July 2011
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| Informal settlement in KwaZulu-Natal |
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| The Voortrekker Monument in Pretoria |
One of the greatest opportunities I have had this summer has been meeting so many people across the health sector – from nurses at rural clinics to senior managers of regional hospitals (including the largest acute hospital in the world!), and from health policy makers and managers at district, provincial and national health departments to the founders of private institutions that provide technical assistance in health care delivery throughout South Africa.
Meeting all these people and learning their unique perspectives has shown me why policies and programs that seem so straightforward on paper are astonishingly difficult to implement in reality. In the countless steps beginning with policy design and ending with implementation at the point of care, dozens of different opinions, interests, and concerns – from clinic workers to private sector consultants – constantly fight to be heard. If the voice of a single critical stakeholder is not accounted for, the entire process may fall apart. One main challenge to executing a health program like ours is navigating the delicate politics – luckily for me, navigating politics usually means talking to many fascinating people and taking road trips to the heart of Zululand in KwaZulu-Natal.
As an unrelated side note, the 18th of July was Nelson Mandela’s 93rd birthday. Though it’s not a public holiday, it’s a huge national event. People were asked to volunteer 67 minutes (for his 67 years of public service) towards community service, with an official website listing pre-organized activities like painting schools, gardening, serving meals to kids, and donating blood. Can you imagine that happening in the U.S.?
It’s hard to believe my summer in South Africa is coming to an end. I’ve been here six amazing weeks, and with only two left to go, I’m already starting to respond to some meeting requests with “I’m so sorry, but I’ll be back in the States by then.” I’m usually then asked when I’m coming back, and I give the somewhat awkward “I’m not sure… maybe next year?” Sometimes they press further, and I must add, “I have to finish school!”