My Master's Thesis:
The Meanings of Sustainable Community Wellness in Grabouw
An exploration of the integrated nature of sustainable development planning and health care was done in the context of people living and working in the town of Grabouw in the Western Cape. The problem that was investigated was that people working within local government and community health networks treated sustainable development planning and health care as separate issues.
The notion of wellness, as different from health, was used as a central theme in the study. It allowed for an acknowledgement of the multidimensionality and contextual nature of human well-being. The notion of sustainable community wellness was used to guide the research, and was viewed as a complex phenomenon. The meanings of sustainable community wellness to people who work and live within local government and community health networks in Grabouw were observed and documented. Complexity theory was then used to discuss the observed perspectives on sustainable community wellness.
Two factors informed the selection of Grabouw as a research site: Firstly, a comprehensive sustainable development programme was being carried out in the town of Grabouw during the research. Secondly, a few community health care initiatives were also being implemented at the time. Community care workers who worked in one of the community health organisations participated as primary research participants.
The research combined conceptual and empirical research. The conceptual research consisted of a literature review of perspectives on wellness in Grabouw. The empirical research methods that were used combined ethnography in the form of participant observation, and participatory action research in the form of participatory photography. The researcher accompanied community care workers on their daily visits to patients. The care workers took photographs of aspects of their surroundings that represented sustainable community wellness, or the lack thereof, to them. Photographs were analysed through focus group discussions and pertinent themes were subsequently identified.
Three meanings of sustainable community wellness were discovered. The first was the structural, governmental meaning that gave importance to health and socio-economic statistics, based on the mortality profile of the area. Wellness was seen from this perspective as a challenge that could be met with strategic planning. The second meaning was the community-based experience of environmental factors in Grabouw that had an impact on wellness, such as water, community forums and living spaces. In this case, wellness was experienced as a rich and diverse set of factors, both social and environmental. The third meaning was observed as instances where the apparent separate entities of local government, the community, and the physical environment were seen as one socio-ecological system, of which sustainable community wellness was an emergent property.
These instances demonstrated the importance of managing the quality of relationships within the system, the need to enhance the autonomy of people working in the system and the potential of community care workers to be agents of sustainable community wellness.