BACKGROUND AND THEORETICAL FRAMEWORK
5.1 Education
A significant portion of the material depicts how such factors played out in the IFCH areas that were primarily Indian (Merebank, Clairwood and Springfield). The preponderance of data from female Indian HEs' is partly due to the composition ofthe HE study sample (see Chapter Three); it also may reflect a stronger sense of ethnic identity among the Indian HEs interviewed, hence a greater willingness to discuss
culturally- related matters. Their testimony exposes an element of the IFCH's service that has often been overshadowed by attention to African cultural and gender contexts in Pholela and Lamontville.
she had difficulty accessing education-"No, because girls were already getting education, they were becoming doctors and teachers and all that"-she also admitted,
But I did have a problem. It all depends on your older generation. Now I must tell you a little of my story ... Now, when you reach puberty, the older people say, you can't go to school now, because girls are not supposed to do so they become, so they might ... fall foul of, you know what I mean. So they are very protective. We are taught the ethical codes, how to protect yourself. Being a female it's more serious. So, they didn't want me to go to school. But we had a headmistress, Mrs.
Morrell,36oand Mrs. Morrell used to tell us - they were all out to encourage women - by that time Dr. Goonarantham was already a qualified doctor. And we had quite a lot of educated females. So it's not every home that had this
restriction. But then others were influenced, to this extent. Fatima Meer was with us in Girls High. And so, at that time, Mrs. Morrell used to say, if any of your parents try and stop you, just be stubborn, like you know, all non-violent. A small satyagraha361 ... my dad was very liberal. My mom was tom between the husband and my grandma. My grandma said, I want to see them get married. She was old- school. Well, I had my small satyagraha. So then I went to Girls' High. Okay.
Well, I had to promise my dad, that I'm going to uphold his trust in me, you see.362
5.2 HEs' Views of Gender Roles
More than anything, cultural and gender dynamics necessitated that HEs adapt to the prevailing social conditions in the communities in which they worked. Programmes carried out in the Indian community, through the vehicles of home visits and primary group gatherings, were tailored to the domestic availability of Indian women, whereas
360 Pauline (Pondy) Morrell (1903-2002) was mentioned by several of the Indian female HEs as a pivotal figure for her unstinting advocacy of girls' education. One HE remembered, "She actually went door-to- door to persuade parents to allow girls to go to school. You know, begging them in fact. The Hindu and
Ch~isti.an families v;,ere ~he first. Mos!ems later, and Gujarati. They were much more resistant to sending their gIrls to school (Violet Padaychl Cherry). Pauline Morrell was the sister ofRelen Cohn, the IFCR's first nursing director, and was interviewed by the author (Durban, 2000) regarding background information about the Karks and the IFCH.
361 "Satyagraha" was the Gandhian term for an act of non-violent resistance.
362 I ntervlew . WI ·th Nee a ovender, 18 Mar 2003. 1 G
health education targeting African women in Lamontvilleoften occurred in the community centre to accommodate their work schedules and greater participation in public life (Stueart 1962:79). HEs learned to adjust their approach to the circumstances, as Violet Padayachi Cherry demonstrated:
... women had such specific roles - [they] were cooking, or washing, or ironing, or doing some specific task that sometimes you felt as though you were intruding.
I would often say, 'Let me come and sit in the kitchen with you. Can I shell the peas, or what have you.' They were very formal in the beginning but once you got to know them they would make you sit down at the kitchen table.363
Women's spaces could be both circumscribed and spread out, as Neela Govender discovered when conducting the maternal nutrition survey in Merebank:
One incident was, this woman was advanced in pregnancy. There were communal taps in the area, ... and there was an area where there was red sand. You had to get the sand to smear the floor ... The son was off duty that day, he was at home. Then she [the pregnant woman] had to bring wood from the surrounding area, and chop the wood. It was open fire. This lady had also to fetch water. I was surprised that this husband of hers didn't make a move to fetch the water. She had this big jug, and she filled the jug from the communal tap, she took the water onto her knee and onto her head ... Then she came home with the red sand to smear the floor, then she chopped the wood, then she was sitting near the fire, preparing supper. I was very, very upset, because I'm a woman's lib lady, you see. So anyway, she did everything. Y oucan 't tell her not to. I mean, you just observe. After, I told Professor Kark that I felt like kicking the man ... So that's the thing, that's the wife's duty. And she was at time a very frustrated woman, with little kids running around, she had other children, and she just went hell for leather with them.
Despite her anger at this situation, Neela felt hamstrung: "You can't interfere too much ... you can't tell the man, you should have helped her. 1 don't think anyone would do that ... You can't suggest it. I wouldn't be allowed in the home anymore. And you feel, as time goes on, that it will change, or by culture contact, with other groupS".364
. 363 Interview with Violet Padayachi Cherry, 23 may 2001.
