How narration could unfold oppression: insights from the experiences of the Kurds in access to Turkish healthcare services.

Abstract

Background: Uncovering the nuances of oppression in qualitative research can be challenging, as oppression often manifests in subtle, implicit ways. In such contexts, individuals from oppressed groups may share their experiences in ways that reveal embedded meanings. As such, when interpreting interviews with people from oppressed groups, it is crucial to look beyond what is explicitly stated to uncover their true experiences. This paper examines how the way non-Turkish-speaking Kurds narrate their experiences reveals the effects of language-related oppression and internalized oppression within Turkish healthcare services.

Methods: This paper is a methodological reflection on a prior qualitative study examining how the exclusion of the Kurdish language from Turkish healthcare system impacts access. Through semi-structured interviews conducted in 2018-2019 with 12 non-Turkish-speaking Kurds, the primary study revealed that language barriers extended beyond miscommunication and were deeply rooted in systemic oppression. In this paper, we reanalysed the data using the concepts of the narrated, nonnarrated, and disnarrated, developed by Vindrola-Padros and Johnson, to reveal how narration could unfold oppression.

Results: We found that non-Turkish-speaking Kurds seeking healthcare in Turkey often excluded (nonnarrated) government services due to the lack of services in Kurdish. They indirectly mentioned (disnarrated) the political conflict as the root cause of their negative experiences; and portrayed themselves as the ones who must adjust to the system, rather than the system accommodating their needs which implied internalized oppression (circumnarrated). As a result of this complexity, the individual often disappeared from their own narrative, relying heavily on family involvement (conarrated) as their primary means of access.

Conclusion: Applying the concepts of the narrated, nonnarrated, and disnarrated to the healthcare access experiences of Kurds in Turkey has revealed important insights into the structural and internalized oppression. By extending the original framework to include the concepts of conarration and circumnarration, we have provided a more comprehensive understanding of the complexities of oppression in healthcare access. Additionally, we found that one form of narration often acts as a response, replacement, or justification for another, urging researchers to consider the dynamism and the intricate relationship between different forms of narration.