Competing vulnerabilities in childhood cancer: the everyday lives of British Bangladeshi children with cancer.

Abstract

PhDThis thesis presents a social study of childhood cancer treatment in a group of British Bangladeshi children living in one city in the United Kingdom. It draws on theoretical perspectives that see childhood as a social construction and children as active contributors to the social world, whilst acknowledging that their contributions are mediated by their dependence on adults. British Bangladeshi children represent a significant minority group whose cultural heritage may challenge the underlying assumptions of biomedical paediatric cancer care. An ethnographic study was undertaken to develop a detailed description of the social and cultural needs of this group of children. Fieldwork was conducted in home and clinical settings to provide an account of how day to day social relations for children, families and health care professionals are experienced. The analysis indicates that cancer service organisation, the dual language of families and clinical implications of the disease simultaneously contributed to the social impact of childhood cancer treatment on the daily lives of children. The data themes on childhood, cancer treatment and culture: language and power reveal that children, parents and professionals differentially constituted vulnerability in childhood cancer. Central to this thesis is the role of relationships between children, parents and professionals in the production of childhood cancer treatment including their ambiguous and borderline nature. I conclude that this produced a day to day reality of diminished power and agency for participants and led to children in particular occupying positions of liminality. This work challenges the assumption that membership of the social category of childhood has equivalent meaning to all social actors. It calls for further exploration of the taken for granted ideas of childhood during illness that professionals employ in their clinical practice from a perspective that acknowledges the structures that frame adult child relations and the context of care delivery