Jana Gerold: Full of Life: old age and care in urban Dar es Salaam, Tanzania

PhD-thesis in Social Anthropology, University of Basel (2013)

“Full of Life” contributes to a growing body of literature discussing care during old age in Africa. This anthropological inquiry with a special focus on medical anthropology was part of the research project “From Cure to Care” led by Dr. Peter van Eeuwijk, PhD supervised by Prof. Dr. Brigit Obrist and funded by the Swiss National Science Foundation (2008-2011).

The research is grounded in 13 months of ethnographic data collection in a poor urban neighbourhood of Dar es Salaam, the largest city of Tanzania. Contradicting clichéd preconceptions of the sedentary elderly, this study reveals surprising mobility patterns amongst elderly people. The first generations of elderly city dwellers live the city along notions of being on the move. Being on the move encompasses three dimensions: physical mobility through actual travel; mediated mobility through virtual connectivity via mobile phones; and immaterial mobility through aspirations – all three criss-crossing and extending beyond the geographic locality of the city.

The main research thrust however addressed care giving for and by older people by focusing on experiences of growing old, meanings of old age and the social interconnectedness of the older generation. The impetus of relational conceptualizations of social life by Norbert Elias guides the analysis, putting to the forefront ‘old age’ as well as ‘care’ as immanently relational analytic as well as emic conceptualizations.
Old age as social category is experienced in relation to other generations, especially to the youth, who doesn’t follow the instructions of the elder generation, as they do not extend helping hands to the aged. In the view of many older persons, their authoritative position is undermined. They are no longer considered as responsible for upbringing, educating and disciplining the younger generation. Furthermore, obliging to norms of how older people should behave, dress, and avoid taboo topics shape the ageing experience. Fear of being ridiculed or even condemned influences not only how the older people participate in public life, but also how they hide or display their love life. These experiences, however, are gendered: Older women tend to hide liaisons from the younger generation while older men are proud to show them off.

In general, however, growing old is experienced with declining competences as notion of loss, with observable physical signs as well as felt symptoms. The loss of strength is expressed in two notions: no strength today or at the moment with the prospect of regaining strength (leo sina nguvu) with the elderly re-arranging their daily activities on an ad hoc basis, and no strength (sina nguvu/kutokuwa na nguvu) referring to persistent decline. Both notions of loss involve others in not only taking over certain activities or assisting/helping (kusaidia), but furthermore in caring and providing support for (kutunza) the sufferer.

In order to make daily life more bearable and to ease suffering, care attains a high value. Mostly family members – and only in very few instances also tenants or neighbours – become important members in the care arrangement of older people. Interestingly, it is not necessarily the people living together that matter in providing care. Living arrangements tend to change in situations where older people experience loss of strength or a sudden health crisis. Such situations entail the mobility of the care giver or the care receiver. Three basic patterns of care arrangements are prominent, two embracing mobility of either the care receiver or the caregiver: Firstly, care giver and care receiver living together; secondly, caregiver coming to the house of the care receiver; and lastly, care receiver moving to the house of the care giver. Generally, these three patterns were neither exclusive nor static arrangements, but varied or were sometimes combined, with two arrangements involving mobility of either the care receiver or caregiver. The main relationship pattern between caregiver and care receiver was intragenerational with spouses and siblings giving or receiving care. The other prominent pattern was intergenerational care relationships spanning across three generations, with children receiving or giving care, with older parents receiving or giving care, and the very aged grandparents just receiving care.

As key finding, the ethnographic study ‘Full of life’ references to three temporal notions of social interdependences: Firstly, the retrospection of establishing manifold relationships in ‘living the city’; secondly in the present in ‘growing old’, despite a ‘loss of strength’ the agility and mobility to engage in care relationships highlighting ‘from cure to care’, and lastly, the aspirations to reunite with the ancestral gravesites as collective reference of origin and belonging.

Info:

Supervisor: Prof. Dr. Brigit Obrist

Head of Project: Dr. Piet van Eeuwijk

Funding: Swiss National Science Foundation

Collaboration: University of Dar es Salaam, Ifakara Health Institute, Swiss Tropical and Public Health Institute

Duration: 2009-2012

Download Poster: Poster (pdf)

Download Brochure: Brochure "From Cure to Care" (pdf)

Keywords: health, illness, care, elderly people

Links: www.socialresilience.ch/old-age-resilience/

Contact: jana.gerold-at-unibas.ch