“What would the history and literature of the period look like if we begin not only with a focus on physicians and nurses but also on social workers, teachers, farmworkers, domestics, housewives and those without an education who facilitated the reach of revolutionary medicine in the United States and South Africa,” asked Kanika Batra of the Department of English at Texas Tech University.
It’s an issue Batra hopes to make a substantial contribution to in her book project. Her book, Black Freedom from Selma to Soweto will include chapters titled hunger, health, sex, injury, song, faith, learn, vote, as well as a conclusion on Black Freedom legacies. For her seminar Batra focused in on the health chapter, offering a comparative, transnational account of South African and US community-health initiatives in the Black Freedom and Black Consciousness movements.
She explained that the project was born during the 2020 global protests following the death of George Floyd. “I teach about race, racialisation and gender so I had a stake. I found the national and international environment suffocating and wanted to highlight the slow forms of social and institutional asphyxiation that cut off air from black and brown people.”
Foundational activities
To orientate her health chapter, she described early interactions in the community-health realm between individuals from South Africa and the US. This included Alan Taylor, then head of McCord Hospital in Durban, who visited the US in the late 1940s to seek ideas from historically black medical schools – Meharry College in Tennessee and Howard Medical School in Washington DC – to establish the Medical School at the University of Natal.
She also highlighted the visit to South Africa of Case Western medical student Jack Geiger to study with Sidney and Emily Kark in the 1950s. The Kark’s are regarded as the early leaders in the field of community-based and primary healthcare and founded both the Institute for Family and Community Medicine in Durban and the Pholela Health Centre. “Geiger was inspired by the Karks’ innovative approach to nutrition, health, housing, hygiene, employment, and patterns of migration in the incidence, prevention, and cure of diseases in rural Pholela,” explained Batra. “As a member of the Medical Committee for Human Rights during Freedom Summer 1964 and co-founder of the Tufts-Delta Health Center in 1966, Gieger and other physicians adapted the South African model for their work among African American communities in rural Mississippi.”
“The community-health model essentially originated in South Africa and moved to the Global North,” continued Batra. “The Karks and their students were very important for that reason. They invested decades of their lives in that work.” Batra explained that in the early 1950s the South African government restricted the development of health centres because of a “state assumption that social medicine was socialist medicine” and once the Kark’s grant funding ended they left South Africa and initially went to the University of North Carolina and later to Israel where they built on and extended their work on community medicine further worldwide.
Women’s work in community health
For the bulk of her presentation Batra intentionally moved away from these foundational (mostly male) figures to focus on women’s work in community health – specifically the work of Lula Dorsey, a social worker at the Delta Health Center, Mississippi, and Mamphela Ramphele, founder of the Zanempilo Center, Ciskei, the hub of Black Consciousness health initiatives in South Africa.
“Healthcare was and still is largely a feminised profession below the level of doctors,” she said. “Community health in particular is premised on women’s involvement.”
“Lulu Dorsey was a significant presence but the only information on her comes from interviews done with her in the 1990s and 2000s when she was Director of the Delta Health Center which include very little about her extraordinary career.”
Born to a poor sharecropper family and a single mother to five children, Batra explained that Dorsey intimately understood the unfairness of the system and cycles of hunger, poverty, illness and death.
She worked in the civil-rights movement – “Ironically due to her parenting responsibilities she often couldn’t participate in big civil-rights protests like the Selma March.”
However, she saw health as a continuation of this work, joining the child-development group – Head Start which provided healthcare, nutrition and education to low-income children and later being recruited by Tufts Delta Health Center to run workshops where, seeing the link between health and hunger, she assisted in developing co-operative food-farming programmes. Dorsey eventually earned a doctorate in social work from Howard University and became director of the Center in 1988.
Mamphela Ramphele, by contrast, is a much more well-known and documented figure in South African history as politician, anti-apartheid activist, medical doctor and businesswoman. She was the partner of Black Consciousness leader Steve Biko. She graduated as a medical doctor from the University of Natal Medical School in 1972 and eventually ended up as Vice-Chancellor of the University of Cape Town and Managing Director at the World Bank.
However, her early work in community health is not as well known. While still a member of the South Africa Student Organisation (SASO), she worked with other students to provide medical care at local community clinics. Influenced by the Karks and others, the models developed made the linkages between poverty, malnutrition, education and healthcare, and included running small food and education programmes. In 1975 she established the Zanempilo Community Health Care Centre outside King Williams Town.
“At Zanempilo attention was paid to cleanliness, good-quality food, and treating patients with respect for their dignity as people,” explained Batra. “The goal was to establish a model of what black people saw as suitable healthcare and the experience was replicated at other clinics.”
“But Ramphele also noted the implementation challenges – pointing to lack of co-operation, inexperience, lack of communication, and the need for integrated cohesion and logistics. She emphasised that medical school did not prepare her and others for primary healthcare and that they had little knowledge about setting up a community-health centre.”
In conclusion, Batra noted that “Health humanities sometimes exclusively relies on narrative, and that this makes for an incomplete picture.” She called for a perspective on health informed by multiple disciplines in Black Freedom movements and beyond. She also emphasised now many women revolutionised health care to save lives. But many lacked the time and education to write about their experiences.”
“Lived experience of hunger, poverty and sickness are often an impetus for women in health and human rights work, but circumstances may constrain them – including fear of female leadership. Women often did not lead projects they had initiated and sustained because of family responsibilities, spousal discouragement or local resentment.”
Batra emphasised her broad aims in focusing on “women’s work in combatting racial malaise or the long-term effects of race-based health disparities”. These include, “to emphasise that Global South health initiatives often serve as models replicated worldwide contra the view that these are imitative of those in the Global North; to underscore women’s leadership in the provision of revolutionary healthcare among black populations ignored by national and local governments; and, to call for feminist understandings of health humanities,” she said.
Michelle Galloway: Part-time media officer at STIAS
Photograph: SCPS Photography