Book chapter: "Therapeutic Clientship"

- Belonging in Uganda’s Projectified Landscape of AIDS Care

Book chapter by Susan Reynolds Whyte, Michael A. Whyte, Lotte Meinert and Jenipher Twebaze in “When People Come First: Critical Studies in Global Health”, edited by João Biehl & Adriana Petryna. Princeton University Press. 2013.

TORCH and therapeutic clientship
Therapeutic clientship is a Uganda-born concept that emerged out of a long collaborative study of the changing relations between communities and health care systems.

The larger project, nicknamed TORCH for Tororo Community Health, was based at the Department of Anthropology, University of Copenhagen, and Child Health and Development Centre, Makerere University, from 1995 until 2008.

Studying ART
Toward the end of that period, four researchers from Denmark and four from Uganda undertook research on the first generation of Ugandans to survive AIDS. The survivors got a second chance to live by becoming clients of projects that provided antiretroviral therapy (ART)—medicines for life.

The authors interviewed 48 people belonging to seven different treatment sites, who recounted their confrontations with sickness in the context of their larger life stories. Among them 23 were willing to receive the anthropologists in their homes for seven more visits over the ensuing year and a half.

Opportunities and dependencies
In this chapter, the authors draw on that material to explore the double meaning of clientship for people on ART. They are consumers of user-friendly professional services — of a standard far higher than most health care in Uganda. And they are also dependent on patrons for access to vital resources for which they exchange discipline, time, and commitment.

You can read more and buy the book at whenpeoplecomefirst.com