A student’s South African experience

Looking through the bushes: A student’s South African experience

Rodriguez, Helen

The phone rang late one night and it was a call from my professor, Dr. Allen, from the university. I had turned in a paper a week ago and thought surely it was not that bad that she had to call me at home. I nervously returned the call and was asked the question of a lifetime. “Do you want to go to South Africa for a nursing research project?” I was so surprised and excited I could barely breathe. Many thoughts ran through my head: my husband, my job, and my life. A decision had to be made, and with the encouragement of my husband I decided to go.

Honestly, I never really thought much about South Africa in the past, I never thought about Africa. This was an opportunity to embark upon an experience that would allow me to put theory into practice while learning about different cultures in a different country.

The Minority International Research Training (MIRT) Program, which is funded by the Forgerty Institute and administered through the University of Illinois at Chicago, accepted me into the program. The program’s goal is to train minority-nursing students in the field of research. Research is a field that is not well understood and is underrepresented by minorities. The program teaches the research process through hands-on experiences.

The cultural expectations flooded my mind once I received the acceptance letter. Several people asked if I was ready to sleep in the bushes. I had thoughts of wild animals roaming freely in the open land and naked people. I checked the Internet several times to look up information about South Africa. There was information, but none dispelled the preconceived ideas I had conjured up in my mind. I knew that Johannesburg was a historical place, but I knew little about the history. I knew there would be black people and I knew there would be white people. I had read about apartheid, but not the impact it had on the nation of South Africa. I knew this was going to be an unforgettable experience.

I said my good byes to all things familiar to me. I was on my way to a place I have never been, with people I had not met, to do something I have never done, in a country I did not know. I was on my way to South Africa. I boarded the plane expecting that for the next 10 weeks I would be “waiting to exhale”.

We finally arrived after 20 flight hours. I saw people of all ethnicities. Johannesburg looked a lot like Dallas, Texas. There were many tall buildings, traffic, cars and even Kentucky Fried Chicken. There were no animals roaming around and people dressed just as we do in America. There were people of all races in the airport. I was pleasantly surprised. We resided in a very nice guesthouse in Pretoria where the only bushes we noted were hedges and the only animals were cats, dogs and birds.

As we drove through the streets of South Africa life here resembled scenes from America. There were some very wealthy areas and some extremely poor areas of homeless people and people selling or begging in the streets. Where were the people you see in Time magazine? Where was the underdeveloped country? I was not prepared for the answers that unfolded as the weeks progressed.

I never appreciated the value of the dollar while in America because it was never quite enough, but in South Africa, one American dollar equaled eight of their Rands. That first transaction immediately suggested to me that the economy might be suffering. In the meantime, however, I was well– off economically because of the value of the appreciated dollar from America. I wondered what suffering I might encounter.

We worked in rural South Africa in the North West Province. We drove for what seem like hours down a long paved road. However, it was only approximately 73 kilometers (45.5 miles) from Pretoria. There were the poor, the indigenous, and the undeserved. I saw homes made of tin, some from cardboard and sparsely dispersed throughout were small brick government homes. The toilets were outside in a small shack, and there was no running water inside the home at all. People were barefoot, and dusty. We visited the squatter homes in Soweto, an urban community on the outskirts of Johannesburg, where the conditions seemed unbearable. The homes were crowded together and there were people crowding the streets. I expected to see poor people, but this was poverty at its worst.

Apartheid, which means apartness, was instituted in 1948 and abolished in 1994, wounded so many individuals and families. The goal of apartheid was to separate black Africans from the whites. Although slavery was abolished years ago in South Africa, apartheid kept it alive by creating laws that enslaved an entire continent. Blacks were not allowed in the cities after a certain time and even then, they needed to have in their possession a “dompass”. It was called “dompass” because blacks were considered stupid and dumb and for them was created a pass for the dummies, the “dompass”.

Seven years after the abolishment of apartheid, the passes are gone, but the bondage and oppression remain for many of the black people in the form of poverty. Many poor people are without jobs and the unemployment rates for black

Africans continue to rise. Many black Africans do not have adequate housing, have limited public-funded healthcare, few job opportunities and limited education. Some parents are leaving their children with their grandparents while they go to the neighboring cities to look for work, but often times finding no jobs and are too poor to return home. Grandparents are taking care of, at times, more than five people in a single dwelling, on a pension that equals approximately $67.00 in U.S. dollars per month.

There are eleven recognized ethnic groups and languages in South Africa. One common bond among these ethnic groups such as Tswana, Xhosa, Zulu and other ethnicities were they were still surviving people and they were alive not because of apartheid but in spite of apartheid. The people of South Africa are resilient and strong. I learned that they appeared happy, warm and friendly in spite of the current situation. Many people stated, “things are getting better” and we are very hopeful of the future. I learned they seemed to value life, family, and living. I learned many of the South African people seem to be interested in quality of life and not the quantity of material possessions. As a practicing nurse, these lessons reinforced my personal beliefs of people. It reinforced the fact that to live in any society, one must be able to learn and to be able to continuously change one’s point of reference. We must not judge people using our own culture as the rule, but to accept the various cultural norms and differences. If we attempt to change other cultures to conform to one that is similar to our own, we are only meeting our needs. My future career in research depends heavily on my objectivity. As nurses, we must listen and interact with diverse groups. We must allow opportunities for people to express their needs and concerns. We must allow all people a voice and to be heard.

