IPE 3050: PUBLIC HEALTH AND HEALTHCARE SYSTEMS IN SOUTH AFRICA

Professor Robert Bensley, PhD [email protected] 269-716-2301

Description: The proposed travel study course will focus on current health promotion and healthcare issues in South Africa, especially within the Nelson Mandela Metropol in the Eastern Cape. South Africa is currently under extreme healthcare duress, leading the world in HIV infection and experiencing a host of other public health related factors, including poverty, violence, alcoholism, and HIV-related infections. The country has experienced great strides following a long history of segregation associated with Apartheid. However, public health systems, including healthcare, continue to be a disparity for cultures within South Africa. Much of this is related practices that evolved due to Apartheid, however, rich cultural traditions also play key factors in how native populations approach preventative health and healthcare. One of the major goals of the US Healthy People 2020 objectives for the nation focuses on eliminating health disparities among US populations. The proposed program is designed to not only provide students with a global understanding of the complexities that exist within international health practices, but also serve as a platform for providing a deeper understanding of the consequences of health disparities as it relates to our own cultures.

This course will include a series of formal and informal meetings with different public health and healthcare individuals and groups, visits to health and healthcare institutions, cultural activities and immersion, hands-on service learning involvement, and group discussions. In particular, students will be exposed to a number of healthcare practitioners, personnel from public health and non-profit centers and clinics, university-based wellness peer helpers, and traditional healers. Service learning will incorporate aiding in activities at a mission center soup kitchen and clinic. Experiences will also include events that broaden the cultural understanding of health practices, including experiencing wildlife game drives and safaris, a two-day excursion to Cape Town, tours of poverty stricken townships, and attending cultural events that include visiting historical Apartheid struggle experiences, and a “braai” (a South African barbecue experience). Experiences will include a series of group debriefings that include discussions as to how the process relates to the broader US and global health systems.

Program Goals: 1. Enhance student understanding of how cultural issues impact public health and healthcare among South African populations 2. Explore how public health and healthcare practices in South African are similar to and differ from those in the US 3. Empower student interest in expanding global impact on the health of populations. Pre-departure Orientation Program: A 2-hour session (and dinner at the Bensley home) will occur in February-March, with subsequent meetings held as needed. During this session students will be provided with materials and information associated with travel needs (such as clothing and other travel necessities), money conversion, and communication necessities. Safety issues associated with travel in South Africa, as well as general safety and protective concepts will also be introduced. An overview of the South African culture and a brief history leading up to current events will be infused with a discussion of the two pre-reading assignments. An orientation to Port Elizabeth and Summerstrand will complete the pre-departure orientation.

Course objectives: Upon completion of this course, students will be able to: 1. Describe major issues currently impacting South African healthcare systems. 2. Identify major cultural issues and limitations associated with effectively impacting HIV/AIDS in South Africa. 3. Compare traditional healer practices with US home remedies and other practices of personal health care. 4. Compare and contrast the African and western wellness perspectives. 5. Explore how peer helping could better enhance public health care in South Africa. 6. Identify cultural constraints that are barriers to effective public health programming in South Africa. 7. Explain how the US public health and healthcare system could be improved by adapting South African practices and beliefs.

3 credit hours

Required reading (prior to pre-departure orientation): My Traitor’s Heart by Rian Malan Travels with Livingstone by Robert Bensley

Grading Accomplishment of above objectives will be measured through participation in group debriefing sessions with Dr. Bensley and a final paper addressing each of the above objectives in context of the experiences and excursions the student observed. The standard WMU university grading scale will apply. Grading will be based on the following point scale: Pre-departure reading synopsis paper 10 pts Onsite debriefings (5 pts each) 30 pts Final paper 30 pts

Housing: Students will be housed in apartments located in Summerstrand. Each apartment is completely furnished and equipped with modern conveniences and Internet.

Food Services: Port Elizabeth is a first-world city with all the amenities necessary for sound nutritional eating. Summerstrand is an oceanfront summer tourist area and, as such, has a full range of dining experiences available for students. In addition, two grocery stores are located within two blocks of student accommodations and are in easy walking distance. Students will be responsible for all food costs during their stay, except for those that would be provided as part of prepaid overnight excursions.

