Africa is a continent well-known for its struggle against HIV/AIDS, and at the forefront of that battle are the doctors, nurses, physical therapists and councillors throughout the rural communities who are working tirelessly to help stem the growing tide of the epidemic. Heidelberg resident Alice Price found herself on the frontlines of the battle last fall as she spent five months in the village of Mseleni in the Northern KwaZulu Natal region of South Africa, which has the highest prevalence of the disease among all South African provinces. Price was on an international placement to complete the final portion of her bachelor of nursing program at Ryerson University, and she spent most of her time in the rural villages observing how HIV/AIDS treatment made its way from the bureaucratic levels of government to the people on the ground.
She received a $6,500 grant from the Association of Universities and Colleges of Canada, and returned to Canada at the beginning of January.
“My project was focused on looking at the policies that the government makes around HIV/AIDS and how it is manifested and implemented at the rural hospital and given to the patients that have HIV/AIDS,” said Price.
She wanted to focus her research on the rural community instead of the cities of South Africa because they are more remote and more difficult to access.
The people living in rural areas have less access to hospital and medical treatment largely because of the difficulty in travelling across the countryside; due to the sand and rocks, four-wheel-drive vehicles are essential, and not everyone has access to one.
“It is harder for them to come into the hospital because they can’t just get into a car and go,” said Price. “They live in homesteads that consist of maybe four or five round buildings that are made of sticks or piles of stones or straw, with a thatched roof.”
From her observations, Price said that there are a number of challenges facing the healthcare providers who are trying to counteract the spread of HIV and AIDS.
One of the biggest challenges is the way that the health care system is setup. She said that there are two levels of healthcare in the country, a public system that most of the people have access to, and a private system that is solely for the white community or the upper-middle class black community.
That division means those in the public system have less access to healthcare compared to the private system. At the hospital she was working at, for example, there were modern machines such as x-rays and MRIs, but if the machine broke, it could take several days to be fixed.
“That wouldn’t happen at a private hospital,” she said.
Perhaps the biggest challenge facing Africa, however, is changing the cultural norms ingrained in their society. Price said that because of the high level of patriarchy, women and children are marginalized compared to the men.
Likewise, cultural norms still take precedence over the pressing need to contain HIV and AIDS. For example, if a man loses his job in one village and travels to another looking for work, he may be away for several months at a time. During that time, he is expected to find a new sexual partner, which only helps spread the disease faster.
She also said that even though condoms are widely available, as well as educational material on how to properly use them, “in the heat of the moment, realistically they aren’t going to use them,” and until that behaviour is no longer tolerated, AIDS will continue to be a deadly reality.
Price said that in the region she was working in, approximately 50 per cent of the population has contracted HIV/AIDS, and women are much more likely to be tested than men because once a woman is pregnant testing for HIV is mandatory.
Price had lots of experience as a nurse before heading to Africa; she graduated in 1984 with her nursing diploma and worked as an oncology nurse and family nurse before starting her own foot-care business. She sold that business prior to enrolling in the nursing degree program at Ryerson in 2010.
Despite those years of experience, though, she thinks that her trip to Africa was one of the best learning opportunities of her life and that she can approach new situations without the cultural bias she might have carried before.
She also said that her time with the Zulu people of Africa – whose greetings can take up to three minutes to complete – taught her the importance of slowing down and taking time to really talk to someone.
“We’re in such a rushed society: you get on the treadmill and you just keep flying straight ahead,” she said. “But if you have an exchange with someone for three minutes, you’re going to actually really stop and look at them.”
Looking forward, Price has also enrolled in the masters of public health nursing program at the University of Waterloo, as well as the masters of nursing program at Ryerson.