Caregiving in families and hospital during war and HIV-AIDS pandemic in twentieth-century Northeastern Zimbabwe

This dissertation is a study of family-based caregiving in northeastern Zimbabwe throughout the twentieth century. Non-therapeutic caregiving is an aspect of African healing which has received little scholarly attention. The dissertation argues that extended families and fictive kin provided many essential services to the sick. It also reveals that caregiving is an ethical tradition that influenced the foundation and practices of the primary hospital of the region. This tradition survived through the persistent warfare of the 1960s to 1980s and the pandemic of HIV-AIDS. The study further demonstrates that continual war and the HIV-AIDS pandemic increased the stresses and challenges of maintaining caregiving, especially for women. Even so, the ethic of responsibility for family members survived because caregiving was understood as an undeniable obligation of kinship and family.

The tradition of family-based caregiving shaped everyday practice at the hospital, for even inside and beyond its walls, family members took the role of primary caregivers to patients. Familial and communal caregiving became particularly important as rural communities engaged the threats posed by armed conflict and the HIV-AIDS pandemic. By transporting, feeding, washing, and supporting the sick, family members helped shape biomedical practice. Familial caregiving also subsidized hospital services. Hospital staff gained status through their provision of biomedicine, but they found themselves held to the obligations of familial and communal relationships. Family members became eclectic caregivers who participated in hospital and home activities, even though the missionaries criticized some pre-biomedical practices.