Healthcare Challenges in Cape Town
South Africa is known as the rainbow nation, a multi-cultural and multi-lingual melting pot. A nation where over 12 different languages are spoken and where South Africans of European, black, white, Indonesian, Indian and various mixed race descent interact. The diversity and openness one sees today sits in stark contrast with the oppressive history of a government system of racial oppression known as “Apartheid”. While official segregation no longer exists, race is still the most important factor affecting where people live, the type of job they have and the quality of government services they are able to access, such as quality education, infrastructure, sanitation and healthcare.
Travel to Cape Town, known as the “mother city”, and one of South Africa’s most beautiful cities. Cape town is the second most populous city in South Africa. Multicultural and diverse, this will be the stage for a first-hand experience of the daily challenges faced by its recently created healthcare system, where students will learn from local healthcare personnel in public district hospitals providing care for the underserved.
Since the fall of Apartheid, South Africa has taken great strides to bridge the wide economic and social gap that was left with Apartheid. Infrastructure, education, healthcare services and economic opportunities have grown. The majority Black population had limited or non-existent healthcare until the 1990s and today South Africa’s healthcare system provides free or low cost care to most of its population. Yet, besides these great strides, South Africa was one of the hardest hit countries by one of the worst pandemics in recent history, overburdening a fledgling system that was just starting to provide basic services to the majority of the population who had little to no access to them. The legacy of Apartheid, poverty, continuing inequality and the lack of knowledge and misconceptions about HIV/AIDS, and other factors.
Adding to the cultural language immersion, live with local families in the Cape Flats area, a racially diverse great urban expanse behind Table Mountain, populated by forced government relocations during the Apartheid era. CFHI participants may also organize weekend trips from Cape Town to the world-famous Paarl and Stellenbosch wine country, or travel on the well-known Peninsula tour circuit to visit Cape of Good Hope Nature Reserve, home to a colony of African penguins.
Clinical Rotations & Public Health Placements
Participants in this program will be placed either at a Secondary Teaching Hospital or in the trauma unit of a large Children's hospital. When applying, please indicate preference between the two hospitals based on the descriptions below. CFHI will do its best to accomodate rotation preferences, though all students should be aware that they may be placed at either hospital.
Secondary Teaching Hospital- This secondary hospital falls under the Provincial Health Department and the University of Cape Town. The hospital has 158 inpatient beds and serves a population of approximately 47,000 per year. 50% of their patients are uninsured, and are served at low cost, and they also see patients with private insurance. CFHI participants will rotate in the Internal Medicine department. Pediatric Department rotations may also be available. Each of these departments has a department head physician who will act as preceptors for the CFHI program. Because students will be rotating at one facility, students have an excellent opportunity to develop a familiarity and rapport with Victoria Hospital's patients and staff. This allows participants to get a more in-depth understanding of the complexity of South Africa's healthcare system in the context of this secondary hospital.
Children’s Hospital: Trauma Unit- This Children’s Hospital’s principal task is to provide care to the children of Cape Town but also serves as a regional and national referral base for many specialties. The trauma unit has 2 operating theatres and the outpatient service 3 theatre. Childhood trauma will be the number 1 disease globally in 2020 according to the the World Health Organization (WHO), as reported in the third World Report on Child Injury Prevention in December 2008.
Trauma in children has become a major cause of mortality and morbidity, disability and a socio-economic burden. It is estimated that over 95% of all deaths due to injury in children occur in low- and middle-income regions and countries. Although the child injury death rate is much lower among children from developed countries, injuries are still a major cause of death, accounting for about 40% of all child deaths.
During their time at the trauma unit, participants will have the opportunity to witness the various medical techniques used in pediatric trauma, such as radiological imaging, total body digital imaging, emergency ultrasound and abdominal sonography for trauma , laparoscopic surgery, non-operative management of abdominal injuries and management of brain injuries, among many others. The hospital is also a leader in South Africa in promoting child safety in order to prevent injuries.
CFHI is considered a global health ethics leader therefore CFHI programs uphold strict standards and comply with all local laws regarding student involvement in health settings. Your experience on the program depends on your previous clinical training (if applicable) and the relationship you build with your supervising preceptor. Above all, YOU are the most important factor in making the CFHI experience as fulfilling as possible by being respectful, culturally humble, inquisitive, and open to the wide variety of learning experiences which you will encounter.
Cape Town is located on the southwestern coast of South Africa, near Cape Hope, the southernmost point in Africa. Flanked by the magnificent Table Mountain on one side and the Atlantic Ocean on the other, the natural beauty in and around Cape Town is awe-inspiring. With first-world infrastructure, it attracts tourist the world over for its natural beauty, history and famous places as Table Mountain, Robben Island, and Kirstenbosch Botanical Gardens. The city also boasts fascinating museums, lots of culture and art, and some of the country's best beaches.
