Workshopping Ethnography of Pain in a Tanzanian Hospital

Abstract (English)

Understanding pain and pain care requires understanding both the perspectives of care seekers and those working to help them manage pain. In one regional hospital setting in Iringa, Tanzania, we have been conducting long-term ethnography on pain care practices to better understand both cultural conceptions of pain and biomedical healthcare system needs to improve pain care. Healthcare providers come into patient interactions with formal education about pain rooted in biomedical frames of nerve signalling and pain as the body’s messages about injury or disease. They also come into pain care encounters with their sociocultural and community grounded perceptions about pain. These two sets of knowledge and conditioning may or may not align with patients’ own needs, beliefs, and desires as related to pain and pain management. As hospital ethnographers, we reflect on the methodological and ethical dimensions of studying the cultural meanings of pain and power dynamics of pain care. We share findings from a workshop we led with Tanzanian and Italian health workers based at the same regional hospital. We opened the workshop with dynamic group activities to explore cultural and gendered ideas about forms of pain, pain expression, and pain treatment and care. In addition to promoting group discussion and reflection, we found these activities to be fruitful elicitation techniques. Our questions opened space for dialogue about the complex meanings of pain for health workers in the context of their multiple roles and responsibilities. We also used the workshop as an opportunity for healthcare workers to respond to our preliminary findings and openly discuss the challenges and ethical caring dimensions of pain management and assessment in under-resourced hospital settings.