Greetings from the Motherland
Greetings from the Motherland!
More than four thousand nurses from around the world convened during the 24th Quadrennial Congress of the International Council of Nurses (ICN) June 30th – July 4th, in Durban, South Africa. “Leading Change: Building Healthier Nations” was the Congress theme. The Minority Fellowship Program (MFP) abstract, “Employing the Logic Model to Assure Relevant and Efficient Approaches for Recruiting and Retaining Ethnic Minority Nurses in Doctoral Programs in the USA” was presented by Dr. Faye Gary, MFP Executive Program Consultant, Dr. Jillian Inouye, National Advisory Committee Member and Alumna, and Janet Jackson, MFP Program Manager. My abstract, ‘The Social Determinants of Substance Abuse in Older African American Baby Boomers: The Effects of Family, Media Images, and Environment,” was accepted for poster pesentation.
Deep Seated, Unspoken, Cultural Understandings: The Importance of Culture in Society
While in South Africa, I not only connected with deep seated, unspoken, cultural understandings, but developed a new found respect of the importance culture plays in society. Below is an excerpt from another abstract, “Substance Abuse and Mental Health in the Black Diaspora: Implications for Transnational and Cross-Cultural Research,” co-authored by MFP Alumni Dr. Bridgette Brawner, Dr. Margaret Wheatley, and myself. Although it was not accepted for presentation at the ICN, I witnessed up close many of the health disparities discussed in the abstract.
“Many throughout the Black diaspora are plagued by substance abuse and mental health concerns. In the United States, depending on the illicit substance, Blacks are admitted for treatment at a rate almost four times greater than Whites (23.6% to 6.5%). With respect to mental health, rates of certain mental illnesses among Blacks in the United States are higher than rates among Whites. In South Africa, illicit drug use in some instances is greater than 55% among Coloreds and Blacks combined (Coloreds-45.8% and Blacks-9.8%).”
Since we were discussing Blacks in the abstract, Dr. Brawner rightfully questioned my inclusion of Coloreds in the collected data. However, that inclusion would prove significant in so many ways while we were in South Africa. With hindsight, I would point out to Dr. Brawner, that the Coloreds of South Africa are the comparison group we should have focused on for our article on social determinants, for they are the group that is most similar to Blacks in the United States. There is a glaring disparity between Blacks, the dominant population group, and Coloreds. Clearly, there is a disparity of illicit drug use (nearly five times higher in Coloreds than Blacks) similar to the disparity found in the United States between Blacks and Whites. Throughout this report, when I refer to Blacks in the United States it is an umbrella for all the people of color who share the sensibilities associated with a history of slavery. However, the operational definition of Blacks used to describe the range of peoples of African descent in South Africa is more complicated. Early on I learned that my understandings of race in South Africa were poorly informed. For example, in South Africa "Colored" is designated as one of the racial groups, along with "Black" (the dominant population group), "White" and "Indian" and the term is not generally considered offensive there, as it is in the United States.
If ever there was a place to argue the significance of race, South Africa is it. I have been angered my entire adult life whenever I was called "Colored," as I felt it was descriptive, disassociating, and generic and had little to do with heritage. While I was growing up I proudly acknowledged that I was Black. However, I find that in South Africa, I would be considered Colored, by Whites, but more importantly, by Blacks as I am not Zulu, Khoikhoi, Kung or from any of the other tribes of South Africa. Oddly enough, but similar to the dominant population group’s (Whites) viewpoint in the United States, the Coloreds, are considered the "problem" by Blacks in South Africa. However, the Coloreds seemingly enjoy a higher social status than Blacks (better housing). Conversely, the Coloreds seem to suffer from a great deal more social ills, such as substance abuse and gang activity. It was very disconcerting to hear a Black cab driver say to me, that he would not venture into the Colored neighborhoods after dark. Somewhere in my ramblings, I think there is an argument for culture being a barrier against social ills.
Although, this is a very complicated society, the Blacks and Coloreds overall seem mentally sound and I would trade what we have at home, for the state of mental health that they seem to enjoy without hesitation. Although discrimination and prejudice exist there it seemingly has a significantly reduced mental effect on the population as they are the majority and feel less oppression than Blacks experience in the states. They don't really seem to care what the small minority of Whites think (mentally), and it is evident that they are happy with whom they are as a people.
Cultural Immersion: From Shanty Town to Cape Town
Shanty towns with little or no infrastructure are still inhabited by a large portion of the population. One room, tin roof houses fabricated from warehouse planks with no plumbing or sewer systems are all too common. Janet Jackson, my childhood friend Curt, and I embarked on a cultural immersion of South Africa that took us from the shanty towns to Cape Town. We were fortunate to meet a guide, Themba, who was kind and knowledgeable to provide us entry into the thoughts and minds of the people and to share with us his understandings of South African Culture.
Durban, the ICN host city and the entry point for the SAMHSA MFP contingency, was nestled into coves just off the Indian Ocean. We visited an outdoor market sprawling with people and with the help of Themba, we gained entry into another market (usually off-limits to tourists) reserved for religious practices, herbs, and medicines. We also visited the KwaZulu Natal high atop a mountain and watched the Zulu dancers perform the Zulu “kick.” Additionally, we visited an animal reserve and observed Zebras, Giraffes, Alligators, and Wilder Beast up close.
Durban was touted as the most developed beach coast in all of Africa, and while we enjoyed our time there, in hindsight we all agreed that Cape Town was the Jewel of South Africa. From Tabletop Mountain to Lions Head Mountain, down to the Waterfront, the vistas were majestic and the beaches just off the Atlantic coast unforgettable.
Finally, we passed just off the freeway (way too close for comfort) a nuclear power plant on our way to visit Cape Town University (CPU). CPU, although closed for winter vacation, bears a remarkable resemblance to the Ivy League schools on the Eastern Seaboard in the United States.
What a wonderful time of discovery in South Africa!
Go in peace.
Robert
Robert Pope, RN, MSN, PhDc
University of California, San Francisco
School of Physiological Nursing
John A. Hartford Scholar
SAMHSA MFP Fellow