364 Interview with Neela Govender, 18 Mar 2003.
Violet Padayachi Cherry stressed that sexual prohibitions further narrowed the channels of knowledge available to women: "many times when they [Indian women] are married, they are virgins. They know so little about their bodies. They don't understand their bodies. And yet the pressure is so great on them to get pregnant. And if you're not pregnant within the first three or four months, it's like, what's wrong with yoU?,,365 By providing young women with forums such as the menarche survey and the girls' discussion groups, HEs aimed to combat restrictive gender roles: "I think women were very oppressed and were really subjected to no free expression at all unless they were alone in a group and they could talk amongst themselves. They certainly didn't dare talk, or take a position, or have an opinion, in front of their husbands".366 The atmosphere in HE-convened forums was deliberately non-didactic. Neela Govender described how she would ''talk about the men's way and the women's way, with jokes, you know, not very official, but informal. It's more effective ... that's how you get them to talk".367 HEs would also recruit "intensive families" to help them address gender restrictions. Violet Padayachi Cherry gave an example: "If we were talking about, maybe allowing more freedom for women, young women, and talking about the arranged marriages piece, we then would target influential families and focus a lot of education on them". 368
Not all HEs advanced a liberating agenda for women. Audrey Bennie, one of the first African female HEs to be recruited in Pholela, enlisted local cultural practices of
365 Interview with Violet Padayachi Cherry, 14 June 2002.
366 Interview with Violet Padayachi Cherry, 23 May 2001.
367 Interview with Neela Govender, 18 Mar 2003.
368 Interview with Violet Padayachi Cherry, 14 June 2002
ukuhlonipa (customary codes of respect and deference), reinforced with a Christian ethos of wifely deference, in her attempts to instil health-promotive household mores: "I would tell wives, 'Ukuhlonipa is the Lord God's law' ... Clean your body, clean your house.
Obey your husband". 369
5.3 Modification of Health Education Materials and Methods
The cultural sensitivity of the IFCH approach is reflected in its adaptation of health education materials and terminology to accord with local norms. Violet Padayachi Cherry remembered,
... when Kark was talking to us about our field projects, and we were going to do something in Merebank about smallpox and vaccinations, I remember doing this elaborate poster and showing it to Kark, and he said, 'Do you think that's going to work, out there?' I said, 'Why not? I've got all this stuff in about getting your vaccinations . .' He said, 'Take that home and show it to your mother, and come and tell me what she has to say about it.' (she laughs) So I did. My mother looked at it and said, ' That's not going to give anybody any information. Don't you know what causes smallpox?' And I said, " It's a germ." She said, "Then you really don't know much about how Indians, your own people. Look at it. This is the visit ofa goddess, the goddess Mariammen.' You're privileged when she visited. Automatically, the house must be cleansed, and people from outside can't come in, it's like imposing restrictions on people coming in and out. You've got to be bathed ... you keep your body cool and you're given light things to drink. It looked to me like in the early days, the gurus in the temple had worked out a way to convey to people certain principles of taking care of people with this disease.
They said, since you're privileged that the goddess is visiting you, your house has got to be immaculately clean. So my mother said to me, "That poster is not going to do anything to convey to Indian people who you're going to talk to about getting vaccinations.' I went back and told Mr. Kark, and he smiled his Buddha smile and said, 'Well, it looks like you're going to have to re-do that.'37o
369 Interview with Audrey Bennie, 23 June 2003
370 Interview with Violet Padayachi Cherry, 23 May 2001.
Maureen Michau also found that at the health centre in Lamontville "a lot of emphasis was placed on the need for the most appropriate approach in terms of cultural beliefs". She noted that HEs ''were provided with techniques to be able to relate
effectively with local people, for example, ideas about communication, ihnovation".371 Medical staff, aware that many of their patients ''would think nothing of going to the clinic and also, when they felt it necessary, going to the witchdoctors" (or traditional Indian healer), sought to harmonise their explanations of etiology and treatment with the cultural beliefs of their patients (Chesler, 1962).372 Maureen Michau cited the chairs ide manner of the dentist at the clinic, "He taught people how eating coarse food was important. The idea of dental hygiene was different. People used reed and bark, rather than toothbrushes. The dentist didn't try to discourage it, because he knew that people didn't have the money to invest in toothbrushes".373
Visual aids used by the health educators were pre-tested by focus groups to increase their clarity and appropriateness.374
Even so, certain educational devices failed to be effective, as Maureen Michau illustrated:
The health educators and nurses used audio-visual aids, like flip charts, stylized drawings, scale models. [It was] a minefield, an absolute nightmare. They needed to adapt to the cultural perceptions, because people didn't understand the
materials. For example, they used a three-dimensional model of a uterus with a baby inside [to illustrate gestation], but the mothers didn't relate to it at all.
371 Interview with Maureen Michau, 18 July 2000.
372 ibid.
373 Ibid.
374 For further discussion of adaptation of materials, for example posters warning of the dangers of obesity that were tested and changed to be more acceptable for their audience (Africans in Lamontville) see chapter by Bert Gampel in Kark and Steuart, eds. (1962), pp. 292-308. '
... Pictures of [enlarged] flies didn't work, because fseople would say, 'No, we don't have any flies like that. Our flies are small,.3 5
As in Pholela, where medical aide Edward Jali had responded to people's bewildered incomprehension of enlarged pictures of flies by using a simple magnifying glass to show them how a fly's anatomy made it an ideal disease carrier, HEs "took an actual fly, and they said, "this is the creature that we've got drawn here".376