rather than through the frames applied to them whether it be that of sex worker, foreigner or mother. [ABSTRACT FROM AUTHOR]

This article draws on research conducted in Kenya, South Africa, and Zimbabwe that focused on violence in the context of political transition. The paperexaminesthe relation between political transition and sexual and gender-based violence in the three countries. The paper argues that it is critical to recognise sexual and gender-based violence as bound to systemic gendered inequality if such forms of violence are to be addressed and mitigated when periods of violent conflict end. [ABSTRACT FROM PUBLISHER]

This article was presented as the keynote address at the 2012 Anthropology Southern Africa Conference. The theme of the conference was Southern African Anthropological Futures: Opportunities and Constraints, and as such in this piece I consider some of the themes I see emerging in Southern African anthropology, from my position as a nascent practitioner. Specifically, I examine the ethical difficulties raised by the discipline's emphasis upon bringing to light the ways in which ordinary life unfolds in contexts of structural violence. I argue that the employment of an 'ethics of care' in these contexts carries a danger of alterity, but that this can be guarded against in particular ways. Some of these ways emerge in the second theme on which I focus: that of an extension of our approach to 'the field'. I argue that the increasing tendency of anthropologists in southern Africa to study at home, in combination with the increasing tendency to maintain relationships with interlocuters over very extended periods of time, allows for the mobilisation of an ethics of mutuality rather than care. [ABSTRACT FROM AUTHOR]

Crime presents a fundamental challenge in South Africa. Particularly disturbing is the prevalence of violence committed by and against young people. The main purpose of this article is to look at how South Africa should deal with the issue of youth violence. It argues that while structural violence constitutes a significant contextual cause of the phenomenon, a more proximate and specific cause lies in young people’s exposure to direct violence in their schools, homes and communities. In many cases, therefore, simply sending young people to prison – where they may experience even greater levels of violence – is not the answer. This article thus examines the potential merits of restorative justice as a response to the problem of youth violence, focusing particularly on the 2009 Child Justice Act. This research is based on fieldwork in South Africa and draws upon both the author’s qualitative interview data and a range of surveys with young people conducted by the Center for Justice and Crime Prevention in Cape Town. [ABSTRACT FROM AUTHOR]

This paper examines conflict and cooperation between South Africans and Somali spaza shop owners in townships and informal settlements in the context of post-apartheid structural inequities. I argue that Somali and other poor newcomers suffer the same daily insecurity as the majority of the population. However, with the exception of the concerted killings, lootings and displacement of migrants in 2008–2009, this Somali case shows that contact between newcomers and local people is not always antagonistic and that newcomers are not passive victims of violence, but rather engage successfully in both competition and collaboration to cement their presence in these areas. I conclude that violence against migrants is rooted in South Africa's continuing structural violence and communal crisis, a condition characterised by tensions with compatriots as well as with newcomers. To solve the problem, attention must be paid to the persistence of this structural violence in the post-apartheid political dispensation. [ABSTRACT FROM AUTHOR]

Tobacco control must remain a critical global health priority given the growing burden of tobacco-induced disease in the developing world. Insights from the emerging field of global health delivery suggest that tobacco control could be improved through a systematic, granular analysis of the processes through which it is promoted, implemented, and combated. Using this framework, a critical bottleneck to the delivery of proven health promotion emerges in the role that the tobacco industry plays in promoting tobacco use and blocking effective tobacco-control policies. This 'corporate bottleneck' can also be understood as a root cause of massive disease and suffering upon vulnerable populations worldwide, for the goal of maximizing corporate profit. Naming, understanding, and responding to this corporate bottleneck is crucial to the success of tobacco-control policies. Three case studies of tobacco-control policy-South Africa, the Framework Convention on Tobacco Control, and Uruguay-are presented to explore and understand the implications of this analysis. © 2011 Mount Sinai School of Medicine [ABSTRACT FROM AUTHOR]

The aim of the study was to explore the structural conditions and social formations that mediate access to quality education amongst low income children in KwaZulu-Natal. Structural violence can lead to injustices to children such as the experience of hunger, disease, poverty and poor quality of education. A total of 117 students (male = 59; female = 58; age range 8 to 18 years) were drawn from three high schools, five primary schools and a special school in a district of KwaZulu-Natal, South Africa. The study captured the voices of participants through individual interviews and focus group interviews. Data were analyzed thematically. Systemic structural conditions in society such as poverty, lack of resources in schools, poor infrastructure in communities, poorly trained teachers, lack of accountability created barriers to educational access for children from poor backgrounds. [ABSTRACT FROM AUTHOR]

It is now commonly accepted that a range of psychosocial and environmental factors interact with genetic vulnerability in the genesis of psychotic illness. The aim of this study was to investigate whether measures of poverty and income inequality impact upon the treated incidence of first-episode psychosis (FEP) in the District of Umgungundlovu, South Africa. Clinical and demographic data was collected from hospital records on all people aged 15–49 years from the District who presented to psychiatric services with FEP (DSM IV criteria) during 2005 ( n = 160). All incident cases were grouped by municipality according to their recorded address. Measures of poverty and income inequality were calculated for each of the seven municipalities using data from the Statistics SA online database for the National Census 2001. Correlations were performed using SPSS to determine the relationships between treated incidence of FEP and poverty and inequality indices per municipality. There was a significant positive relationship between treated incidence and Inequality Index (Partial correlation coefficient 0.840; P = 0.036) and a non-significant negative relationship between treated incidence and Poverty Measure per municipality (Partial correlation coefficient −0.660; P = 0.154). These findings remained significant after adjusting for gender, age, ethnicity, urbanicity and employment status. Importantly, these results were not adjusted for individual level poverty. These findings lend support, in an African context, to increasing evidence that social, economic and political factors such as poverty and income inequality “shape both the landscape of risk for developing (psychosis) and the context in which health-care is provided” (Kelly in Soc Sci Med 61:721–730, 2005). These complex environmental factors appear to impact on the development and course of psychotic illness. [ABSTRACT FROM AUTHOR]