Sentosa : a feminist ethnography of a psychiatric hospital in Sarawak, East Malaysia

Abstract

This doctoral thesis is a feminist ethnographic study of psychiatric patients in the State of Sarawak, East Malaysia. The study took place at a psychiatric hospital located in the capital city of Kuching, commencing in 1997. Although Hospital Sentosa is a small institution it is the only psychiatric institution in the State and therefore constitutes an important mental health resource in this region. This ethnographic study primarily concentrates on the lives of women patients in keeping with my chosen methodological approach and seeks to explore the 'culture' of the hospital setting through facets such as daily interactions, activities and relationships. The feminist approach has not however precluded the accounts of male patients whose experiences are utilised in a comparative exercise with those of women counterparts. In addition the views of staff of both sexes and all ranks are considered in relation to their attitudes towards the care of psychiatric patients and the broader area of work-related concerns including collegial support and occupational hazards. In keeping with an ethnographic approach themes developed in the thesis are drawn through an analysis of findings as noted by observation methods as well as through interviews with participants. Furthermore a self-reflexive approach has been an important aspect of analysis commensurate with feminist methodology, in which my role as a researcher is considered in relation to issues of culture, gender and class as well as some of the difficulties of research in a post-colonial and unfamiliar cultural context. Although some avenues of inquiry in the study have not easily lent themselves to an analysis of gender, this thesis primarily argues that the hospital reproduces oppressive policies and practices that impact with greater severity on women patients. Oppressive practices in relation to gender and ethnicity at the hospital are viewed against a backdrop of contemporary psychiatric care as enacted on wards. It is argued that these practices can be viewed in turn as being, for the most part, historically premised upon imported British models of care replicated through colonialism in Malaya and by extension at a later period in the multicultural State of Sarawak.