Prof Chris Myburgh and Marie Poggenpoel kindly took me to a game reserve today. It was just beautiful! Lions, elands, springboks, baboons, zebras, guinea fowl, waterbuck, impala, wlldebeast, African squirrels, giraffes, and the list goes on. It was just beautiful to see these graceful creatures. And perhaps even more beautiful was the landscape…I kept thinking of the movie, “Out of Africa.”
We also had lunch at the reserve. This eland came right up to the deck where people were eating. The eyes on these animals are incredible — just so cool!
While in Cape Town, I had the opportunity to visit 4 of the townships….the not-so-beautiful side of the city. townships refer to the underdeveloped urban living areas that in Apartheid times were reserved for non-whites - blacks, colored, and Indians. They are physically located on the edge of Cape Town A driver took me and 2 women from Ireland on a tour of 4 huge townships: Khulani, Khayelitsha, Herare, and Langa.
Within the townships, shacks are put up and have substandard or non-existent sewage, water, sanitation, and electricity. We visited one home where 8 adults and children lived. The dirt floor was covered with a plastic sheet. There was a TV and a small gas stove. Electricity is purchased for use …. and when you run out … you run out. Paraffin is used to heat the shacks and is a major source of fires which often result in loss of life, as well as contributing to breathing problems for children and adults alike.
A man by the name of Niall Mellon — from Ireland, has been building homes in the Cape Town townships. The houses are small but nice and very functional. Locals told us that you have to put your name on a list and wait to be selected and the homes are highly sought after. I was told a home would run about R200,000.
The people we met were unbelievably humble, warm, friendly, and hardworking. Surely does make you appreciate all that you have been given. Photos above show some of the township sights.
I spent last week in Cape Town - part of the time playing tourist and was also able to collect some research data. Cape Town (known as the “Mother City”) is just incredibly beautiful with unparalleled views. Lots of tourists from all over the world. The city has a very different feel from Johannesburg and the weather is very different …. CT is damp and feels cooler. It rained almost everyday that I was there.
Above are some of the beautiful sites in Cape Town.
Globally there is an increasing Cesarean birth rate — and that is especially true in South Africa where Cesarean rates in the private facilities have been reported to run as high as 65-70% — and the bulk of women (where Cesarean isn’t planned) reportedly have labor induced. Rates of Cesarean birth are lower in the public hospitals. What memory is there of normal birth?
I was recently at a conference here in South Africa. A company has come up with a formula for infant’s born by Cesar. Interesting marketing approach (see photo above).
UJ has such a beautiful campus…and big! Three campuses with close to 50,000 students. Nursing is housed on the main Kingsway campus but will be moving to the Doornfontein campus in November to be with the other health science departments. The nice part is that it will be close a large hospital and the campus is very nice.
Above are pictures of the Kingsway campus….just really lovely.
367 South African Rhino’s have been poached so far this year….most in Kruger National Park. Most of the poaching is done to obtain the rhino horn which is sold primarily in the Far East for big dollars. Concerted efforts are underway to find ways to reduce such terrible animal cruelty.
Below are photos (credit Troy Otto) of a pregnant rhino who was killed for her horn, as was a 2 year old calf that was with her. The calf was shot first and as she stood over the calf, she was shot.
5/20/2013 Project to Improve Maternal Infant Health Services in Gauteng Province
The University of Johannesburg (UJ) Department of Emergency Services has recently partnered with Philips Corporation and the Gauteng Province Department of Health in establishing a new project designed to improve maternal-newborn health services. At the present time, when a women in labor needs transport to a hospital from clinic or home , an ambulance is called. The call is put in queue with ever other call. This new project will have a dedicated ambulance (with another to be put into service soon) — this ambulance will respond to mom’s and newborns who need transport, taking them to a dedicated facility - Rahima Moosa Mother and Child Hospital.
UJ had a lovely ceremony announcing the project and corporate partners. The ceremony was held on the Doornfontein campus (downtown near Hillbrow district). This is the campus where nursing will soon be moving to and joining the other health sciences departments. It is a lovely, large campus.
