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“志愿者不计报酬,因为他们无可替代”:埃塞俄比亚城市艾滋病治疗干预中社区卫生工作者的能力与价值

"Volunteers are not paid because they are priceless": community health worker capacities and values in an AIDS treatment intervention in urban Ethiopia.

作者信息

Maes Kenneth

机构信息

Department of Anthropology, Oregon State University.

出版信息

Med Anthropol Q. 2015 Mar;29(1):97-115. doi: 10.1111/maq.12136. Epub 2014 Sep 24.

DOI:10.1111/maq.12136
PMID:25257547
Abstract

This article analyzes community health workers' (CHW) capacities for empathic service within an AIDS treatment program in Addis Ababa. I show how CHWs' capacities to build relationships with stigmatized people, reconcile family disputes, and confront death draw on a constellation of values, desires, and emotions encouraged by CHWs' families and religious teachings. I then examine the ways in which the capacities of CHWs were valued by the institutions that deployed them. NGO and government officials recognized that empathic care was crucial to both saving and improving the quality of people's lives. These institutional actors also defended a policy of not financially remunerating CHWs, partly by constructing their capacities as so valuable that they become "priceless" and therefore only remunerable with immaterial satisfaction. Positive change within CHW programs requires ethnographic analysis of how CHWs exercise capacities for empathic care as well as consideration of how global health institutions value these capacities.

摘要

本文分析了亚的斯亚贝巴一个艾滋病治疗项目中社区卫生工作者(CHW)提供共情服务的能力。我展示了社区卫生工作者与受污名化人群建立关系、调解家庭纠纷以及面对死亡的能力如何借鉴了社区卫生工作者家庭和宗教教义所鼓励的一系列价值观、愿望和情感。然后,我研究了部署社区卫生工作者的机构重视他们能力的方式。非政府组织和政府官员认识到共情护理对于挽救和改善人们的生活质量都至关重要。这些机构行为者还捍卫了不给社区卫生工作者支付经济报酬的政策,部分原因是将他们的能力构建得如此有价值,以至于变得“无价”,因此只能用无形的满足感来补偿。社区卫生工作者项目中的积极变化需要对社区卫生工作者如何行使共情护理能力进行人种志分析,以及考虑全球卫生机构如何重视这些能力。

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