BACKGROUND AND THEORETICAL FRAMEWORK
7.4 Urban Nature
Physical working conditions in the peri-urban IFCH areas were quite distinct from the Pholela (or Tongaat) practice, where the remote setting played such a large role in the lives of health centre staff and local people.427
Some of the IFCH areas such as Lamontville, Clairwood and Springfield, were still works in progress, with ongoing construction of houses and streets. As Violet Padayachi Cherry noted: "We had to go out and chart streets. There were no streets. There was something on a map, but we'd have to go find it".428 Physically, the work could be very demanding: "It was pretty
tough ... working in the garden and you walked miles and miles because they [a driver]
425 Interview with Violet Padayachi Cherry, 14 June 2002.
426 Interview with Violet Padayachi Cherry, 23 May 2001.
427 I~~H areas s~c? as ~Iairwood and Springfield.were "urbanized", yet were classified as peri-urban by mUniCipal authOrIties, With consequent neglect of mfrastructure and services (Scott, 1994).
428 Interview with Violet Padayachi Cherry, 14 June 2002.
dropped you at a point, and everything else was walking on foot. And it was hot, in the . h t" 429
summer It was very 0 .
Urban conditions could sometimes be daunting given the inadequacies of infrastructure and services, but as the Karks' descriptions ofPholela demonstrate, the deficiencies were even more apparent in the rural areas. Maureen Michau spoke of African HEs' willingness to be assigned to a rural health centre after their training as evidence of their dedication, given the challenges of rural conditions:
... at that stage, moving into a rural area was considered to be like going into hell, but many ofthem [African HEs], I would say the majority of them, understood that they would be able to do their best work in the rural areas ... You know, that was a very big thing. It may sound little to someone who wasn't aware of how different the rural areas were. I mean, they were going into conditions where they had absolutely no modem facilities. And they were people who had grown up in townships, I know some of them didn't have much, but at least they probably had electricity, they had an infrastructure where they could catch a bus and go places and so on. They would be going into isolated areas, but they were prepared to do it.43o
Section Eight: Political Implications
The model of health care implemented by the IFCH emphasised, in the words of Maureen Michau, a "broader sociological understanding of the underlying socio-
economic causes of poor health, such as the land issues and migrant labour".431 Yet HEs diverge in their opinions about whether this emphasis contained political implications, with the majority accenting the hazardous repercussions of overt anti-government
429 Ibid.
430 Interview with Maureen Michau, 14 Mar 2003.
431 In tervlew . Wlt . h M aureen MIC au, 18 July 2000. . h
messages or activities during the apartheid era, and the consequent need to re-frame issues in less threatening terms.
8.1 Contradictory Views
At times, paradoxical views may converge in a single narrator. Maureen Michau maintained that the IFCH "training was done in a scientific, sociological way, rather than political". 432 When training African HEs, she framed the issues to encompass the
" .... basic underlying economic situation in the country at that time.
'" how little land there was available to a very large segment of the population, and how poverty is an incipient thing that can undermine almost anything that you do. For example, you tell people to eat healthily, and to cook things properly, and often they didn't even have the means to buy the fuel to cook healthy foods. I tried to point out that underlying poverty would be very difficult to overcome.433
F or her African audience, Maureen's candour signalled that they too could voice their resentment of the status quo:
They got quite angry. They realised, some of them realised the sort of situation they were actually in. It was sort of a feeling of helplessness, but also a feeling of anger. It was a beginning, a realisation that you couldn't just accept this. Don't forget, the fifties were quite explosive years in this country, and people were becoming aware of their inferior situation, there's no other word to describe it.434 In an earlier interview, Maureen had insisted, "We were not a lot of political hotheads. Just dedicated people ... who were trying to be honest. Bright young people who
432 ibid.
433 I ntervlew WI . ·th M aureen M' h IC au, 14 Mar 2003.
434 I ntervlew WIt . . h M aureen M' h IC au, 14 Mar 2003.
were conscious".435 Yet honesty and consciousness demanded action: "I became very, very politicised ... .1 took part in all sorts of rallies, 1 joined the Liberal Party, and I felt that I had to make my voice heard ..
