uma spent the first six years of his life on his family’s ruralshamba—or farm—inShinyanga District, one of two administrative districts that make up Sukumaland.In 1996 (when Juma was four), the shamba included approximately two hectares ofland that Juma’s father inherited from his father in accordance with the customarypatrilineal land-tenure practices of the Sukuma. Like most smallholder farmers inthe region, Juma’s father cultivated cotton and devoted a smaller patch of land tosubsistence foods, including maize and sweet potatoes

Eventually, the drinking and smoking pot lead to hard drugs because there's never enough to keep the pain away. Finally the drug controls you, and you don't feel that pain anymore.

One woman mentioned that she would just sit at atable and cry for God’s help. Several women (6) chose todistract themselves from their symptoms and worries

feelings of helplessness: ‘‘What is the use of taking anytreatment? Whatever has to happen will happen. There’sno solution for it. If he [husband] is good, theneverything would be fine’’.

o. That he, that they come to him with accusations, that the dead woman iscoming, as if he is guilty...for not saving he

Especially problematic is the fact Yosef is not studying Torah. Inaccordance with Haredi values, Rabbi Dov said that the fact that Yosefwas not steeped in learning created a dangerous situation

The whole thing was you had to get the facts. And thefeelings were something that was outside the medicalarena. And I think it helped me start to change the focus ofmy consultations onto the feelings that were going on. Andof course that’s the way in which you do—that contact withthe body self that’s being presented. People come intoyour practice and they present what they know isacceptable to present. They present biomedical facts. Butyou learn to switch out of that onto the feelings...and youstart to actually contact the self

The illness narrative as a moral testing of our basic moral premises isconcerned with finding a framework within which the illness can be dis-cussed. That is to say, we test various hypotheses for the onset of the ill-ness: for example, illness as a genetically determined and thereforeunavoidable event, or illness as an event caused by our own negligence orattitudes to life (smoking, for example) and which has been proved tohave had negative consequences.

52 Lars-Christer Hydenclinical work can, through illness narratives, become better able to attendto what their patients say. But just as narratives gradually came to occupyan increasingly centralised position in social science generally, so also hastheir importance in illness research grown. A central aspect of the narrativeconcept is that, besides being an important knowledge form, it is able torepresent and reflect illness experiences in daily life. Today the narrativeconcept enjoys the pivotal position once assigned to concepts like identity -it could even be argued that the identity concept has become subordinateto the narrative concept (see for example Mathieson and Stam 1995).The growing theoretical importance of the narrative concept in the fieldof illness research is most probably a reflection of the change and expan-sion of the illness concept towards a greater emphasis on siiffering as apoint of departure in social scientific studies of illness. This makes it pos-sible to study the patient's illness experience and illness world as a socialreality apart from the conception and definition of illness as formulatedby biomedicine.Methodologically, earlier views on illness narratives were based on theidea that identity could be conceived in terms of one individual life his-tory. We have become increasingly aware, however, that situational fac-tors play a decisive role in the construction of narratives and that wecontinually produce new narratives in new contexts. Thus, it seems all themore evident that it is not a question of the narrative, but rather of dif-ferent possible narratives which are determined by situational factors,particularly by the interaction between narrator and listener. Several writ-ers have shown how factors of this kind may affect the way in which theillness is presented (Clark and Mishler 1992).Narrative and illnessAny illness constitutes a disruption, a discontinuance of an ongoing life(Bury 1982). The current of daily life is obstructed, perhaps blocked alto-gether. Illness may revise our conceptions of what is changeable, and wemay be forced to change the premises upon which we plan and evaluateour lives (Charmaz 1992).Acute illness, in the best of cases, has only a temporary significance inour lives: it constitutes a transitory and limited disruption; an acute ill-ness may cause us to re-examine our lives in the light of our own frailty.Chronic illness, on the other hand, usually changes the very foundationof our lives because the illness creates new and qualitatively different lifeconditions. Our range of options no longer seems so wide and varied, wemay be forced to look at the future from a totally different angle. Thus,even the past acquires new meaning: as a part of lived life.All types of illnesses thus affect one of the fundamental aspects of life- its extension in time, its temporality. T

Any illness constitutes a disruption, a discontinuance of an ongoing life(Bury 1982). The current of daily life is obstructed, perhaps blocked alto-gether. Illness may revise our conceptions of what is changeable, and wemay be forced to change the premises upon which we plan and evaluateour lives (Charmaz 1992).Acute illness, in the best of cases, has only a temporary significance inour lives: it constitutes a transitory and limited disruption; an acute ill-ness may cause us to re-examine our lives in the light of our own frailty.Chronic illness, on the other hand, usually changes the very foundationof our lives because the illness creates new and qualitatively different lifeconditions. Our range of options no longer seems so wide and varied, wemay be forced to look at the future from a totally different angle. Thus,even the past acquires new meaning: as a part of lived life.All types of illnesses thus affect one of the fundamental aspects of life- its extension in time, its temporality. T

ury (1982) points out in an early article that espe-cially chronic illness can be looked upon as a disruption of a person'songoing life, thereby also entailing a disruption of the person's identity.Chronic illness alters the relationship between the patient's body, self andsurrounding world. Thus, for the chronically ill, the reconstruction ofone's own life story is of central importance (Williams 1984). Narrativis-ing the chronic illness within the framework of one's own life historymakes it possible to give meaning to events that have disrupted andchanged the course of one's life (see also Williams 1993, Bury 1991).