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Learning to let go. Combating inequality.


 In South Africa, the University of Western Cape started a project in August 1991 in the poor and isolated settlement of Mfuleni. Mfuleni has 30,000 people but no public transportation, no post office, no public telephone, and a single school. It does, however, have a community health center with a health committee composed of community representatives. Participants in the University project included pharmacists, nurses, physiotherapists, and dentists, all of whom pledged to follow the principles of primary health care and to change their familiar attitude and ways of working to achieve democracy, participation, collaboration, equity, and transformation. The first change that was necessary was in attitudes and language; the formal terms which resulted from a medical education seemed hostile to the people to be served. Participants also learned that they could not keep a usual 40-hour work week but had to work the hours that fitted in with the community needs and in places where the people felt comfortable. Participants also had to learn to break down the professional barriers which existed among them and work together on an equal basis. The staff of the community health center was instrumental in pointing out to project participants that they were clinging to old ways of doing things which prevented them from working in partnership with the community. Monthly tutorials attended by university staff, students, community members, and health center staff provided a forum for discussion in the community. This project will provide community-based work for students at the University's new school of public heath and will become an integral part of the undergraduate curriculum.
