At a time when a nation is griped by oppression, some people will muster the energies and find the willpower to tackle that oppression, to tear it down and then replace it with a better, fairer system. There are others, though, who, while acknowledging the weight of that tyranny, will realise that their own energies must instead go into making that nation a better place, even as oppression remains. Both may be necessary, but sometimes the people who choose that latter course may be overlooked – as the statues and commemorative broadcasts go to the men and women attempting to surmount the barricades.

Herb Kaiser, a retired American diplomat who passed away on 30 March at the age of 94, was one of the latter. And perhaps his was the most notable of all of such quiet efforts. His unique creation, the Medical Education for South African Blacks (Mesab) project, became a spectacular success both as an institution as well as for the impact it had on the people it helped.

Born in very modest financial circumstances, he served in the US Navy during World War II, and through the support of the “GI Bill”, the university tuition assistance grants offered to military personnel after the war, he was able to attend Swarthmore College, one of those old line, very elite tertiary institutions, a school that otherwise would have been well beyond his finances.

He then joined the foreign service after graduating from Swarthmore, rather than going on to law school, because, as he had remarked, of the need for an income to support his growing family. After various other assignments, he eventually ended up in South Africa as the third ranking diplomat in the American Embassy in Pretoria (and in Cape Town when the country’s government moved there for the parliamentary session). Unlike too many of his colleagues assigned to South Africa in those years, Kaiser declined to adhere to the stark, racially segregated mores of the time – insisting instead on building a much wider, more inclusive circle of friends of all races.

One officer who served with him back in those days, Robert Gosende, said of Kaiser and his wife:

“We realised right away that the Kaisers were remarkable people. Herb was a most accomplished political analyst. His knowledge of South African history, politics, religion, economics, and culture was encyclopedic. Listening to his briefings on what was going on around us in that complex society was like auditing a graduate course on South Africa. And hearing his counsel as we worked to develop an effective educational and cultural programme for USIS [the US Information Service] across South Africa to assist and support the forces seeking a democratic change in the country was invaluable.

“Joy [his wife] and Herb also set the standard for how we went about multiracial entertaining in South Africa at a time when it was not at all apparent to many of our Embassy colleagues that we should even be contemplating such activity. As senior Embassy staffers, Joy and Herb took the lead in this with aplomb, while we followed their example. We were regular guests at their home and they at ours as we shared our contacts and knowledge. The Kaisers made a major contribution to South Africa’s peaceful transition to democracy.”

But, like every other diplomatic family, the Kaisers eventually moved on to other countries and new challenges, and then, ultimately, to retirement from the Foreign Service. Unusually, however, the Kaisers had an extraordinary second act in their lives.

As Herb Kaiser later told friends, while he had been living in South Africa, a South African doctor had successfully treated him for a melanoma. Then, when he learned that a white surgeon had given up his practice to teach medicine to black South African medical students, Kaiser took serious note of the fact there was a vast disparity between the quality and quantity of medical care (as well as the number of black medical practitioners) available to black versus white South Africans.

In retirement, together with his wife, Joy, they resolved to do something about it. They began the process of collecting funding to support a new programme, one that was privately funded and supported, that would provide scholarships – bursaries – to black South African students in the medical and allied fields for doctors, dentists, nurses, and the full range of medical technologists.

Beginning this project in the mid-1980s, of course, had come during a particularly tense and difficult time in South Africa’s circumstances. All across the nation there was the impact of government-imposed states of emergency, together with police repression, student strikes, mass arrests, trials and prison sentences, and all too often, the injuries and death that came from that repression. Many, perhaps most, people were thinking rather too little about the importance of ensuring quality medical care for the future – and rather more about dealing with the immediacy of the nation’s political health.

As guiding principles, the Kaisers believed additional black health professionals would quickly improve access to healthcare for black South Africans and that these new caregivers would eventually come to play a greater leadership role in formulating health policy in a post-apartheid future. (At the time of Mesab’s establishment, there were fewer than 400 black doctors in the entire country and segregated (black) hospital occupancy rates were approaching 150% in many cases.)

Reflecting on his father’s death, Herb Kaiser’s son told American newspapers he remembered his parents huddled around the kitchen table, poring over maps and lists of foundations, charities, advocacy groups, and potential corporate and individual donors. They made those fundraising cold calls to attempt to gather support for their newfound cause.

Especially in those early fundraising years, his son added that Kaiser also faced opposition from an unsympathetic white government in South Africa, as well as from various groups and individuals in America who were opposed to doing anything ameliorative in South Africa until apartheid had been swept away completely. Regardless, Kaiser was a man on a mission, and he kept up the hunt for support.

The New York Times noted in its obituary in looking back at the effort, of Kaiser:

“Besides the tensions and factions within South Africa, the Kaisers had to deal with the international pressure that was causing many prominent people and companies to withdraw investments from that country. Raising money for their fledgling organisation was difficult. But eventually a number of companies, including Johnson & Johnson, Kellogg’s and Pfizer International, signed on, and community leaders in South Africa got behind the effort…

“ ‘South African blacks have had to cope with decades of poor primary and secondary education, as well as social neglect,’ Saul Levin, Mesab’s chief executive, said in 2005. ‘Students who come into universities from rural areas are shellshocked. I have had students who tell me they’ve never had a bank account or ridden in an elevator.’ ”

Back at the time of Mesab’s greatest efforts, the New York Times had reported:

“Mr. Kaiser said he had been told that half of the nonwhite students who qualified for medical school did not bother to register because they could not find the money. One student who wrote him enclosed 20 rejections from South African lending institutions. ‘Many kids won’t apply because they think there’s no money and no hope,’ said Yusef Dinath, the chief administrative officer of the Witswatersrand Medical School.”

