The Relevance of Context in Understanding the Lived Experience of Aphasia: Lessons from South Africa

Purpose: In this paper we describe a study of aphasia in a unique sociocultural context, to show the value of the anthropological perspective for the clinician faced with a diverse caseload. Methods: We present findings of an anthropological study of the experience of aphasia for adults living in Khayelitsha, a township on the outskirts of Cape Town, where the isiXhosa speaking residents live in conditions of poverty and where health and social resources are either lacking or in disarray (Legg, 2010). The study involved three years of intermittent fieldwork that included in-depth case studies of five adults living with aphasia in Khayelitsha and sustained contact with a number of healthcare and community institutions. Results: Interpretations and experiences of aphasia assumed a wider significance than communication disorder and were, essentially, a window onto the sociocultural and economic struggles that beset the lives of our participants. These struggles had profound influences on experiences of aphasia and responses to treatment. Conclusions: Understanding the unique contextual influences on experiences of aphasia will place the aphasia clinician in a more potent position to develop relevant interventions.