IHP Health and Community: Globalization, Culture, and Care (Spring 2)

Spring 2011 Letters

South Africa Letter Home

Written by Trustees Fellow Siobhan Brewer

We arrived at the OR Tambo Airport in Johannesburg, South Africa, eager and excited to get to know our final destination for the program. We were greeted by our wonderful country coordinator, Jan Vermeulen, and quickly taken to the Wilgespruit Fellowship Centre. Here we would live for the next week as we learned the detailed political history of South Africa, Apartheid and life since 1994. With a strong understanding of the past, we left the city behind to experience village life in the Mpumalanga/Limpopo provinces and catch a glimpse of the Big 5!

Before we left Vietnam, we watched the movie “Amandala!” a documentary that recounts the evolution of music over 40 years of racial separation and discrimination in South Africa. This powerful documentary taught us about the resistance movement of black South Africans during Apartheid. Once in the country, we realized we needed a detailed account of the history. Fortunately for us, we were staying at a place that played an important role in the struggle against Apartheid. The Wilgespruit Fellowship Centre was created in 1948 in response to the policies of Apartheid and forced racial separation. Here, people of different races and cultures came together to work, worship and live as a family. Over the next 4 decades, the Wilgespruit Center became a space for the liberation movement to come together for resistance activities, training and education. We felt honored and privileged to have the opportunity to live and meet people who worked hard to liberate the country from the oppressive policies of Apartheid.  In addition, we learned the history of South Africa from guest lecturer JP, and through site visits to the Apartheid Museum, The Hector Pieterson Memorial Museum, and a trip to Soweto, and were able to gain an understanding of the painful history of South Africa to set the context for the present challenges faced by the country and the people.

Looking at the history of South Africa, many of us began drawing parallels between the Civil Rights Movement in the US and the Apartheid Regime. In our academic synthesis, we discussed issues of race and class within both countries, and we thought a lot about what it means to have a minority group holding power over a majority people. We were shocked by and inspired to learn about the process of “Truth and Reconciliation” that the country went through after the Apartheid regime ended. Truth and Reconciliation was a way of bringing the country together to heal after the many violent and painful events that took place during those 40 years. This process aimed at providing amnesty and forgiveness to those who had admitted to committing violent crimes during the regime and to help the country to move forward.

With a democratic government since 1994 and “reconciliation,” South Africa has accomplished some large scale achievements like poverty reduction, new housing, sanitation and electricity, and an emerging black middle class. However, we quickly learned that the policies that divided the country 20 years ago continue to have a heavy influence on the lives of the people today and that the challenges are greater than they may seem. Failures of the former President to seriously address the HIV and AIDS epidemic within the country, has made improving the health of South Africans (and those who migrate to South Africa for work) one of today’s biggest priorities for the government. Economic instability and limited resources create disproportionate spending on and access to health services. Poverty still remains a prevalent issue, especially in rural areas. On top of this, South Africa is not only responsible for taking care of its 49 million citizens, but to be an example and leader for other countries in sub-Saharan Africa.

When the African National Congress took governmental power in 1994, many hoped that the livelihood of black South Africans would improve drastically. Although the ANC has done much to try and bridge the disparity gap between whites and blacks, by providing better quality health care, education, and community services, poverty and HIV/AIDs are still major issues affecting black South Africans. When the ANC came into power they created a National Department of Health to address many of the health issues faced by black South Africans. Currently, South Africa faces one of the highest rates of infected population in the world, with HIV/AIDS being the number one cause of death within the country, and President Zuma and the new Ministry of Health have made it a priority to spread knowledge through schools and the media, and to provide testing, counseling and ARVs to the people. In Joburg we visited the Aurum Institute, a non-profit center, that works to educate vulnerable sectors of the black population, specifically working with the prisons, mine workers and informal taxi drivers. The center has developed creative outreach and educational methods to teach people about AIDS, HIV and TB and works to make testing available for people who do not have access to health services. They do this by bringing services directly to the people. For example, taxi drivers generally do not have time to visit a clinic, often working 16 hour shifts. By bringing services to their work, the drivers have an opportunity, as well as the passengers and many of the informal market traders selling products, to get tested in the metro station. The Aurum Institute is taking inventive approaches to addressing the HIV/AIDS epidemic within the country.

