I think they have a very difficult time with HIV prevention and or treatment because of the stigma that is still attached to HIV. You know, it's not that we're perfect here in the US, because there is still work to be done in that area as well. But it's even that much more difficult. In South Africa. People don't want to take their medications because if they're taking a medication, they kind of out themselves as potentially being HIV positive, and they don't want others to know that even people in their family.
In an interconnected world, the health care of a population 1000s of miles away can ultimately affect the state of health near or in our own homes. This is random acts of knowledge presented by Heartland Community College. I'm your host, Steve fast. Today, we are speaking with two members of the Heartland Health Sciences Division who engaged in a service learning trip to South Africa. What they learned about health care in that country. And how it compares to ours is something they hope will benefit health sciences students back home.
My name is Martha Stearns, I'm the program coordinator for the medical assistant program here in Health Sciences at Heartland Community College.
And I'm Susan Karl. I'm the director of nursing education and Associate Dean of Health Sciences here at Heartland Community College.
So recently, you two took a service learning trip to South Africa. When did that happen? What was the objective of going there?
So we went at the end of May for 14 days to Cape Town, South Africa, we partnered with Harper College, which is up in the northern suburbs, to take students to South Africa to experience different health care systems with in another country.
Susan, how many students did you take?
There were four nursing students from Harbor College that were along with us.
What were your expectations going into this that you would learn and be able to bring back to Portland Community College? What knowledge did you want to gather for what we do here?
We hadn't had a group in South Africa before. So it was kind of an exploitative kind of trip. Also, well, not also it was an ex foreign, that we happen to have students come along with. So the expectations were, of course, to learn a new culture or experience a new culture, look at the different healthcare systems within that culture. But we were being open minded about it with our different experiences that we had planned there.
What organizations did you visit during this trip? What all places did you go to?
Oh, we went to Luma Lele, which is a orphanage, but they also have respite care there. We went to the YMCA, that is in South Africa, which
the YMCA was kind of different in that their home health, nursing and physical therapy caseworkers, social workers, that type of thing. They all operate out of the YMCA, which was quite unusual and different from how things are here. And we went to the Desmond Tutu HIV Foundation, we visited a couple of sites there. And those were, I mean, personally, for me, that was one of the big things I wanted to go for just to see their clinic in the public sector, as opposed to the private sector, that they have their hospitals, it was a very stark difference between the two. So that was very eye opening. And I hope the students kind of picked up on that as well.
The infection rate for HIV in South Africa is much different than the infection rate for HIV in the United States, the United States is less than 1%. In South Africa, it's 13% of the population. So it's something that is needed in that country. And just the setup of the foundation. It was funded by Bill and Melinda Gates. And so it was it was an eye opener,
you're sure definitely was
when you look at how we're so interconnected in the world right now. And I think we saw this with COVID. Because even though there's a lot of debate about the origins of COVID, and how it, you know, spread it was an international event, they first had an area where things started to spread very quickly. And then before the rest of the world could sort of keep up with what was happening. It made it a worldwide event. And when you look at health care systems in other countries, this is say something to you about, well, how we need to think about our local health care, doesn't need to be more holistic to think about, well, there might be something happening in South Africa or there might be something happening in another country that eventually will impact our lives here.
I think that is very fair, because We don't we don't live in a vacuum. And like you mentioned with COVID. First, it was somebody else's problem until it became our problem. And with travel and any number of things, it's too easy for disease processes to travel. So we can't just say, oh, that's their problem, they have to worry about it, because it's not. And the other part of that is, we are very fortunate to have the health care that we have here. And I, I feel like we should find a way to help others be as fortunate with their health care, because that's not always the case.
Also, maybe it might make people appreciate the opportunities for preventative care here a little bit more, as well, because the way that I'm hearing what you're explaining from your experiences, it seems like there might be a real haves and have nots that starkly between a private availability of health care and public health care. And probably in a lot of the instances where you saw things in public health care, there weren't as many opportunities to take preventative measures as you could have.
Well, and there's a lot that goes into it as well in the public sector, I think they have a very difficult time with HIV prevention, and or treatment because of the stigma that is still attached to HIV. And you know, it's not that we're perfect here in the US, because there is still work to be done in that area, as well. But it's even that much more difficult. In South Africa. People don't want to take their medications, because if they're taking a medication, they kind of out themselves as potentially being HIV positive. And they don't want others to know that even people in their family. And then you look at the living situations that a lot of them are in their communal living with a you know, different generations of families in the same area. So they're never alone to be able to take their medications privately, so they just don't. So that makes it difficult to control. There are a lot of ways that it needs to be approached.
You mentioned that in some of the cultural differences, what were some of the other things that you learned about or saw a better example of that, culturally, the approach towards towards treatment and towards healthcare? Was there a reluctance in other ways, you know, as a great example, you gave involving the stigma, which, as you say, we do see, you know, stigmas attached to certain things here that people, even though they might be able to have access to health care, they might not be forthcoming to their caregiver. But were there other barriers that you saw there culturally, in the folks that you were exposed to, and that were involved in treatment in South Africa?