But one of Cape Town’s hidden gem is the warmth of its people. The diversity and Cape Town’s ethnic make up speaks to its history as a main port of entry to the southern tip of Africa - Malay, Blacks, Whites, and other mixed nationalities. It is knows as the capital of the mixed race, also known with the South African term “coloured”, who speak their own language (Afrikaans- a sister language of dutch) and have their own cultural practices. As with most South African cities, Cape Town is structured according to class, the richest being closest to the city center and the poorest being the furthest away.
The major languages in the Western Cape include Afrikaans, English, Xhosa, and Sotho. Language should not be a problem as English is spoken by everyone, even if it is their second or third language.
Things to do
Cape Town has some of the worlds most beautiful and interesting sights. CFHI participants have free time most evenings and weekends and may choose to organize weekend trips to nearby destinations and take part in cultural activities offered within the city of Cape Town itself.
During the first few days in South Africa, participants will get the opportunity to participate in an educational day-long tour of Cape Town, focusing on the history of Apartheid. By visiting the Apartheid museum and the various neighborhoods that were razed and its inhabitants forcibly removed because of their race, history is not something that is just in the books, one can see first hand how it has shaped every facet of daily life for millions of South Africans.
Accommodations & Homestays
You will be staying with a South African family in the Cape Flats area of Cape Town, in a middle class suburban neighborhood. This allows for immersion in the culture and a better understanding of South Africa. You will likely be sharing a room with another student in the program. Bathrooms are shared with the family. All homestays are located in close proximity to one another.
Homestays provide a unique opportunity to learn about local culture. Accommodation includes two meals a day and laundry once a week. At the welcome orientation participants will be instructed on safety guidelines and recommendations on getting around the city during your free time.
Eligibility: Who Can Apply?
This CFHI program is ideal for students and non-students of all levels and health disciplines and welcome anyone interested in and passionate about health and medicine in urban settings. The program offers an overview of the challenges in providing healthcare services to underserved communities at public hospitals focusing on the influence that Apartheid and the HIV/AIDS pandemic have inflicted on the local population. For more information, please read CFHI's general eligibility requirements.
Language Required: English
While South Africa has many official languages, English is spoken fluently by most every Capetonian, but you may hear Afrikaans spoken at homestays and Xhosa between patients at clinics.
Participants should plan to arrive on the designated arrival date (a Saturday) and depart on the designated departure date, also a Saturday. If you wish to arrive before the program start date or depart after the program end date, you must contact email@example.com to determine if lodging and transport are available on your preferred dates. CFHI cannot guarantee airport pick-up or accommodations outside of designated program dates.
Participants should arrive in Cape Town, South on the program start date and will be picked up from the airport by a CFHI representative and taken to their homestay. A welcome orientation will take place the Sunday after arrival.
Visas are not required for U.S. citizens staying less than 3 months in South Africa. More information on travel and logistics will be provided by CFHI after acceptance into the program.
- Guidance from CFHI staff in San Francisco before departure
- Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc.
- Airport pick-up upon arrival and transportation to homestay with local CFHI representative
- Welcome orientation with other participants covering safety, transportation, and other logistics
- Educational tour of Cape Town
- CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
- Weekly meetings and lectures on local healthcare system and socio-economic determinants of health
- Placement and coordination of clinical/public health activities
- Accommodation and two meals a day
- Local transportation to and from clinical sites
- Local cell phone
- International emergency medical and evacuation insurance
- Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
- CFHI alumni newsletter highlighting events, resources, and ways to stay involved
Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically underserved health systems. Read more.
Avril Whate- CFHI Cape Town Medical Director: The role of the Medical Director is to arrange clinical and public health placements, supervise the participant experience at these sites, and provide instruction on healthcare topics during weekly meetings.
Avril has served CFHI since April 2004. She studied in Cape Peninsula University of Technology where she obtained her RN, NP, and Dipolma(s) of Midwifery, Community Nursing, Nursing Management, and Honours Occupational Health Nursing. She has worked for the Provincial Health Department for over 20 years and was a Facility Manager at a community health center for several year. Avril enjoys working with CFHI students because it allows her to learn about “global health concerns, its values, but most importantly, the impact it has on communities and individuals alike.” When she is not working, Avril likes to travel.
Marion Williams– CFHI Cape Town Local Coordinator: The role of the local coordinator is to organize housing, transportation, orientation and weekly meetings. Marion, a native Capetonian, is a great resource for any questions related to navigating Cape Town, cultural norms and tips on planning weekend travel. Marion has served CFHI since February 2003. In addition to working with CFHI, Marion has worked as an artist logistics assistance for the Cape Town International Jazz Festival form 2002 to 2006. She enjoys working with young people. During her free time, Marion likes to explore different places around Cape Town and other parts of South Africa. She’s always up for a good party!
What Alumni Say
"CFHI is an amazing organization that does an excellent job melding a learning experience with assisting global communities. I've been a part of many nonprofit organizations and CFHI is by far one of the most organized and thought provoking. As a volunteer in both South Africa and India, I felt well immersed and blended into the local communities" Read More
-Volunteer (South African Program), September 2015)
The Sustainable Development Goals are a global roadmap set forth by the United Nations General Assembly to end poverty, protect the planet, and ensure the well-being of all individuals by the year 2030. This program highlights the following SDGs: