Dr. Barry Kistnasamy, dean of a renowned medical school in South Africa, discussed health care under apartheid in a speech last Friday, stressing the importance of keeping a global view on health issues.
Kistnasamy credited an active student movement in the 1970s for bringing health and apartheid issues to the forefront of global consciousness. He expressed his appreciation for active young college students to a capacity crowd of nearly 100 in Carson L02.
Although he admitted that the campus of The Nelson Mandela School of Medicine is "not as beautiful as Dartmouth," Kistnasamy strongly encouraged Dartmouth students to study at the College's environmental studies foreign study program in Durban, South Africa.
Kistnasamy emphasized the power of global unity, singling out NAMDA, a South African association of black doctors and progressive white doctors and dentists. NAMDA was instrumental in outlining the effects of apartheid on the health system, Kistnasamy said.
In discussing NAMDA's civil disobedience programs, he said he and his colleagues marched in the streets of Durban with white coats and stethoscopes chanting, "Why can't we go into white hospitals?"
Kistnasamy also briefly outlined his experience as an East Asian during apartheid, mentioning the fact he has been detained several times. However, this discussion of the past summarily concluded with Kistnasamy's explanation that "it is not something we want to go back to."
He went on to speak about the state of the health system during apartheid. Health facilities were segregated, Kistnasamy said, and human resources were racially skewed. During apartheid, there were five medical schools for whites students and only one school for black students.
Kistnasamy explained, "As a [non-white] physician, I was not allowed to give white nurses orders."
In 1994, South Africa had its first democratic elections.
"It's nice to be part of a democracy," Kistnasamy said.
In 2000, Nelson Mandela gave his name to the medical school Kistnasamy now heads. Mandela credited the school with helping to transform South Africa into a more equitable country. Black Africans account for 65 percent of the students, and 25 percent of the students are Indian.
Inequities still exist in South Africa, however Kistnasamy said they are getting better. Kistnasamy hopes to retain many of the students of his medical school to work in the public medical field in South Africa, he said.
Kistnasamy's description of South Africa and the effects of apartheid expanded to a discussion of his views and hopes for the future.
Only 10 percent of global health spending is spent in developing countries, which Kistnasamy said concerned him. He said he is equally worried that only seven percent of South Africans have a tertiary education.
Kistnasamy explained the differences between Western medical education and South African practices. In South Africa, students come straight out of high school into medical school. One school recently qualified a 20-year-old as a doctor. The student reportedly entered the school at 14.
Kistnasamy's eclectic approach to medicine reflects his assertion that the exchange of goods and ideas will make the world a better place to live in. He said he believes in considering traditional and tribal theories on medicine along with traditional Western conventions.
He summarized his belief in alternative healing methods in a story about his mother.
"If my mom feels good by a pastor putting his hands on her," Kistnasamy said, "he is healing her."
His advice to those pursuing a career in medicine is to not enter medical school with a one-track mind.
Kistnasamy also touched on the effects that AIDS and other diseases are having on South Africa. He explained that there will be 2.5 million orphans by the year 2010 as a result of AIDS.
He said something must be done to decrease the HIV infection rate, currently at 10 percent in South Africa. However, he declined to propose any particular policy measures.
"I'm out of the political loop, and I am building a medical school," Kistnasamy said.