On a final note, I had the pleasure and privilege of meeting the Gauteng Department of Health Director of Maternal Child Health and Nutrition (Dr. Sikhonjiwe Masilela) Health Minster— who happens to also be a midwife! Above are pics from the ceremony.
Along the road side there a craftsmen selling things they have made. Lots of beaded animals, baskets, etc. But the picture above demonstrates a really unique talent — carving animals that are pretty big — and really life-like. The guy wanted R200 for one … which is about $20.
I flew out of Polokwane International Airport and back to Joburg. The Polokwane Airport was small but had a real theme going. There were airport attendants dressed with sequence covered jackets, black slacks, and glittery shoes! Right out of Vegas! I wanted to grab something to eat before my flight — the restaurant was like the set from the Jetson’s…really catchy! Fun place to sit and have dinner and a drink.
When flying back from Polokwane in Limpopo province, I was waiting to board the plane and a lovely gentleman was in line next to me. We struck up a conversation and he told me that he is a 19 year member of the South African parliament, a member of the African National Congress, and a representative from Limpopo province. His name is Nelson Diale and he was on his way to Cape Town for budget hearings. I learned a bit about his personal journal through his biography which he kindly shared with me (see photos above).
The ANC is the ruling party, was formed in 1912 and was instrumental in ending apartheid. The current President, Jacob Zuma, is a member of the ANC; the policies of the ANC are determined by its membership and its leadership is accountable to the membership. The ANC has been the ruling party for the past 19 years; the opposition party is the DA (Democratic Alliance). The ANC controls 8 of the 9 provinces in South Africa. Next elections are in 2014.
5/19/2013 Beautiful Handiwork by a Beautiful Afrikaan Lady
The UJ doctoral nursing student who took me to Limpopo province, soon-to-be Dr. Reda Jacobs, was kind enough to have me in her home in Polokwane. Her mom and dad live with them and her mother - a school teacher of many years, was an absolute delight! She is not only beautiful - but also very talented. She crochets the most beautiful works and uses glass beads to adorn the beautiful stitchery. I was amazed that she could do such fine work at near 80 years of age! She truly creates art! See photos above
5/18/2013 Meeting with Maria - a Traditional Healer
While in Limpopo, I had the opportunity to meet with a Traditional Healer, Maria, and discuss her work. She has a master’s degree in education but is not longer teaching. She had the calling from her ancestor’s about 10 years ago. She now heals those who need her healing services. People come to see her for aches, pains, general worries, and for some, because they feel they have had a curse placed on them by a witch doctor.
She told me that once or twice a year she has a healing ceremony where many, many people come to participate. At the ceremony she sings, dances, and speaks with the ancestors. In addition, a cow or goat are sacrificed and the blood is smeared on the person she is healing with the meat given to the people. These two animals hold special significance for traditional healers. The animal skins are put on a rack behind her house to dry — then used later in sessions with individuals.
In individual healing sessions, she prays, dances, speaks to her ancestors through the horns of cattle, and burns herbs so that individuals can breathe in the smoke for healing purposes. She also mixes herbs for specific conditions - including pregnancy. For pregnant women, herb use typically begins in the last month or so — and are used again following birth.
The daughter of one of UJ’s nursing doctoral students, Le-Marie, was kind enough to act as my tour guide and driver so that I was able to see some of the countryside. We went to one small village in the eastern portion of Limpopo — not too far from Kruger National Park. It is very hilly there — beautiful landscape with tons of pine trees. In fact, they have a mill there. We spent some time in one small village — Haenertsburg — very quaint, quiet, and peaceful with small shops and a few key shops (grocery, couple of restaurants, and a bar).
I was invited to travel to Limpopo province and it was just a wonderful experience. Limpopo is one of 9 South African provinces and you can see where it is on the map below (I am living in Gauteng province — pronounced “how-ting”). We visited one small town and experienced a bit of rural South African life. Above are pictures of housing in the town of Nobody — which has a population of a a few hundred.