In the Mpumalanga province, we visited Hlokomela, a HIV/AIDS private non-profit center, whose purpose is “to improve the health and reduce the vulnerability of commercial migrant and permanent farming communities to HIV and AIDS, TB and other chronic health conditions through improved knowledge, awareness, access to services and healthier living conditions”. This organization provides an array of services such as peer education, health education, training and mentoring and support groups, media campaigns, health services, recreational activities and a community vegetable and herb garden. Hlokomela is an inspiring organization really tackling the health issues of a very vulnerable group where resources are far more limited (than in the city).

In addition to these NGOs, we were able to visit a few clinics and the Tinswalo hospital to learn more about the health services provided to the community in the rural province of Mpumalanga. Because of the high prevalence of HIV/AIDS in the region (over 25%), the President strongly supports community and home based care to provide peer health education and lessen the burden on hospitals and clinics that lack the resources and capacity to care for all of the sick. Interestingly, in comparison to Vietnam, medical doctors strongly discourage using or combining traditional medicine with ARVs and other HIV/AIDS drugs.

Islington: Our Home
Our final homestay for the program proved to be a challenging yet truly wonderful experience. It was during this stay in the small village of Islington where we were exposed to some of the daily challenges black South Africans face, such as a lack of running water, transportation, and well-paying jobs. In class we learned about the forced removal and relocation of black communities during the Apartheid regime, which contributed to the development of Islington and other villages within the Mpumalanga and Limpopo provinces. During Apartheid, black South Africans were separated from the land that connected them to their ancestors and traditions and were relocated to homelands that were unfamiliar.  With guest lecturer Loot Schulze, and within the Environment and Food case studies, we explored and discussed how the impact of displacement has played a role in contributing to poverty within the community and threatens the existence of wild animal life and the health of the environment. In the village we learned about the challenges relocating has had on knowledge of food systems and farming on unfamiliar land. In addition, we learned about South Africa’s struggle with the prospect of absolute water scarcity and how the dense population of the villages in Bushbuckridge exacerbate this issue.  At our homes, most of us adapted to taking bucket showers, using outdoor latrines, and fetching fresh water from a barrel that serves the entire village. This experience really made us think about our relationship to water and how important access to water is, not only for hygiene and agriculture, but for survival. 

One of the most interesting experiences in the village occurred during the Easter weekend. We observed the roles and relationships between men and women, the role of religion within the community, and the importance of family. Over Easter, we witnessed a swell in population of Islington, as many brothers, fathers and cousins returned home from working in the mines and city of Joburg. This is a common situation among many households within our village, and the surrounding villages, as many men are forced to find work in the big cities far away from their families. During this weekend, many of us participated in religious activities, traditional dancing, and feasting with our families. Another interesting event was a musical fundraiser that student John Metais put together to raise money for a group of church youth in the village. At the fundraiser students from IHP and the young people in the village came out to share their musical talents. It was truly a special experience to be a part of. We will miss our families and the village of Islington. 

As the program came to an end, we spent the last week at a beautiful resort center preparing to re-enter the “real world”. This trip has been a challenging, intense, inspiring and life-changing experience. Over the four months we’ve laughed, cried, bought a bunch of scarves, taken risks, stepped outside of our confront zone, eaten food with names we couldn’t pronounce, learned a few languages and made deep connections with people and places. This has been an unforgettable journey, one that we’ll talk about for the rest of our lives.

Thank you.

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Credits: 16

Duration: Spring, 16 weeks

Program Sites:
USA, Argentina, South Africa, Vietnam

Prerequisites: None. Coursework in public health, anthropology, biology, or related field recommended. Learn More...

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