“Waiting to Die”: Language, discourse and meaning in palliative care contexts in Kenya

The contemplation of death is for most of us inherently disconcerting, making it natural repress such an unpleasant reality both on an individual and on a societal level. Language provides us with the facility for suppression of such thoughts, achieve different outcomes and construct different realities by words chosen and their shared meanings. This paper reports the findings of a study conducted to investigate the discursive construction of palliative care in the Kenyan context. The study was conducted in four hospices in Kenya, namely Siaya, Kisumu, Busia and Eldoret. Like in many African countries, palliative care is yet to be fully integrated into the mainstream healthcare system in Kenya, and these centres, although located within the proximity or sometimes within the premises of the respective county referral hospitals, were mainly operationally autonomous. Participants were selected for the study using purposive sampling. purposively selected for the study. Data was collected over a period of six (6) months using the principles of focused ethnography and guided by the study objectives and relevant theoretical framework. The care givers were all relatives of the patients who doubled up as care givers of during the hospitalization period. The findings of this study show that the language used in palliative care contexts in Kenya varies considerably and reflects diverse conceptualizations of illness, diagnosis, treatment and death. It emerges that these conceptualizations are constrained by cultural practices, religious beliefs, speaker identity and the goals of the palliative care facility.