Isabel Dyck

Hidden geographies: The changing lifeworlds of women with multiple sclerosis

This paper discusses the microgeographies of unemployed women with multiple sclerosis, as they manage the physical, social and economic consequences of their illness. Recent directions in the geography of health and health care draw attention to the relationships between space, place and health experience, and in this paper a focus on the everyday lives of women with Multiple Sclerosis reveals the complex interweaving of space, physical impairment and gender in how they experience place. In-depth interviews were used in the study to investigate how women occupied and used home and neighbourhood space after leaving the paid labour force. The majority of women were found to experience shrinking social and geographical worlds which rendered their lives increasingly hidden from view as patterns of social interaction changed and use of public space diminished. The paper discusses the womens residential and household changes, mediated by marital and socio-economic status, and presents two brief case studies to illustrate the remapping of the meanings of work and place as women renegotiate their lifeworlds. The focus of the study on the spatio-temporal settings of the womens everyday lives revealed an interplay of biomedical discourse, policy structures, sociocultural norms and local sets of social relations that shaped the strategies the women used in reconstructing their lives. The women showed a diversity of responses, but these were all characterized by a restructuring of home and neighbourhood space, a reordering of personal relationships and increasing interpenetration of the public sphere in their private lives. The findings suggest that attention to the body in its geographical as well as social context provides an avenue for investigating the links between subjective experience and the broader social relations and processes which shape the illness experience.

Transforming the relations of research: towards culturally safe geographies of health and healing

Abstract The ‘cultural safety’ debate in New Zealand concerns the power-ladenness of health care interactions and the (controversial) need for health professionals to be fully conversant with the historical and contemporary circumstances of Maori people. We take this debate as a prompt to survey the implications of different ‘ways of seeing’ for how we define and investigate issues of health and illness in geography. The paper reflects on the issue of representation and the attendant question of how to include the researched in the construction of knowledge about health and healing. Given that knowledge and experience of health issues are social and cultural constructions, we suggest that geographical studies of health and place need to be centred in ‘culturally safe’ research practice.

Space, Time, and Renegotiating Motherhood: An Exploration of the Domestic Workplace

Recent discussion in human geography has heightened awareness of the problems and possibilities of the use of social theory in empirical research, This paper is concerned with showing how insights from feminist theory and Giddenss theory of structuration informed a study focusing on womens mothering practices in a Canadian suburb. In concert these approaches cast attention to the implications of recognizing subjects as knowledgeable human agents in analyses of social and economic change. These include a renewed emphasis on the ‘everyday’ and its links with general processes, an interest in methods appropriate for investigating the generation of meanings central to our social and spatial worlds, and the need to incorporate womens experiences in the construction of theoretical knowledge. Included in a new research agenda within feminist geography are questions concerning the active construction of gender identities through practices which vary over time and space. In the study reported the meaning of the domestic workplace to mothers of young children was explored. It is shown how the notion of motherhood and the sets of practices making up mothering work were interpreted and negotiated as women responded to social and economic structuring in a particular place. The paper includes a concluding discussion on the links between the theoretical underpinnings of the study and its empirical findings.

Inquiry into Environment and Body: Women, Work, and Chronic Illness

The recent call for the reorientation of analysis in medical geography to more critical approaches has been met with both enthusiasm and caution. Critical theories of health and health care services are emerging, which complement the well-developed focus on the spatial aspects of disease and service delivery. Yet in reconceptualising the links between place, space, and health, care must be taken in theorising in context experiences of health and illness. By context we mean the richly textured social formation wherein social relations are threads of a tapestry woven together. One topic which lends itself to such an inquiry is how material and discursive bodies combine to create identities for women with chronic illness around issues of gender and (dis)ability within the context of the wider social political economy. In this paper, we propose a feminist political economic analysis of environment and body as an addition to the critical frameworks emerging in medical geography. We first discuss what a radical body politics entails conceptually. Then we make suggestions with regard to undertaking such inquiry, using in illustration empirical work on womens reshaping of their environment in response to chronic illness. This type of investigation extends previous work on the formation of womens identities, experiences of chronic illness, and the materiality of everyday life. Last, we recast the concepts of environment, body, and identity formation while maintaining a commitment to the fluidity of conceptual and material boundaries.