Each year the UJ Department of Nursing hosts a post-doctoral forum where issues related to the development of nursing science are discussed. Nurse research scientists from across South Africa, as well as doctoral nursing students, were invited to attend. I had the privilege and honor of keynoting the forum, “Model Generation: The Appreciative Value in Nursing.” Notable nurse scientists (Profs Anna Nolte, Marie Poggenpoel, Chris Myburgh, Elzabe Nel, and Jeanette Maritz; as well as Drs. Annie Temane and Yolanda Havenga) presented a panel discussion after the keynote — raising many key questions. Approximately 50 attended from several universities and the discussions were great!
The forum was held in a beautiful venue …the Avianto Estates in Muldersdrift on the banks of the Crocodile River. Just a lovely setting with fantastic food.
Today was UJ’s Annual Research Day which was hosted by the Department of Nursing. It was held at the Bunting Road campus — a wonderful venue with a beautiful auditorium and terrific food. Approximately 100 students and faculty attended from UJ and other universities in South Africa, as well as the Dean of the faculty of Health Sciences, and faculty from select departments at UJ. I had the privilege of providing the keynote address: Sensibility and Science: Evidence Based Practice in Nursing. Best of all were the research presentations which followed by master’s and doctoral students. UJ’s research day is definitely worth attending! Well-done Dr. Downing (conference organizer)!
I learned today that out of 23 South African universities, UJ ranks 6th in research output!
5/8/2013 14th Annual State of the World's Mothers Report
was just released and it doesn’t look that great for many industrialized countries across the globe … UNLESS they have most care delivered by well-educated midwives. More intervention does not equate to better perinatal care. Where midwives provide the bulk of care to women who are low-risk (which is the majority of women) — and where those births respect the sanctity of the birth environment, the better the outcomes. Midwifery care should be the standard of care during pregnancy and birth — cost effective, higher patient satisfaction, and improved mother-baby outcomes. It is unfortunate that the press coverage fails to mention the midwifery model of of care and a low-intervention approach. Midwives….the world’s best kept secret.
4/29/2013 Midwifery in a Private Hospital in Gauteng Province
Life St. Mary’s Women’s Clinic is a hospital owned and operated by Life Health Care in Springs, Gauteng and I was fortunate to spend time there today. I have been to public hospitals in South Africa, as well as a midwifery run birth centre, and wanted to see a private hospital and how midwifery is practiced in this setting.
The hospital has 21 maternity beds, 2 theatres, a water-birthing room (and some of the docs do waterbirths!), 5 neonatal isolettes, 2 labor/birth rooms, and a triage room. It also sports a regular nursery (though mostly used for procedures as rooming-in is practiced), a Kangaroo Mother Care Unit, and a well-baby clinic. The hospital is old but the building has such charm and character — even so, they move to a brand new facility in 1 years time.
There are 27 nurses on staff, 8 midwives (3 advanced education) and I believe 5 gyne’s. In private hospitals in South Africa, midwives typically handle the labor and then call the physician to attend the birth. The Cesarean rate is about 35-40%; approximately 90% of patients are induced. About 3% of patients who give birth vaginally have received an epidural — much lower rate than most U.S. facilities. Patients who have had a vaginal birth are discharged in approximately 2.5 days; C/Section patients in 3.5 days. Patients seen at Life St. Mary’s Women’s Clinic would normally have medical aid (private insurance).
Marie Hattingh is an advanced midwife and matron (head) at the facility and is very dynamic with a great vision. She has had much experience, including 3 years doing homebirths. She has been instrumental in working with colleagues to develop a unit that will be midwifery led. This unit will see patients managed by midwives who will also birth with women. The patients will see the physicians twice — once for fetal ultrasonic survey, and one other time. Patient’s will be discharged earlier (at 1.5 days for an SVD and 2.5 days for a C/Section) and will be followed up postpartum by the midwives. It is a new and exciting model that has great potential for application in other settings.
Finally, one interesting thing I learned today is that nursing/midwifery students, as well as physicians, have their clinical training in public/government facilities only.
Note: My apology to Life Health Care if there are any errors in the statistics or description above.