This postmodern feminist ethnographies research aimed to explore the everyday meanings of primary health care (PHC) held by rural community nurses. Secondly, the research aimed to explore the everyday meanings of care held by the clients of the rural community nurses who participated in the study. The representation of this research is written in four voices which converse with each other to varying degrees in each chapter. This writing strategy is a deliberate one aimed at destabilising the usual approach to representation of research. It is also a strategy which seeks methodological coherence. The third aim therefore is to deliberately trouble the acceptable grounds concerning how nursing research is represented. The research utilised dialogical (conversational)and participant observation methods concerning the everyday meanings of nurses and their clients.The meanings I made of the information were created from a deconstruction of the texts. These texts included fieldnotes of participant observations and transcripts of conversations with nurses and their clients. The form of deconstruction utilised was informed from multiple sources and involved three levels of analysis. A realist interpretation was followed by an oppositional interpretation and then a reconstructive movement. The results revealed that rural community nurses practice is both spatio-temporally contextualised and metaphorically situated in an in-between space. This in-between space is situated between margin and the centre. Rural community nurses working on the margins traverse this space in order to overcome further marginalisation whilst working with Indigenous Australians and the aged. Moreover, the in-between space encompasses and creates opportunities to mutually exchange the gift of desire that being - empowering and compassionate relationships with clients and colleagues. Futhermore, whilst rural community nurses are strongly committed to the philosophy of PHC, their evryday working life is discursively constructed by powerful discourses which result in oppositional tensions. The tensions and the 'in-between' space allow the rhetoric of PHC to be resisted and reframed. Consequently, the oppositional constructs of their practice were displaced. Moreover, this necessitated the negotiation of space and place, and required the reconstruction of subjectivity, intersubjectivity and becoming / Doctor of Philosophy (PhD)

To date, there has been only limited research investigating the musculoskeletal health of Indigenous Australians. Nevertheless, the pain and disability associated with musculoskeletal conditions are thought to be high. This thesis reports on the outcomes of a cross-sectional survey and clinical assessment designed to measure the prevalence of musculoskeletal conditions, and uses them to inform the development of a community-based musculoskeletal training program for Indigenous Australians living in one of the largest rural Indigenous communities in Australia. There were three separate community-based studies comprising this thesis: The first describes the development of measures for assessing the prevalence of musculoskeletal conditions and the associated risk factors and barriers to managing these conditions for people living in this Community. The development of a screening survey and clinical assessment protocol was based on a literature search, existing validated measures, feedback from Indigenous focus groups and pilot testing with Indigenous people in order to achieve cultural appropriateness. The second study piloted the research tools, then measured and assessed the prevalence of musculoskeletal conditions, associated risk factors and barriers to managing these conditions in the Community. The third study describes the development and implementation of a preliminary community-based intervention delivered by AHWs that responded to the outcomes of the prevalence study. It assessed the cultural acceptability of a musculoskeletal training program (MTP), as well as piloting an approach to assessing changes in skills and knowledge of Aboriginal Health Workers (AHWs) who participated in the MTP. The conduct of these studies reiterates the difficulties associated with conducting studies in Indigenous Communities according to mainstream concepts, which rely on randomly selecting participants in order to achieve generalisability to the larger population. Beyond empowering Indigenous people through sustainable, community-based training initiatives, lies the immediate need to improve access to musculoskeletal health services and to remove this current and considerable barrier to improving the musculoskeletal health of Indigenous Australians. The conclusions of this thesis highlight the importance of giving consideration to cultural sensitivity and collaboration in planning health service delivery to Indigenous people. The application of the community-based model used in this study may have the potential to be seeded in Communities throughout the country as a step towards promoting the musculoskeletal health of Indigenous people living in rural Australia and beyond. / PhD Doctorate

The main objectives of this research were to determine the influence of bush identity on attitudes to mental health in rural Australia, what influence these attitudes have on service provision and utilisation, and what measures can be taken to improve attitudes to mental health and services in the bush. The research has included an extensive literature review of Australian historical and contemporary rural culture, the political economy of rural restructuring, rural mental health, as well as State and Federal policies and programmes for mental health care delivery. An ethnographic community study of “Ruraltown”, a rural centre in Queensland, was undertaken over a three-year period which involved semi-structured interviews, questionnaires, observations and community interaction. The results from the questionnaires and interviews in the community study indicate that attitudes to mental health in rural areas are influenced by bush identity, defined by reference to historical and current characteristics which include self-reliance, resilience, independence and stoicism. Social identity theories have been applied in this study to determine how the socialisation processes have incorporated these characteristics among the rural population, and rural males especially. In turn, these incorporated attributes and values have a direct impact on their attitudes to mental health and the willingness to seek help for problems of a psychological nature. Other aspects of rural life such as perceived lack of confidentiality and anonymity, fear of gossip, and isolation also impact on attitudes and the utilisation of mental health resources. Stigma is a significant barrier to recognition and acceptance of mental health issues. Hence, seeking help for mental health problems does not form part of the coping strategies for many in the bush. Mental health services, therefore, are not as readily accepted or utilised in rural Australia. Although some rural people do access mental health services, many more go on suffering with mental health problems rather than addressing them. Recommendations have been made to promote awareness and enhance education and attitudes to mental health, improve services and increase service utilisation. The study has also identified the problems facing mental health consumers in Ruraltown and some suggestions have been made to overcome these and assist in consumer empowerment.

