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E-grāmata: Who is Nursing Them? It is Us: Neoliberalism, HIV/AIDS, and the Occupational Health and Safety of South African Public Sector Nurses

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ABOUT THE BOOK This book explores the impacts of HIV/AIDS and neoliberal globalization on the occupational health of public sector hospital nurses in KwaZulu-Natal, South Africa, where HIV/AIDS prevalence is among the highest in the world. Just before the epidemic took off in the mid-1990s, South Africa achieved independence from apartheid/colonial rule, raising hopes that conditions would improve for the poor. HIV/AIDS, and a turn toward neoliberal policy, hindered this process. The story of South African public sector nurses provides multiple perspectives on the HIV/AIDS epidemic—for a workforce that played a role in the struggle against apartheid, women who deal with the burden of HIV/AIDS care at work and in the community, and a constituency of the new South African democracy that is working on the frontlines of the HIV/AIDS epidemic. Through case studies of three provincial hospitals in KwaZulu-Natal, set against a historical backdrop, this book tells the story of the HIV/AIDS epidemic in the post-apartheid period. Nurses and hospital managers describe significantly different settings—from a historically neglected rural district hospital to a high-tech, high-level care facility operating as a private-public partnership. Despite the disparities, nurses' occupational health dilemmas were largely the same. While neoliberal policies led to disinvestment and privatization that created workplace inequalities among public sector nurses (though all were low paid), stigma and denial about HIV/AIDS consistently hindered workplace health and safety programs. Even so, nurses and public health managers make a strong case about what is needed to support the South African public health system and the people who rely on it. In so doing they point the way toward a labor/work environment approach to a global public health crisis.Intended Audience: Academics in public health, occupational health and safety, labor and nursing history, and public policy; readers interested in the global HIV/AIDS epidemic and health systems development.

In an exploration of the perspectives of frontline public health personnel on the HIV/AIDS epidemic, three case studies of provincial hospitals in KwaZulu-Natal, South Africa, are analyzed against a historical backdrop to explore the question: what would it mean to address a global health crisis from a labor/work environment perspective?

Preface v
Acknowledgments vii
Introduction: Understanding a Public Health Crisis from a Work Environment Perspective 1(16)
Chapter 1 Globalization and Health in sub-Saharan Africa
17(16)
Chapter 2 Neoliberalism in Postapartheid South Africa and the HIV/AIDS Epidemic
33(16)
Chapter 3 The Work Environment of Nurses
49(14)
Chapter 4 Case Study Setting: Three Public Hospitals in KwaZulu-Natal, South Africa
63(26)
Chapter 5 Staffing, Occupational Health, and HIV/AIDS
89(40)
Chapter 6 Nurses Speak
129(20)
Chapter 7 Discussion---Breathing Life into Policy: Toward a Labor/Work Environment Perspective on a Global Public Health Crisis
149(22)
Appendix: Group Interview Results Summary 171(4)
References 175(14)
Index 189
Jennifer Zelnick, Charles Levenstein, Robert Forrant, John Wooding