MEDICAL EDUCATION FOR SOUTH AFRICAN BLACKS : Deserves Recognition

It never ceases to amaze me how many organizations there are out there trying to help various communities in Africa. Quite often I am embarrassed that I did not know of the existence of certain organizations.

Yesterday I received in the mail an invitation to a reception in Washington, D.C. for the Medical Education for South African Blacks (MESAB) and I must confess that I had to go to their web site to learn about them.


MESAB says that it is a "collaborative American and South African effort to improve the health of South Africa's black majority by training black health professionals in South Africa." Currently they are the largest source of funding from private sources for students of color preparing for careers as health professionals in South Africa.

MESAB began in 1985, and at that time there were only 500 black doctors in the entire nation of South Africa. And in the massive community of Soweto there were only 2 doctors. Clearly not enough to serve that community's 2 million black residents.

Since 1985, progress has been made in South Africa and the country's 32 million blacks have benefited to some degree, THERE ARE STILL ONLY 2500 BLACK DOCTORS IN SOUTH AFRICA!

While the huge obstacles of apartheid have been removed, black South Africans continue to suffer from unacceptable rates of infant mortality, infectious disease, HIV/AIDS, TB, accidental death, and other physical impairment simply because many do not yet have access even to basic health care. One approach to improve this situation is to dramatically increase the number of black health care professionals in South Africa.

So, 20 years, MESAB has worked to provide disadvantaged black students with scholarship support in fulfilling their goals of becoming health professionals. And it is needless to say that this support is greatly needed. Over the years MESAB has sponsored 6,841 students and given a total of 10,689 grants.

While MESAB provides scholarships to students who are pursuing health professions degrees across a range of disciplines the need for black health care professionals continues to grow. Currently it is estimated that the number of black doctors in the country at 3,000. Working to fill a critical gap in medical services MESAB is providing scholarships to accomplished students. Additionally, through their prenatal health initiative, they have maintained their training program for nurse midwives delivering health services to expectant mothers and their children in rural areas of the country.

In recent years, due to the devastating effects of the HIV/AIDS epidemic in South Africa, MESAB has sought ways to support current efforts to address that scourge while at the same time adhering to their core mission. The implications of this crisis, with more than four million of the nation's citizens living with HIV or AIDS, are enormous. The already overburdened health care systems are straining under the crisis and a generation of orphaned children is being created. The caregivers for those with AIDS few places to receive training and support.

Because of the enormous number of those infected with HIV hundreds of thousands of AIDS patients are not getting the basic care needed to enable them to live their lives with dignity and lessen the unnecessary suffering.

MESAB's goal is to change that through its newly launched Palliative Care Training. They seek to improve the quality of life for those with HIV/AIDS by strengthening and expanding community-based services that train caregivers with enhanced knowledge and skills to better meet their patient's needs.

Because of the HIV/AIDS crisis, the health care needs of South Africans has never been greater.


In 1989 MESAB launched its Mentor Program to help ease the transition for students as they go into the dramatically new and demanding environment of academia. Some of the students who receive scholarships from MESAB have never been to a proper library, before arriving at their colleges. They have never had a bank account or conducted a science experiment in a real laboratory. Also, in South Africa, it is not unusual for a student of color to have never sat in a class beside white students before.

These are some of realities for many of MESAB scholarship recipients as they enter into their university studies. Growing up in poor and/or rural communities where educational resources remain rudimentary, as some of the recipients did, the chance to enter a whole new world of ideas and relationships with professors and peers that MESAB offers presents many challenges.

The Mentor Program was originally offered on six campuses and is now available at all 22 of those universities and technikons attended by MESAB scholarship recipients. The program is supervised by a MESAB-appointed and funded coordinator and open to all black students in health care studies, not just MESAB scholarship recipients.

When a MESAB-funded student arrives on campus he or she is meets with the mentor program coordinator and is paired with a mentor who is generally a medical student at the senior level of his or her studies. Each mentor may assist as many as twenty mentees. And in this way, the program reaches between 1,500 and 2,000 students at any given time.

While the cornerstone of MESAB's mission is its Scholarship program supporting young, black South Africans aspiring to enter the medical profession, mentoring addresses challenges created by and an iniquitous system of apartheid which besides being traumatic for learners, created an inequality of starting points for learners of various cultural backgrounds. And those challenges still remain because of the residual effects of the apartheid system.


MESAB states that its average scholar comes from a poor family with a per capita income equivalent to only US $3,000 - $8,000 per year. Also, it is most likely that his or her parents never graduated from high school. Those students who come to MSAB seeking financial assistance have overcome tremendous obstacles in their quest to become doctors.

MESAB scholarships are need-based and hold no special stipulations. And any student who qualifies to enter a South African institution is eligible. The exact amount awarded to each student varies depending on individual need, but the minimum grant covers basic tuition.

Also, in order to stem the "brain drain" afflicting many African nations, MESAB encourages young medical professionals to stay in South Africa once graduated and beyond the government-required service in the country.


Another important initiative of MESAB is Perinatal Education. In rural areas of South nurses and midwives often serve as primary caregivers because there is limited access to hospitals and clinics. Because of the lack of trained health care professionals, expectant mothers and infants living in rural areas often receive inadequate attention.

In 1995 MESAB helped to launch the Perinatal Education Program (PEP) to address this urgent health care need of rural South Africans. Based on a set of manuals developed by Professor Dave Woods and the Department of Pediatrics at Groote Schuur Hospital in cape Town an advanced training course for nurse-midwives, PEP provides practitioners and primary care givers with training in the care of mothers and their newborns.

With MESAB's assistance, over 1400 practitioners have completed the PEP training since 1995. Over 30 hospitals and clinics having partnered with MESAB to offer the PEP training.

With the support of a grant from Levi-Strauss in 1997, MESAB funded the development of an "additional manual used in the treatment of expectant mothers and infants with HIV/AIDS. The manual offers practical methods for preventing HIV and AIDS transmission from mother to infant. Professor Woods is currently developing another manual designed to address overall perinatal health by focusing on the 'well mother.'"


If you have not yet heard about MESAB take a look at their web site, because they deserve recognition. Medical Education for South African Blacks