At the opposite of numerous countries in the world, despite its natural assets and its enormous surface and underground water potential, Cameroon is still trying to put down effective policies for the supply of safe drinking water for its rural population. Many initiatives to supply these communities through a national water distribution network have remained for the most dead letters or fruitless. A very high number of people still endanger their life daily by relying on archaic water supply techniques – when they are working – and by consuming unsafe water. This study therefore investigates if fog and rainwater harvesting could help in securing safe drinking water to these same rural communities, leaving the remaining demand - if any - to be provided by the existing but too often non-reliable supply system. Two pilot sites have been selected for their different climatic conditions; a village in the mountainous Western Province and another in the low-lying area of the Far-North Province of Cameroon. Average climatic data and basic topographical information from each location were used to determine the size and number of required collectors. The potential monthly water-yield at each site was then assessed using an actual climatic data series (8 years) and the theoretical performance simulated based on an increasing per capita daily consumption (10 – 40 l.d-1). An estimate of implementation cost is provided as part of the discussion on the feasibility of using both fog and rainwater harvesting as low-cost approaches to securing safe drinking water in Cameroon.

Rural communities, often called outports, throughout Newfoundland are currently experiencing important socio-economic changes. External forces, such as the ever-growing oil industry in Alberta and provincial planning based upon centralization, are undoubtedly reconfiguring the life and future of people living in small, isolated outports. For many of them, tourism has become a way to secure their present and future by exploiting their rich historical and natural heritage. A highly successful example of a tourism oriented endeavor in rural Newfoundland is the Viking settlement at L’Anse aux Meadow in the Northern Peninsula. White Harbour is a small community on the Baie Verte Peninsula of Newfoundland and is used here as an example in a study attempting to understand the reasons behind the lack of tourism-related initiatives, particularly on the part of women. White Harbour has it all: an important archeological site, a museum, rich history, traditions, and a wonderful natural setting. Women in White Harbour, most of them aged 30–60, stay home and do not seasonally migrate to Alberta as many men do. They perfectly understand the potentiality of their place but most do not attempt any tourist-related entrepreneurship. As the study will reveal, there are many, often contrasting reasons why women do not become entrepreneurs. These reasons, which may be personal, cultural, or economic are very different in character and constitute a complex web that often discourages women from starting small businesses like coffee shops, art galleries, or bed and breakfasts. This study aims to uncover some of these difficulties and offers a unique opportunity to reflect upon them. The findings are discussed in light of the latest works on rural communities, women, tourism, and globalization.

Rural communities, often called outports, throughout Newfoundland are currently experiencing important socio-economic changes. External forces, such as the ever-growing oil industry in Alberta and provincial planning based upon centralization, are undoubtedly reconfiguring the life and future of people living in small, isolated outports. For many of them, tourism has become a way to secure their present and future by exploiting their rich historical and natural heritage. A highly successful example of a tourism oriented endeavor in rural Newfoundland is the Viking settlement at L’Anse aux Meadow in the Northern Peninsula. White Harbour is a small community on the Baie Verte Peninsula of Newfoundland and is used here as an example in a study attempting to understand the reasons behind the lack of tourism-related initiatives, particularly on the part of women. White Harbour has it all: an important archeological site, a museum, rich history, traditions, and a wonderful natural setting. Women in White Harbour, most of them aged 30–60, stay home and do not seasonally migrate to Alberta as many men do. They perfectly understand the potentiality of their place but most do not attempt any tourist-related entrepreneurship. As the study will reveal, there are many, often contrasting reasons why women do not become entrepreneurs. These reasons, which may be personal, cultural, or economic are very different in character and constitute a complex web that often discourages women from starting small businesses like coffee shops, art galleries, or bed and breakfasts. This study aims to uncover some of these difficulties and offers a unique opportunity to reflect upon them. The findings are discussed in light of the latest works on rural communities, women, tourism, and globalization.

