Bayram Tevfik
School of Public Health, University of Montreal, Montreal, QC, Canada.
Centre de Recherche en Santé Publique (CReSP), Montreal, QC, Canada.
Int J Equity Health. 2025 May 30;24(1):156. doi: 10.1186/s12939-025-02510-6.
Uncovering the nuances of oppression in qualitative research can be challenging, as oppression often manifests in subtle, implicit ways. In such contexts, individuals from oppressed groups may share their experiences in ways that reveal embedded meanings. As such, when interpreting interviews with people from oppressed groups, it is crucial to look beyond what is explicitly stated to uncover their true experiences. This paper examines how the way non-Turkish-speaking Kurds narrate their experiences reveals the effects of language-related oppression and internalized oppression within Turkish healthcare services.
This paper is a methodological reflection on a prior qualitative study examining how the exclusion of the Kurdish language from Turkish healthcare system impacts access. Through semi-structured interviews conducted in 2018-2019 with 12 non-Turkish-speaking Kurds, the primary study revealed that language barriers extended beyond miscommunication and were deeply rooted in systemic oppression. In this paper, we reanalysed the data using the concepts of the narrated, nonnarrated, and disnarrated, developed by Vindrola-Padros and Johnson, to reveal how narration could unfold oppression.
We found that non-Turkish-speaking Kurds seeking healthcare in Turkey often excluded (nonnarrated) government services due to the lack of services in Kurdish. They indirectly mentioned (disnarrated) the political conflict as the root cause of their negative experiences; and portrayed themselves as the ones who must adjust to the system, rather than the system accommodating their needs which implied internalized oppression (circumnarrated). As a result of this complexity, the individual often disappeared from their own narrative, relying heavily on family involvement (conarrated) as their primary means of access.
Applying the concepts of the narrated, nonnarrated, and disnarrated to the healthcare access experiences of Kurds in Turkey has revealed important insights into the structural and internalized oppression. By extending the original framework to include the concepts of conarration and circumnarration, we have provided a more comprehensive understanding of the complexities of oppression in healthcare access. Additionally, we found that one form of narration often acts as a response, replacement, or justification for another, urging researchers to consider the dynamism and the intricate relationship between different forms of narration.
在定性研究中揭示压迫的细微差别可能具有挑战性，因为压迫往往以微妙、含蓄的方式表现出来。在这种情况下，来自受压迫群体的个人可能会以揭示内在含义的方式分享他们的经历。因此，在解读对受压迫群体人员的访谈时，至关重要的是要超越明确表述的内容，以揭示他们的真实经历。本文探讨了非土耳其语库尔德人叙述其经历的方式如何揭示土耳其医疗服务中与语言相关的压迫和内化压迫的影响。
本文是对先前一项定性研究的方法学反思，该研究考察了库尔德语被排除在土耳其医疗系统之外如何影响就医机会。通过在2018 - 2019年对12名非土耳其语库尔德人进行的半结构化访谈，初步研究表明语言障碍不仅限于沟通不畅，还深深植根于系统性压迫。在本文中，我们使用温德罗拉 - 帕德罗斯和约翰逊提出的叙述、非叙述和反叙述概念重新分析了数据，以揭示叙述如何展现压迫。
我们发现，在土耳其寻求医疗服务的非土耳其语库尔德人常常因缺乏库尔德语服务而排除（非叙述）政府服务。他们间接提及（反叙述）政治冲突是其负面经历的根源；并将自己描绘成必须适应系统的人，而不是系统满足他们需求的人，这意味着内化压迫（环绕叙述）。由于这种复杂性，个体常常从自己的叙述中消失，严重依赖家庭参与（共同叙述）作为他们就医的主要方式。
将叙述、非叙述和反叙述的概念应用于土耳其库尔德人的就医经历，揭示了对结构性和内化压迫的重要见解。通过扩展原始框架以纳入共同叙述和环绕叙述的概念，我们对就医压迫的复杂性提供了更全面的理解。此外，我们发现一种叙述形式常常作为另一种叙述形式的回应、替代或理由，促使研究人员考虑不同叙述形式之间的动态性和复杂关系。
