During my study abroad time in South Africa, I worked in a community health clinic in a township of Durban called Inanda. I was working as an intern/volunteer in which I would observe and assist health professionals in treating patients from the Inanda community. Before entering this setting, I learned about the healthcare system in South Africa and how it may differ from the health system in the United States. In the United States, health care is typically delivered privately, while South Africa has both a private and a public health care system. The community health center that I was working in was a product of the public health system, meaning that it would likely be different from the health care I have experienced as an American citizen.
Even though I expected the conditions to be different, it was shocking to see how resource-limited this clinic was. When working with many of the doctors and nurses in this clinic, they complained of being overworked and underpaid. This could be seen by the long queues of people waiting for all the services that were offered at this clinic. On average for a regular primary doctor, it would take about 4-6 hours to be seen by a doctor and leave with a treatment plan or referral. This is not only hard on the health professionals who must deal with the large amounts of patients to be seen daily, but it is also hard for many of the patients who likely had to take off work or school to wait to see the doctors. In many cases, people can’t even afford to take off work to do this making access to healthcare extremely hard. This was frustrating to me because it seemed like the public health care system was failing both the health professionals and the patients. In this specific community, the average annual household income was R14,600 which is equivalent to about $860. This shows that most people in this community can’t qualify for or access private healthcare services meaning that if they are looking for healthcare, they can only access it through the public system. During my first week of this internship, it was extremely difficult to observe in this setting because of how resource-limited they are. While it would appear as though the health care being delivered is inadequate, given the setting and resources. I would come to find out that even with limited resources, they were able to deliver quality health care regardless of the barriers that this clinic faced.
After having spent 4 weeks in this internship, I was able to learn how the health professionals overcame the barriers of having long hours (with basically no breaks), limited resources, high crime and violence, long queues, and clinic construction. Something that I immediately noticed about the patients and the doctors was their sense of patience. In America, long waiting queues would leave people restless, impatient, and angry, while people in the Inanda clinic were calm and collected. Something that also really impressed me about this clinic was that all the services offered were guaranteed to be free of charge. From delivering safe births to X-rays to HIV medication, all of it was free to all the patients who came to the clinic. I was also extremely impressed by how the HIV clinic within the Inanda clinic was run. It was highly organized, and the doctors were very knowledgeable about the medication and treatment of HIV for each of their patients. I was also able to see how passionate the healthcare workers were about this specific community, and they always did everything they could to deliver the best quality healthcare possible. Through this experience, I was able to learn how to use my positionality to better understand how to navigate my feelings and judgments. Rather than viewing this clinic from an American perspective, I needed a South African context for this specific clinic to better understand how health care is delivered to these communities.
There are two distinct racial groups in South Africa. I was mainly living alongside Black South Africans as my host family was in a township in Durban. The white Afrikaans groups are still noticeably separate from South Africans living in townships. For this assignment, I will approach it from the perspective of someone living in a township. In my own opinion, I don’t think it would be shocking or surprising at all for someone from my host culture to view my experience. Likely, they have had experience with the public health care system and understand that there will be long waiting times. I also think they would understand better that the public health sector in South Africa is underfunded which would mean that some of the technology and infrastructure will be less sophisticated. Due to the impact of apartheid, racial segregation within society is still very apparent, especially for individuals who are of a lower socio-economic status. Most people I encountered in the township would likely blame the government and the lack of work to reintegrate people into society. However, in many other ways, I experienced that people living in the township are content with the lives that they built even if they understand that they are still living in an unequal society. Through this experience, I think I’ve gained the ability to acknowledge my positionality and perspective and attempt at removing those preconceptions to be open-minded in my experiences. South Africa turned out to be one of the most educational and insightful experiences of my life and I’m extremely grateful for the people I met while I was abroad. South Africa is a beautiful place with beautiful people and culture; however, it is important to note that there is still so much that can be done to establish a more equal society for all citizens living in SA.