Access to potable water has been on the forefront of the international agenda for almost three decades. The international community has been working together in developing potable water management programs and improving potable water access. This thesis examines how the nature of rural communities influences water usage and rural potable water projects in Nicaragua. Factors such as proximity to urban environments and exposure to nongovernmental organizations are demonstrated to play a role in shaping community expectations and satisfaction with potable water projects. The author proposes approaches for addressing urban influence focused on improving flexibility of project consultation processes, strengthening project monitoring, and enhancing the level of community knowledge with respect to available potable water systems. The author briefly explores how this case study is transferrable to other communities in developing countries.

The relationship between protected areas and the surrounding communities is important in enhancing the success of both parties. The aim of this study was to examine the socio-economic impacts of tourism on poor rural communities adjacent to the Hluhluwe-Umfolozi Park with specific reference to Mpembeni community. Triangulation (a multi method approach) was used to find out attitudes and perceptions of the communities towards tourists, resources within the park as well as the role of communities in the development and promotion of tourism in the park. The study of the Mpembeni Community adjacent to the Hluhluwe-Umfolozi Park (HUP) shows that this community benefits in various ways. Accessibility to natural resources such as meat, grass, firewood and water was cited as one of the benefits. Participation in the operation and management of the park was yet another benefit that was identified. In addition, the results show that a range of opportunities for positive interactions with park's management/staff include job opportunities, good working relations and joint problem solving. Tourism development as a benefit was revealed through two specified areas namely interaction with the tourists as well as the desire to have more tourists visiting the community and the establishment of other tourist facilities in the community. The respondents also cited opportunities for tourism and related incomes, which involve the sale of handicraft products, job opportunities and cultural activities. Furthermore, education/ training programmes particularly children wildlife camps, capacity building and the training of tour community guides were also cited. In addition, natural resource management including the establishment of the Community Conservation Game Reserve (CCGR) and participation in decision-making were also identified as speci fic benefits. The socio-economic impacts in all the identified specified areas except with participation in the management of the park where local communities are not fully involved were positive. This suggests that there is a need to involve local communities in the operation and management of the park as well as other community-based tourism ventures in order to uplift their standards of living. KEY TERMS: socio-economic. impacts, tourism, poor rural communities / Theses (M.A.)-University of Durban-Westville, 2001.

The use of information and communication technologies, ICTs, is increasing the possibilities to exchange information and communicate in different contexts all over the World. The use of ICTs for development, ICT4D, in order to contribute to the improvement of living standards in developing countries is one of these possibilities. This paper presents a qualitative research based on a case study in Nicaragua, which explores the current situation when it comes to the uses of ICTs and its potential to be used to develop in a sustainable manner. The research framework is based on empowerment theories and the study of the diffusion of innovation and it shows how ICTs are being used in a rural community in Nicaragua to amplify their needs through communication, gaining visibility among other actors, increasing their opportunities and empowering themselves by increasing the awareness of power imbalances and identifying and learning about new possibilities through ICTs. This paper also studies the diffusion of ICTs in the community and deepens the understanding of the role of individuals and other interpersonal factors in the innovations-adoption process. / Information and communication technologies, ICTs, are becoming more and more popular all over the World. The use of mobile phones, smartphones and the Internet is a revolution that affects our everyday lives in both professional and personal contexts. These potential for different uses has converged in the appearance of ICT4D, ICT for development, which promotes the use of new technologies to offer new social and economical opportunities for developing countries. On the other hand, the use of resources and the impact of development on the environment is also a trigger to consider sustainability in the combination together with ICT4D in countries that are aiming to grow during the upcoming years. This paper presents an overview of the uses of ICTs in a rural community in Nicaragua through a case study and explores the potential and limitations for the use of new technologies to achieve a more sustainable development. The study presents how different community members use ICTs to communicate with other individuals in a personal sphere (family and friends) but also that there are other uses related to other actors which implies the creation of networks and therefore the increasing of visibility and opportunities for the community. These uses are leading to new situations where the community is gaining power in relation with other actors. The thesis shows how ICTs are promoting and amplifying the communication among actors, which, at the same time, are bringing new information and opportunities for the community. Due to the fieldwork in Nicaragua, this thesis has been able to identify the uses of ICT4D but also the role of different individuals and how some personal characteristics are promoting the use of new technologies. Different stages for the diffusion of the innovation are explained to show that among the interviewees we can identify degrees in the knowledge and practice of the ICTs where different uses are tested before the adoption of the innovation or not. At the same time, the paper presents the main limitations identified by the actors for the use of ICTs, which should be considered in the implementation of ICT4D such as degree of education, age, economic resources, fear to change or lack of motivation among others. Finally, in relation with the use of ICTs for sustainable development, the paper presents the opportunities identified by the actors being aware that the environment is presented as an instrumental element to develop socially and economically but also that ICTs are considered as an opportunity to learn about a more sustainable resource management and as a way of obtaining new resources from entities to avoid or reduce environmental impacts.

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