Opinionista

Beyond the textbook: Why Nelson Mandela University’s new medical school was set up in Missionvale

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Professor Fikile Nomvete is director of the Medical School at Nelson Mandela University in Gqeberha.

We want to send our medical graduates out into the world knowing how to practise primary healthcare in holistic, culturally sensitive and comprehensive ways. Impoverished areas – urban and rural – are massively underserved, and this was a major factor for Nelson Mandela University to place our new medical school in Missionvale.

The purpose of Nelson Mandela University’s new MBChB programme is to train caring, competent, socially responsive and committed medical doctors. But, you may ask, surely that should be the aim of all medical schools? Yes, indeed, so there must be more to it than this. And there is – much more.

Mindful of our responsibility as the only university bearing the name of the late former president Nelson Mandela, we want to develop graduates who have a heart for our beloved country, its ugly disparities, its deep challenges and its ongoing needs.

This means we want to send our medical graduates out into the world knowing how to practise primary healthcare in holistic, culturally sensitive and comprehensive ways.

Studies have shown this is the most inclusive, just, economical and efficient approach to enhance physical and mental health, as well as social wellbeing.

The wide-ranging impact of investment in this has been growing around the world, particularly in times of crisis such as the Covid-19 pandemic. The World Health Organization (WHO) in April this year announced that scaling up primary healthcare interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030. The WHO recommends that every country allocate or reallocate an additional 1% of gross domestic product to primary healthcare, from government and external funding sources.

This is, of course, what is needed right now in South Africa, and in the Eastern Cape in particular where the third wave of Covid-19 is adding to the existing triple blights of poverty, unemployment and inequality.

The pandemic highlighted this in 2020 when university representatives became part of the Provincial Coronavirus Command Council, an ongoing relationship as we tackle this global threat to health.

Add this to our severe shortage of doctors and healthcare workers in general nationally, which over the past 15 months has seen public and private health systems stretched almost to breaking point, and you can see the need for a medical school with this orientation.

The university’s interprofessional education and collaborative practice model further builds bridges between disciplines relevant to holistic primary healthcare.

It is a holistic approach and, internationally, the ideal of inclusive and equitable health for all is enshrined in the UN’s 2030 Agenda for Sustainable Development (2015) and Sustainable Development Goals.

We strive to equip our graduates with the knowledge, skills and qualities to fully embrace the complex healthcare and lifestyle challenges facing our diverse communities, particularly the poor.

Hence our medical school has a strong public health education component, working hand-in-hand with local actors to build solidarity and partnerships.

But it is a co-creation, because it places agency within their hands.

We see individual wellbeing as intimately connected with community health – the principle of South Africa’s much lauded ubuntu, where the concept of community is one of the basic building blocks of a thriving society.

However, this ideal can only be achieved in the context of social equality in broader society.

And this is why other Mandela University initiatives on Missionvale Campus are also key: the psychology clinic, for example, gives people living nearby access to mental healthcare and the Law Clinic gives access to legal aid.

Impoverished areas – both urban and rural – are massively underserved, and this was a major factor for the university to place the medical school in Missionvale.

We are embedded on a campus already reaching out to the community with multiple strands. There are several key NGOs nearby, such as the non-profit trust Missionvale Care Centre and Ubuntu Pathways in Zwide.

Missionvale Care Centre’s values resonate with those of the university as we both believe, deeply, that education is a powerful avenue to build resilience and transcend poverty, unemployment and inequality.

Community engagement is more than a slogan; it has to be an authentic and multidimensional process and include the voices of others. Among others, the university is setting up a community advisory board in Missionvale.

This is not an ivory tower model, it is hands-on as our students go out into the community to meet the residents and hear their voices. Even in this, with their first year disrupted by Covid-19, our new students have visited households and clinics in the surrounding areas.

Visiting people in their homes, standing with them where they are and listening to the stories of their lives, yields an invaluable experience no textbook can give.

At the same time, of course, our graduates will be equipped to work anywhere on the continent or in the world. DM

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