.1
think that we were all in a politically charged atmosphere at the health centres. It was definitely so" .436 Maureen was not alone in her activism, but "funnily enough, it was many of the white HEs [who were political.] There were girls who came from very, very well-off homes, privileged homes, and who were quite appalled by conditions in this country, and in fact many of them actually left this country ... There were quite a few of them, who were very aware of the situation". 437In contrast to Maureen's contention that "we were all in a politically charged atmosphere at the health centres", Pat MacLeod declared: "It wasn't political ... The atmosphere was very congenial".438 She is echoed by Violet Padayachi Cherry: "I don't think any of us went systematically after the political message", though citing one male Indian HE, Ampraghosh Meharchand, who "was very active. He was jailed at one time ... we all knew about his activities, but we didn't come out openly and march with him or anything, but we were very supportive ofhim".439 Referring to other politically active, or at least vocal, IFCH staff, she stipulated, "We knew that various people were [politically active], but it was not something you openly discussed ... because you knew that there might be repercussions for people".44o Despite such trepidation, she became
435 Interview with Maureen Michau, 18 July 2000.
436 Interview with Maureen Michau, 14 Mar 2003.
437 ibid.
438 Interview with Pat McLeod, 5 July 2000.
439 Interview with Violet Padayachi Cherry, 14 June 2002.
440 ibid.
involved in "behind the scene" activity with the Progressive Party and the Liberal Party, along with many of her fellow Indian friends and colleagues: "We all knew Alan Paton.
We went to things that he gave, any event that he organised, we were there." She even
"helped with campaigns, although [she] couldn't vote".441
Bala Govender, who spoke of being politically active since his time as a HE in Edendale with the Local Health Commission, responded somewhat evasively to a
question about whether he had ever discussed political issues with Sidney Kark, "He [Dr.
Kark] was interested in a certain aspect of health; he had in mind to raise standard of health care for the under-privileged".442 He added that, as civil servants, neither he nor Dr. Kark could be openly political. This opinion was shared by Pondy Morrell, who socialised with the Karks: "He was hesitant about making statements about politics.,,443 Violet Padayachi Cherry outlined the possible repercussions of activism: "You know you had to tread a very careful line, because if it got out that you were there being paid by the Union government, before you knew it you would be locked Up".444 She felt that certain issues could be discussed more openly if cast apolitically:
441 ibid.
It was okay to say, 'You're right to want your children to be educated, their only hope is to get educated, so we have to work harder to get schools built, and that may mean making sacrifices and collecting money for school-building, which was happening ... Don't put your aspirations on hold. Accept the fact that the
government is not going to build them for you.445
442 Interview with Bala Govender, 4 July 2000.
443 Interview with Pondy Morrell, 29 June 2000.
444 Interview with Violet Padayachi Cherry, 14 June 2002.
445 ibid.
Neela Govender also refuted the idea that the IFCH's work was political, preferring to see it as a catalyst for self-help and mutual aid:
I didn't view it as political. I saw it as a way of helping people to help themselves.
I don't know what you would call that. To make people responsible for their lives as much as possible, under whatever circumstances. Some of them do have the resources, but they don't know how to challenge them, you see. And then who has got the information and the knowledge and they means, can always help the other, to give them a helping hand, to bring them to their level.. .. by exchanging ideas, they were giving them some means of self help .... 446
She characterised the IFCH in a broader philanthropic rather than political light:
"it was a serVice for the good of the people, maybe for the people that deserved it. But overall I thought it was something that was wonderful for humanity as such. So I never gave it [the political implications] a thought ... To me, it was just an overall humanitarian effort to improve the quality of life of the people".447
Despite the variance in opinion among the HEs regarding the political
implications of the IFCH's work, they were in accord that after 1948 the sense of political threat increased: "Social, Socialist, that's the connection they [the Nationalist Party government] made. Several of the Kark people, colleagues who worked with them were labeled communist. I think at times, even Kark and his work, his concepts, were labeled communist".448
446 Interview with Neela Govender, 18 Mar 2003.
447 ibid.
448 Interview with Violet Padayachi Cherry, 14 June 2002.