America has its own atrocities. America had its own version of apartheid. The civil rights movement fought for equality and justice for black Americans. South Africa and black America fought similar battles and it took time to change the laws, mindsets and behaviors of some people. Furthermore, both countries are still working towards those goals. To function in a global community requires cultural sensitivity and awareness. Nurses need to be able to understand other cultures to practice in the global community. If we believe and understand people are similar regardless of skin color, language and geographical location, then we can recognize it may be only the cultural practices and beliefs that separate us. Learning about different cultures can only enhance our own lives and help us to gain a better understanding of other people.

I encountered several ethical issues while in South Africa concerning as race relations and healthcare. Nevertheless, I am only addressing the two issues having the greatest impact on me. These were economic disparities and inequity in the education system.

The economic status for the people of South Africa was greatly disproportionate. Companies from many different countries are moving to the new South Africa. These industries should create jobs and boost the economy. However, what is happening may be described as economic apartheid. The unemployment rate in South Africa among blacks is approximately 43% and more than 50 % are living in poverty. I did not encounter poor whites during the 10 weeks in South Africa. Where were they? The white people I encountered in South Africa had homes, clothing, food and jobs. In my opinion, it is unethical to deliberately put the blacks or any ethnic group in such inhumane condition, but it is more unethical to leave them in these substandard conditions. Jobs are being created in the cities away from the townships. The unemployment cycle continues because these jobs are far from most people, public transportation is not easily available, therefore, many people are unable to gain employment. Creating jobs in the townships and rural areas would give people some income. Jobs would also create stability and economic growth within their community.

Inequities in the educational structure were another identified ethical issue for me. We were able to visit several educational institutions. The contrast was of great magnitude. In areas where primarily white people resided, the schools appeared dean. It was reported that teaching supplies were adequate and there were playgrounds for the students which appeared safe. The schools in the rural areas appeared unclean, often broken windows were noted. There was no playground for the children and it did not appear to offer the best conditions for learning. It was reported at one school there had been frequent burglaries and books were lost or stolen. The books available were old and in poor condition. At one school, I observed one faucet for water in the courtyard, both for drinking and cleaning. This scene was frequently noted from one area to another and from elementary to the universities. Furthermore, there was a news report indicating in some areas classes were conducted under trees. The question arises “how do you learn in such extreme weather conditions where heat can make one faint and coldness can make one shiver?”

The ethical issue arises when payment for grade school level education is required. How does one choose between educating a child, which is one avenue out of poverty, and feeding your family for the day? Residents paid for education in the rural community. When there is no money, no jobs and poverty that sometimes, (especially in areas where blacks resides), extends as far as the eyes can see, there is limited access to education and the cycle of poverty continues. What actually is the goal? If it is to keep the impoverished poor and the rich richer, the goal seems to have been met. However, if the goal is to provide equality to all people, South Africa has fallen short of the goal and must continue to strive for equality for its citizens.

I felt powerless observing these conditions and situations as a visitor. Nevertheless, as a nurse, I understand the importance of the concept of reaching across the globe to help those in need. International research becomes imperative to help identify needs of communities and of individuals. No one person can mend the wound of a wounded community; it takes collaboration of the community and the health profession. Working together, hand-in– hand, one can help to identify problems that are faced by others. International research can bring nurses together from around the world. The research and interventions project could potentially bring together the community and empower them to grow from within.

Economic empowerment may be the beginning of building a community. It is one strategy to promote continued success after researchers have left the country. Empowerment helps to build hope, self worth, and strength. Empowerment, through research, may be one method for bridging the gap between global communities.

Cultural experiences are necessary for both professional and personal growth. Viewing a culture from exposure to the people and separate from the influences and bias of home helps one to become a more global thinker and more culturally sensitive. Cultural experiences do not change who we are but enhance who we are becoming. Many of us, as health professionals, may be busy trying to see the forest past the trees and may often fail to see life lurking in the bushes.

I am an experienced RN, who practices in a large urban community setting at the time of this journey and a full-time student in an RN to BSN program. My trip and work as a member of this research team was a synthesis experience and one that I will reflect on for years to come. I have been enriched by South Africa and the needs of this rural community will have my attention for years to come. When I think of my community-based nursing today, I think of the global community, especially one rural community, in South Africa that was encountered, during my research experience.

Helen Rodriguez, RN, BSN-Completion, CCRN, Prairie View ABcM University, Houston, Texas.

Copyright Riley Publications, Inc. Center for the Study of Multiculturalism and Health Winter 2002

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