I think one of the big thing that we saw, I don't know if you can say a lack of resources, but as far as PPE, so personal protective equipment, gloves, masks, things like that they held on to them, or they stored items instead of use them. So for instance, one of our students did see someone draw blood on a patient who was HIV positive and not use gloves. And the explanation is they didn't have gloves, they certainly don't have resources in the quantities that we do, we take it for granted that we have another, you know, 20 boxes of gloves in the in the storage cabinet. And they don't, but they they save them for the what if cases, or the case scenarios. And that went true for masks to TB, we were told it was TV season in the country, but no one was wearing masks. And so windows open for cross breeze to have better ventilation to decrease exposure that way. And so things that we take for granted here, they don't have access to those or they're limited in their resources, so they do the best that they can with what they have. It
sort of sounds like their culture has more of a scarcity of use that they don't want to use these things because they think it's going to be the things are going to get worse. So they'll need to use those PPS in the future. Is that what you're saying? Yes.
And also, there's a huge discrepancy between the public sector and then the private, they have as far as private insurance and public that's covered by the government. And so the private, of course, is for those who can afford to buy that insurance and have those luxuries that resemble more of what the United States have as far as the hospitals, the clinics, the care, as opposed to the public sectors that it would seem that they were more trying to hold on to things and only use them when needed, and they had a lot fewer resources to work from. And we were mainly within the public sector. We did visit a private clinic, but we functioned more so in the public sector.
So what was the visit like at the private clinic? What did you see there? Was that comparable, more to what you would experience here in clinical situations back home?
Yeah, their private hospital was I mean, it was very reminiscent of hospitals here, actually probably probably a little better. And they had in that particular clinic or private hospital, we were at, they had a blood cancer area, like a leukemia bone marrow transplant area, I want to say they had like a cardiac cath lab type area. But there were other specialties that may not be served at that particular clinic. So if they had a patient, they would have to come basically transport them to another nearby clinic that may have that service. So it was a little bit different in that aspect. But just the whole atmosphere was very, very much like a US hospital,
as you think about expanding these opportunities in service learning to our own students here, which I know is something that we'd like to have more opportunity for the college, or were there any things in particular you thought about this is something that I think our students should be exposed to, this is something that would be beneficial in one way or the other towards a student in one of the programs, medical assistant or nursing here at Heartland?
Absolutely all of it. All of it, it was Community Health, nursing, we had nurses there. But certainly, all of our health sciences programs could play a role and get great experience from everything that we did when we were there, health care wise. And then also we had a lot of different cultural experiences to outside of healthcare, why we were in the country, just to learn about South Africa itself. So it could apply to all of our students in health sciences. And the hope would be to be able to grow the program to get more students there.
You know, I think a lot of people might say, Okay, I don't connect with the idea of a community college and international experiences, because they just maybe think more in a trade learning or a tech learning mindset. But these are valuable experiences. And I wonder if you could talk about what that would bring to the students if they have that opportunity.
I mean, first and foremost, it's exposure to another culture, to look at, maybe step outside of our, our view, from this area, it
translates into better patient care, right? Because you have a different view of how different people function, depending on where if they come from different places, or even different cultures within our community. It just makes you a better practitioner overall, to be able to have different experiences like this.
One, I think one of the things that stood out to me as well, is that in Cape Town, we were the minority. Yeah. So having that experience in and of itself is kind of eye opening. If you've never traveled somewhere where you are the minority. I mean, that is valuable, because it gives you that perspective that you wouldn't otherwise have. That's kind of what I was trying to get out before.
Absolutely true. Yes. Well, and Martha, you alluded to this a little bit, when part of your trip involves going to a place where they're dealing with an HIV epidemic, really, in that area, it's certainly going to be one of the more impactful experiences and something that as they say, you don't see every day. But I imagine there are probably things that were a little less dire that you got to be exposed to. And you got to see in the cultures, what are some of the more fun experiences that you had there and the opportunities that you had beyond just being in those clinical settings where you were dealing with people who were experiencing some extreme health issues?
Sure, first and foremost, the country is beautiful. The City of Cape Town is on a coast of the ocean, and there's mountains, to them, the north of us. And so it's just a beautiful country overall, the people of Cape Town were wonderful. Our guides were fantastic. We got to go do a lot of different things. As far as seeing the there's a penguin colony there. We did go to a few museums as far as Museum of Modern Art. And we also did see the District Six museum that talks about apartheid. Apartheid was still very fresh within that country, the memory of it and so the museum was devoted to education about that. And then we did go see Robben Island where Nelson Mandela was held as a prisoner, a political prisoner there. But we also then saw more of the beauty of the country as far as we went to a nature reserve and then everyone went on a safari as well. About two hours north of Cape Town we traveled to go see elephants and it was amazing. Amazing rhinos and hippopotamus, and everything else. So it I mean, though, the country is just an amazing country with just so much beauty and just so different from the United States. We have our beauty here, but we have not been like that beauty there. So it was a really great experience that way, too. So
do you think that this particular site is something that we will be doing more with in the future? Is this something that we're looking to develop for taking students there? Absolutely.
We already have another group going next May. And it is a service learning course, it's worth three credit hours. So the course is already developed. And so we're going to continue on and try to grow more, we'll be partnering with Harper again, and hopefully we're going to be billing in some more colleges to see if we can get more students involved and, and then hopefully, of course, to get more Heartland students in particular involved. Well,
Martha, Susan, thanks so much for talking to us about this today. It sounds like an amazing experience and something that will not only benefit your perspectives on the work that is done in health sciences, but also offer some opportunities to your students to learn a lot more about our world and maybe learn about our own healthcare system by seeing another one.
Thank you. Thank you.
Martha Stern is program coordinator for the medical assistant program at Heartland Community College. Susan Carl is director of nursing education and Associate Dean of Health Sciences at the college. If you are interested in other interviews about health care, international studies, or other topics, subscribe to random acts of knowledge on Spotify, Apple podcasts or wherever you found this one. Thanks for listening
