Exploring the lived experience of people affected by podoconiosis in Nyamasheke District, Rwanda
: Understanding intersectionality.

  • Jean Paul Bikorimana

Student thesis: Doctoral Thesis

Abstract

A growing body of knowledge shows that human experience is shaped by individuals’ positionality and identities, but knowledge of how identities influence the experience of podoconiosis, a disabling leg swelling, in Rwanda is limited. I explored the lived experience of those affected through the lens of intersectionality to understand how identities assigned to people shape their experience. I employed qualitative approaches; participant observation with patients, in-depth interviews with patients and relatives, Key Informants interviews with community representatives, and healers, focus group discussions with community health workers and photo-voice with patients. Through a six-month period of fieldwork, I documented compounded podoconiosis experience, which arises from convergence of each individual’s identities and social positions, which intersect with distinctive contextual and structural factors. This thesis has five empirical chapters, and explores how social identities and positions influence the construction and meaning making of podoconiosis and the experience of affected people. These identities also influence help seeking, leading to heightened disparities. I have also explored how individuals’ positionality shape the stigma and suffering experienced by affected people. Lastly, I discussed my findings and provided the contributions of my thesis in the discussion chapter.

The key argument in this thesis is that people with podoconiosis faced an intersectional experience that is shaped by the convergence of their identities, social positions, as well as illness features, contextual and structural factors, thus amplifying the experience of podoconiosis. People affected had a range of encounters due to their diverse positions and identities, leading to instances of oppression and health inequality, especially affecting those with marginalised identities. Their experiences were affected by diverse individual identities, positionality, and social structures, such as geographical location, beliefs, socio-economic, age, gender, education, employment, marital status, body image, disabilities, productivity, and social status. Consequently, individuals with oppressed identities endured heightened levels of inequality. It is my hope that this understanding can help professionals, community members, policy makers, and academicians to shape the practices aimed at addressing health disparities due to podoconiosis. This thesis has examined unexplored areas of podoconiosis, and applied the framework of intersectionality, thus shedding light on health disparities due to podoconiosis.

It makes an original contribution to existing knowledge on podoconiosis in Rwanda, and to the use of intersectionality as a framework by which to understand the experience of podoconiosis.
Date of AwardJul 2024
Original languageEnglish
Awarding Institution
  • University of Brighton
Supervisor Papreen Nahar (Supervisor), Dr Josephine Mukabera (Supervisor) & Gail Davey (Supervisor)

Keywords

  • Intersectionality
  • podoconiosis experience
  • suffering
  • stigma
  • help seeking
  • Rwanda

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