I came, I saw, I left . . . but not unchanged. As we all have said, this trip to South Africa has been an opportunity of a life time. We have seen a coastline that is absolutely beautiful and wide open land that stretches for miles. There are forests and waterfalls/oceans and mountains, all providing tourists with endless opportunities for adventure and fun. Ziplining, bunjy jumping, walking with the elephants, playing with the lion cubs all in one place – awesome!


But, there is more; we have seen poverty that is just incomprehensible until you stand in the middle of the wooden shanties; free clinics that are overcrowded (250-300 patients per day), and public hospitals that function with equipment dating back to the 1940’s & 50’s in many areas. Healthcare access for specific needs (patients needing orthopedics were referred to Livingstone, psychiatric patients were treated only at Dora Nginza) could be an all-day experience and that’s if one had the money for transportation or the strength to walk. Nursing has the same approach to health problems as in the U.S, namely history taking, examining, and planning. Patient education, however, is different. Educating about medication purpose, timing, and completing the dose is routine; however, how do you tell a patient not to eat salt, sugar, fried foods; or to eat green veggies, citrus fruits, etc. when the only thing your patient gets to eat all day may be a cup of soup and bread provided by community organizations. When babies are born at home in shanties, the community wheelbarrel serves to carry water from the community tap and doubles as a way to get ailing patients to hospitals, and people are waiting for a “real house with plumbing and electricity what do you do, how do you help? What do you work on first to decrease the poverty, the AIDS, the TB? We as nursing students (American and South African) are taught to educate our patients; how can anyone focus on learning when they are cold, hungry, and tired?
While I was in South Africa I would say, “America has the same problems of homelessness, poor access to healthcare, and poverty; it’s just that South Africa has a bigger volume”. Now, as I sit in my home with all my creature comforts, I have to say the poverty and homelessness abroad is overwhelming! With unemployment at 60%, HIV/AIDS at 34%, and medical equipment outdated, where do you start? Janel is correct in writing that one cannot look at the whole picture. The needs are so great and the government is so new. America has had 100+ years to work on healthcare issues and we still say there are pockets of poor access, poverty, etc. South Africa’s new government has had only about 14 years to sort things out. People keep asking what was it like over there? With the problems so great, hope so aboundant, and cultural beliefs so strong I can only reply, “God Bless the leaders with knowledge, leadership, understanding, and perserverance.” As the nurses at the clinics say, “We do what we can and then we go home only to return tomorrow and try again to help.”

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