Academic and Student Support: Dr. Andre de Jager, previous director of the Student Counseling and Career Development Centre and current a Research Associate at NMMU is a co-facilitator in this proposed program venture. As such, he has direct access to numerous community and university support services; academic, emotional, career, and wellness counseling. Drs. Bensley and de Jager will accompany students on all lectures, site visits, and excursions, providing necessary academic relevance to each experience.

Site Visits: . Missionvale Care Centre Missionvale is located in a township of Port Elizabeth. Started by Sister Ethel, it has become a beacon for standard of care for many health and human services. Included in the center are a public health clinic, soup kitchen, elementary school, clothing distribution center, welfare office, youth and recreation center, and job skill-training program. Drs. Bensley and de Jager have been involved with Sister Ethel and the center in the past and will lead the expedition. The academic aspect will focus on a service-learning event where students will experience how the incorporation of health and human services are being used to improve the public health of needy populations in South Africa.

. Dora Nginza Hospital A visit to Dora Nginza hospital in the Port Elizabeth area will be organized and led by a health professional in PE, with Drs. Bensley and de Jager accompanying. The academic focus will center on the current state of public healthcare being provided in South Africa.

. Traditional healer A visit to a traditional healers in the Hogsback area will be organized and led by the Nomfundo Mlisa from the University of Fort Hare, with Drs. Bensley and de Jager accompanying. Traditional healers are an integral component of South African health practices. The academic focus will center on traditional healer practices and how they integrate into South African healthcare.

. Children’s Hospice Center A visit to a center that focuses on hospice care and services for children primarily afflicted with AIDS. Lectures focusing on hospice services will be provided and shared with students.

. NMMU Peer Helper Project Students will work with Nelson Mandela Metropolitan University wellness peer helpers in exploring and sharing activities designed to improve the health and well being of student populations.

Excursions Six excursions will be undertaken, with each one designed to provide a deeper and broader understanding of the unique cultural and environmental aspects that make up South Africa. Excursions include a city and township cultural tour; two wild game parks (Kraggga Kamma and Schotia) with an overnight stay at Schotia; hiking within Tsitsikamma National Park and Hogsback (with overnight stays at each locale); a 2-night excursion to Cape Town with visits to Table Mountain and Robben Island where Nelson Mandela was imprisoned). All of these excursions will be planned and led by Drs. Bensley and de Jager, both of which have participated in each excursion multiple times over the past decade.

Safety and Security: Students will be required to obtain all immunizations necessary for travel to South Africa. This can be accomplished through the Sindecuse Health Center at WMU. However, there are no recommended immunizations needed where the course will be offered, other than what current students should have received during childhood. A consult with the WMU travel nurse should be made, nonetheless. Safety orientation will be included in the pre-travel orientation session. Students will reside in housing near the de Jager’s and travel together as groups. Port Elizabeth, within the Nelson Mandela Metropol is a first world environment, reducing the likelihood of experiencing extreme hardship. Summerstrand, an area within Port Elizabeth, is where the university is located and the students will stay. Summerstrand is a beachfront community on the Indian Ocean and home for tourism and summer recreation. There are no known travel advisories to South Africa over the past 12 months. Emergency evacuation assistance, if needed, will be coordinated by both Dr. Bensley and Dr. de Jager. Dr. Bensley will be in contact with the US Consulate related to procedures to follow in the extent of an evacuation emergency. Dr. de Jager will aid in organizing any transportation necessary for evacuation. Port Elizabeth has a regional airport (similar in size to Grand Rapids airport) located within 5 miles of where the students will be staying. ITINERARY

Day Date Time Event Academic Relevance Academic Hours

February- Pre-departure orientation Pre-departure orientation lecture on 4 March South African culture, safety issues, and travel preparations and other issues.

