Critically ill homeless patients benefit from the same level of care and have globally the same prognosis than housed patients but experience longer lengths of stay. Most precarious patients living in street have a higher mortality rate. The study perspective is not ICU centered but also concerns the global organization of healthcare since homeless patients are referred by numerous sources and discharged to different wards.

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Consumption has become a central focus in South African politics, one that hinges especially on evaluation of the behaviour of the new Black middle class.Based on an ongoing ethnographic study of Durban, mainly among the lower middle or "professional" class across a range of racial categories, the article addresses three aspects of this question: food provisioning and consumption across and within the various communities; interaction in shared social spaces that were previous segregated, especially shopping malls; and moral discourses in the media concerning this new class. The so-called 'Black diamonds' are a South African urban type of the sort labelled by Benjamin as a phantasmagoria. South Africans are willing to experiment beyond the boundaries of their native communities and there is an emergent national middle class culture, but there are marked regional differences and nothing yet that would amount to "creolisation".

Mauss’s intention in writing The Gift was to refute the strong ideological opposition between gifts and market contracts which would have the one free, generous and social, the other obligatory, self-interested and individualistic. The ease and frequency with which purchased commodities in Western societies are converted into presents supports his view that the two forms overlap and are permeable, each combining freedom and obligation, individual personality and social constraint. Mass-produced commodities are used to build up the material culture of a private domestic universe in a social process of appropriation. Presents are compared here with inherited objects, purchased items and immaterial donations such as money, gift vouchers and wedding list subscriptions. In light of this comparison of ethnographic observations made in France and Britain, the distinction between gifts and commodities seems to blur and the boundary between them is easily crossed.

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Résumé L’émergence d’une classe moyenne noire dans l’Afrique du Sud post-apartheid est mesurée à l’aune de deux critères : l’accès à une consommation réservée jusqu’alors aux Blancs et la proportion d’entre eux ayant quitté les townships. Un terme spécifique, les « Black Diamonds », a été inventé pour désigner les membres de ce nouveau groupe. L’article, fondé sur l’analyse des discours et des représentations élaborés dans la presse, met tout d’abord en évidence la façon dont la consommation apparaît comme un analyseur des rapports raciaux et sociaux. Mais ensuite, l’auteur montre que cette première lecture médiatique masque les véritables enjeux sociaux et politiques de la construction de cette « figure » de consommateur.

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