Telling it Like it is? Constructing accounts of settlement with immigrant and refugee women in Canada

This article reflects on the methodology of a study of immigrant and refugee womens settlement experiences in Vancouver, Canada. It specifically takes up the ways in which the womens accounts were co‐constructed through social and political processes and relations operating at different geographical scales, but were experienced at the local scales of body, home and neighbourhood. The study consisted of in‐depth interviews with 16 immigrant and one refugee woman and their teenaged daughters. Here we focus on the mothers accounts showing how their story‐telling of life since coming to Canada was framed by multiple discourses and local material conditions. We use two case examples from the study to raise substantive issues in the research, focusing particularly on the womens talk of work and health and how these framed their understanding of ‘womanhood’ in Canada, routes to a desired ‘integration’ and their daily practices. Their quotidian life embodied their multiple identities as women, mothers, wives, workers and immigrants and the interviews were used by them to express the frustrations and hardships which were in direct contradiction to their expectations as ‘desirable’ immigrants or refugees under protection. We argue that methodological reflection is not simply an important dimension of rigour in feminist qualitative research, but is also critical to the opening up of taken‐for‐granted categories brought to the politically charged study/construction of ‘the other’. In this research the identities of study participants and researchers, in the specific space of the interview, were intricately involved in ‘telling it like it is’ for these immigrant and refugee women settling in an outer suburb of one of the three major destination cities for immigrants to Canada.

Body, Corporeal Space, and Legitimating Chronic Illness: Women Diagnosed with M.E.

The trendiness in using the body as a unit of analysis does not keep us from trying to understand how the body is part of the mundane stuff that makes up everyday life, particularly the chronically ill body. In our research with women diagnosed with chronic illness, we found that women experience their bodies, both sensorially and in their capacity for labor and leisure, through social scripts, seeming economic imperatives, and their own blood, sweat, and tears. The synchronous existence of the discursively ill and materially ill body seemed to be highlighted in these womens accounts of their experiences of myalgic encephalomyelitis (M.E., popularly referred to as Chronic Fatigue Syndrome or CFS). This spurred us to rethink the body in terms not just of embodied social practices but also of embodied experiences. In this paper we draw on womens experiences of M.E. as a way to assist in building a radical body politics. We first review and critique various attempts to come to terms with the simultaneity of the discursive and material body. We then present our empirical study comprised of in-depth interviews with women diagnosed with M.E. and living in Victoria and Vancouver, British Columbia, Canada. We then elaborate the notion of corporeal space as a way to access embodied experience. We close with comments about how body and space create a nexus through which we can access bodily existence within space.

Women talking: Creating knowledge through difference in cross-cultural research☆

Abstract This paper discusses the research process of a cross-cultural study investigating the health care experiences of Chinese Canadian and Indo-Canadian women. Employing the notion of reflexivity, the paper discusses the use of an accepted feminist method, the in-depth interview, in a study involving women from racialized groups. The paper discusses the layering of power relations at the different sites of data gathering, and the negotiation of “difference” between researchers, research assistants, and study participants throughout the study. The position of research assistants, as mediators of the research process, is given particular attention. In discussing our attempt to put the principles of feminist research into practice in cross-cultural research, we argue that problems encountered in the interview method require critical reflection, not only on the grounds of the practical issues of gaining detailed, narrative accounts of womens lives, but also in relation to the way in which “others” are constructed through research practices.

Managing the body work of home care

Body work is a key element of home healthcare. Recent restructuring of health and social care services means the home is increasingly a key site of long-term care. While there is a growing literature on the social dynamics between care recipients and their family caregivers, less is known about the formal work dynamic between paid care workers and care recipients and family caregivers. Drawing on interview data from an Ontario-based study of long-term home care, we explore how body work is negotiated through the embodied practices of care in the home and through care relationships associated with home care. In particular we focus on how the practices of intimate body care (such as bathing, toileting, and catheter management) show the diverse dynamics of care work through which caregivers, care recipients and homespace are constituted. We argue that the practices of care are shaped by a complex interweaving of regulatory mechanisms associated with home care along with the physical and affective dimensions of intimate body work. In turn this suggests the need for new ways of understanding body work in contemporary landscapes of care.

Using Qualitative Methods in Medical Geography: Deconstructive Moments in a Subdiscipline?

As medical geography reinvents itself as health geography, the linkages between social theory and the deconstruction of central categories organizing its medical orientation are being explored. This paper discusses the contribution of qualitative research to this process. In providing access to alternative ways of understanding health concerns, and emphasizing issues of power in the production of knowledge, qualitative methodology carries the potential for reconceptualizing key issues framing investigation of the relationships between place, people, and their health. In pursuing current issues in social theory, qualitative research also contributes to the blurring of the subdisciplines boundaries and revitalizes its agenda.

Feminism and Health Geography: twin tracks or divergent agendas?

Feminist geographies of health and illness have emerged over the last 10 years, marking an increased interest in the highly gendered nature of health, health care and caregiving. Yet work in this area remains relatively sparse. This article examines parallels and divergences between feminist and health geography, which frame the context of feminist geographers doing health work. Interconnections between the two subfields where there is most exchange relate to the admission of experiential knowledge in a ‘reformed’ medical/health geography, and work engaging critical theory—particularly that of the body. The positioning of health geography in the shadow of medicine brings ambiguity to the issue of transformative politics; institutional conservatism vies with an opportunity to bring feminist work to the interstitial space of social science and critical medicine.