Saturday 5/5/18 Depart from US to SA

Monday 5/7/18 Arrive SA

Settle into accommodations, walking tour of Summerstrand/Pick n Pay for supplies

Arrival dinner at de Jager's

Tuesday 5/8/18 9:00 Finger breakfast at de Jager's/official welcome and orientation 11:00 Depart for Kragga Kamma 12:00-4:00 Excursion: Kragga Kamma game This excursion provides a broader 2 drive understanding of South African wildlife and natural environment. The animals in South Africa are well revered. 6:30-9:30 Welcome braai at de Jager's

Wednesday 5/9/18 10:00-12:00 Lecture: Peer Helping and Wellness in 2 South Africa 12:00-1:00 Lunch at NMMU 1:00-4:00 Project: Peer Helper Project Peer helping is a student 1.5 lifestyle/counseling practice that has been integrated into South African university campuses, centering on the Ubuntu South African philosophy of "I exist only through you." Marina de Jager’s an international leader in the development and integration of peer helping in campuses around the world. WMU students will engage with and learn from peer helper students from the Nelson Mandela Metropolitan University in this project. 4:00-5:00 Debriefing #1 1

Thursday 5/10/18 10:00-12:00 Lecture: Public Health Issues in South 2 Africa 1:00-4:00 Lunch/free time 4:00-8:00 Site visit: City and township tour, Central to understanding the state of 2 including stops at township South African health and healthcare craftsman and supper at a township practices is to understand the extent to tavern with traditional meal which poverty exists and the historical nature that created this poverty. The academic relevance of this excursion focuses on a greater understanding of the living conditions of the majority of South Africans.

Friday 5/11/18 9:00-4:00 Site visit and service learning: The academic aspect will focus on how 3.5 Missionvale Care Centre and Clinic the incorporation of health and human services are being used to improve the public health of needy populations in South Africa. 4:00-5:00 Debriefing #2 1

Saturday 5/12/18 9:00-5:00 Overnight Excursion: Tsitsikamma This excursion provides students with and Otter Trail hiking an opportunity to see and explore one of the beautiful national parks in South Africa. Overnight at Tsitsikamma cabins 6:00-8:00 Tsitsikamma braai

Sunday 5/13/18 9:00 Breakfast at Tsitsikamma 10:00-1:00 Return to PE 1:00-10:00 Free time

Monday 5/14/18 9:00-12:00 Lecture: Stereotyping 3 1:00-4:00 Free time 4:00-5:00 Debriefing #3 1

Tuesday 5/15/18 9:00-12:00 Overnight excursion: Travel to Eastern Cape/Hogsback 2:00-5:00 Site visit: Traditional healers Traditional healers are an integral 1.5 component of the healthcare services among native populations within South Africa and many other African nations. It is common for South Africans to visit both western medicine and traditional healers as part of their care, as the healers are the conduit to the ancestral spirits that are crucial to total mind, body, and soul healing. 6:00-7:00 Dinner at King's Lodge in Hogsback 7:00-8:00 Debriefing #4 1

Wednesday 5/16/18 8:30 Breakfast at King's Lodge 10:00-3:00 Hiking in Hogsback area 3:00-7:00 Return trip to PE

Thursday 5/17/18 9:00-11:00 Lecture: Healthcare Issues in South 2 Arica 1:00-5:00 Site visit: Dora Nginza Hospital 2 6:00-7:00 Debriefing #5 1

Friday 5/18/18 8:00-12:00 Cape Town 2-day excursion 2:00-5:00 Visit Table Mountain

Saturday 5/19/18 9:00-2:00 Visit Robben Island Robben Island was the site where 2.5 Nelson Mandela was imprisoned for years during Apartheid. A visit to this historic prison is central to understanding the struggles the current government had in establishing itself and caring for the South African population.

Capetown Lodging 2:00-10:00 Free time

Sunday 5/20/18 10:00-12:00 Return flight to Port Elizabeth Free day

Monday 5/21/18 1:00-5:00 Chidren's Hospice Visit with 4 Lectures

Tuesday 5/22/18 9:00 AM Overnight excursion: Schotia Safari 3

Wednesday 5/23/18 10:00-2:00 Visit Addo Elephant Park 2

2:00-4:00 Return to Port Elizabeth

Thursday 5/24/18 10:00-11:00 Debriefing #6 1 11:00-6:00 Free time 6:00-9:00 Farewell braai at de Jager's

Friday 5/25/18 Flight home en route Debriefing #7 2

Saturday 5/26/18 Arrive in US

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