Lessons from the Townships


Serving in South African hospital emergency rooms and medical clinics gave David Liskey unforgettable lessons at the intersection of culture and health. (Photo: Jan Sonnenmair)

November 3, 2009

What David Liskey learned in South Africa changed his life

By Gary Dulude

In Brief

University Honors College and biology student David Liskey got a new
view of the medical profession during an 11-week educational trip to
South Africa. He saw how race, culture and poverty affect health care
in a country with the highest HIV infection rate in the world. 

On his way to a medical career in the United States, David Liskey took a detour to South Africa. The Oregon State University biology student saw people and a medical system struggling under the enormous burden of HIV-AIDS. He learned how the echoes of apartheid still resonate across the country's townships.

"When I first looked at South Africa, I had some misconceptions about what it would be like and the reasons it would be that way," he says. "After being there, I realized it's a very complex situation."

Liskey used his experience as the basis for a University Honors College senior thesis, a study of the influences that race, culture, poverty and access to health care continue to have in South Africa. "It has shaped some of my ideas," he says. "The different experiences and topics I studied had an effect on the way I see the world."

Race Matters

Before he traveled to Africa, his world view was stirred by an anthropology class, Cultural Issues on Race. "We talked about perceptions of race, what race is and what the consequences of race are," Liskey says. "It got me thinking about racial issues, and set me up for my summer internship."

Even 15 years after the end of apartheid, its presence remains in poverty, health care and access to basic services, Liskey explains. Black and white South Africans still live mostly separated, and there remain large disparities between rich and poor, white and black. The middle class is only a small portion of the population.

Over 11 weeks, working at six public hospitals and clinics in the province of Kwa-Zulu Natal, Liskey saw surgeries, in-patient wards and emergency rooms. He visited clinics that treat patients with AIDS and tuberculosis. It wasn't all observation. He helped to suture wounds and assisted doctors and nurses.

An estimated 5.7 million South Africans were estimated to be infected with HIV in 2007 according to UNICEF, more people than in any other country in the world. AVERT, an international HIV and AIDS charity in the United Kingdom, estimates almost a third of women aged 25-29, and over a quarter of men aged 30-34, are living with HIV.

Culture Affects Health

The most common forms of transmission are between heterosexual couples during sexual contact and from mothers to children during pregnancy and breastfeeding. The conventional thinking points to a need for education about HIV and AIDS. But Liskey discovered cultural and social customs also come into play.

The South African government has mounted multiple campaigns giving out free condoms and promoting them for preventing sexually transmitted diseases. But as a local doctor told Liskey, most black South African men refuse to use condoms, and most women either do not or cannot insist on them.

The other problem is simply a lack of access to prevention and treatment, something Liskey saw first hand when he went into the poor townships and worked in a rural hospital. Although South Africa has government-funded health care, many rural South Africans don't have the money to get to distant hospitals for treatment, and rural hospitals are underfunded and poorly equipped. He said doctors would often never see patients again after they had been diagnosed as HIV-positive.

Liskey graduated from OSU in 2009 and plans to work as a nursing assistant before applying to medical school.

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