Beyond his duties at the university medical school, Dinath had also led Mesab’s South African office between the years 1984 and 2006, and upon hearing of Kaiser’s death, Dinath told this writer:

“This unique programme was driven by Herb’s passion to serve selflessly and with compassion. It was a privilege for me to be an instrument that allowed Herb Kaiser to such success in his quest to train underprivileged black South Africans who now serve in hospitals and clinics in this country. His dedication and single-minded drive was appreciated and recognised by all who came into contact with him. I valued and respected his humanity.”

Persevering at the beginning, the Kaisers had their first major funding breakthrough when they gained a $100,000 grant from the Marjorie Kovler Institute for Black-Jewish Relations — an American Jewish group that was dedicated to encouraging bonds between black- and Jewish-Americans. This first big cheque helped lever open the door to the much larger corporate donations that eventually came their way.

As Mesab was gaining momentum, Illinois Democratic Senator Paul Simon, then the chairman of the Senate Foreign Relations Committee’s subcommittee on African affairs, had said of the Kaisers’ efforts,

“I recently visited Soweto and other townships in South Africa and have seen first-hand the desperate conditions there. This grant will shine a light into that gloom.”

From Mesab’s inception in 1985, until it drew its programme to a close some two decades later, it had provided 11,243 (!) grants to black students in 26 South African universities. Moreover, it created South Africa’s first mentor programme designed to help medical students succeed, providing support for more than 6,000 students at 17 South African universities.

Further, it supported advanced training for nurses in midwifery and neonatal care and backstopped university rural outreach programmes. Additionally, its palliative care initiative promoted and supported home-based care for terminally ill Aids patients as well as training for doctors in the provision of palliative care for such patients. It also created an awards programme for academic and professional achievement by black health professionals.

Another retired American Foreign Service officer, Harvey Leifert, had taken over the running of Mesab in America once Kaiser had stepped back from the active running of the programme he and his wife had willed into being. Leifert commented on Kaiser’s passing that even after the two founders had retired from the project formally, they continued to participate actively in Mesab’s annual fundraising drive.

In one special feature of this programme that helped students master the material, Leifert explained that organisers gained agreement from some participating universities for “black medical students to stretch their course over more than the normal six years [to help make up for the students’ inadequate prior preparation], but they had to meet the same graduation standards. We also instituted a project to train black nurses in prenatal and postnatal care, in areas where doctors were scarce.”

Describing the natural cycle of bringing the programme to a conclusion, Leifert added that Mesab began to recede in importance once non-racial democracy had taken hold in South Africa because “American firms and foundations tended to be less motivated than when apartheid existed.

“And, in fact, the SA government was beginning to rectify the neglect of black students that had been the norm in the past. Mesab was less needed, and in a move rare for NGOs, it eventually declared its mission accomplished, transferred the remaining funds to SA, and shut down.”

By the time Mesab’s operations drew to a close, a long list of luminaries in both nations had joined its twinned board of directors (later joined into one body). These included Stanford University president Donald Kennedy (and a former director of the US’s Food and Drug Administration), as well as Dr Louis Sullivan, president of Morehouse University’s School of Medicine and himself a former secretary of health and human services.

South Africans included renowned paleoanthropologist Phillip Tobias and the anti-apartheid activist and widely respected physician, Dr Nthato Motlana, among numerous others.

Mesab’s fundraising comprised corporate, foundation, and individual donors, eventually including support from George Soros, Bristol-Myers Squibb, the Coca-Cola Co, Ford Motor Company, Henry Schein Inc, Hewlett Packard, Johnson and Johnson, Kaiser Permanente, the Kellogg Foundation, Levi Strauss and Co, Pfizer, the Starr Foundation and USAID, among others. By the time it closed shop, it had raised $27-million for its scholarships and related efforts.

The Kaisers were given the Order of the Companions of OR Tambo by the South African government and they received honourary doctor of science degrees by the then-Medical University of South Africa and Swarthmore College.

As Joy Kaiser said at the time of their Swarthmore degrees:

“South Africa […] gets under one’s skin. When Herb retired from the Foreign Service, we began to think about ways that outsiders could somehow help black South Africans.”

And he added:

“They appealed to us as Americans to support training for black doctors. We also saw training black health professionals as preparation for black leadership roles in a post-apartheid society. We knew that apartheid had to end – it was morally and economically untenable. We did not guess then that it would implode so soon.”

Summing up the impact of this programme, Archbishop (emeritus) Desmond Tutu has written of Mesab:

“If someone had told me in the 1980s that 10,000 blacks would have been trained as health professionals — doctors, dentists, nurses, etc. — in the space of 22 years, I would have recommended that they go and consult their psychiatrist. And then to add to such an unlikely scenario the prediction that over 27-million US dollars would be raised for this enterprise, would have confirmed for me that someone was in desperate need of psychiatric treatment.”

Besides the energy and vision of the founders, and all those who gave of their time to make it happen, the special character of American charitable giving was crucial for the programme. Such activities gain their traction from the ability of donors to deduct their gifts to activities such as this one from their gross earnings, before paying federal income taxes. Doing well by doing good.

A decade or so after Mesab drew to a close, and even as the thousands of its beneficiaries provide medical care to yet many thousands more, the active memory of a success such as this one is becoming increasingly faint.

Perhaps the Kaisers felt that the work itself was sufficient; but surely besides all the necessary commemorations of fighters for freedom, there is a bit of space for some public acknowledgement of the good that came from the dogged determination by a pair of private individuals – rather than from armies or governments – to address a desperate need at a time of great risk. 

Maybe it is now time to name a medical school building in South Africa in honour and memory of Joy and Herb Kaiser and Mesab? DM

Photo by Phalinn Ooi via Flickr