Paper short abstract:

South Africa’s bone marrow transplant (BMT) network discourses/practises, observed in Cape Town, reveal both entrenchment and transformation of the relationship between genetic materiality and identity. Resources and social awareness required in BMT highlight issues of health resource prioritisation acutely affected by inequity and the prevalence of poverty related disease.

Paper long abstract:

This research examines discourses and practises in the Bone Marrow Transplant (BMT) network in South Africa, as observed in Cape Town: South African Bone Marrow Registry (SABMR), Sunflower Fund (SFF) and transplant centres, analysed in concert with accounts from patients, donors, and family members who interact with this network. A prominent discourse is a suite of assertions articulated in the BMT network:

1) Genetically inherited HLA (Human Leukocyte Antigen) types appear in certain ethnic populations more commonly than others.

2) Patients who cannot find an HLA match for BMT in their family are most likely to find a match in the same ethnic group.

3) Ethnic groups not well-represented on the SABMR database of HLA-typed volunteer donors lead to patients of those backgrounds having little chance of finding a match.

4) SABMR and SFF are working to increase the number so that all ethnic groups are represented on the SABMR given South Africa's unique and diverse gene pool.

This reflects a complex interweaving of biological materiality, ethnicity, culture, mortality, health resource rationing, South African nationhood, and the limits of bodily integrity and necessitates engagement with several issues: health inequalities, human rights, and the prioritisation of first and third world medicine, the meanings of race, culture, ethnicity, and nationhood in a diverse South Africa (especially given its history as a highly racialised society and its contemporary political agenda of transformation), conceptions of donor shortage, and the imperative of treatment vis-à-vis transplant technology and socio-genetic matching.