Assessing Apartheid's Damage: The Broken Marriage of Anthropology and Epidemiology in South Africa

South Africa is currently grappling with the problem of transforming a fragmented, apartheid-inspired health delivery system structured along racial lines. Cuban doctors have been invited to serve in rural areas where many South African-trained medical personnel refuse to go, often joining the post-democracy 'brain drain' as a result of dissatisfaction with government health policies. This paper attempts to bring to light a once very successful and highly innovative health delivery model that was conceived and piloted in South Africa over a half-century ago. This model combined anthropology and epidemiology and resulted in calls for a re-design of national health delivery based on what was called the Pholela model. Due to short sighted government policy at the time, the model was exported abroad (via immigration) where it formed the basis of several progressive health initiatives in various countries. Significantly, it marked the beginnings of social science and medicine collaborations that are still viewed as an ideal for developing more effective health interventions. The author suggests that this historic experiment at Pholela has much to offer in terms of providing a model that could foster transformations in both academic and medical service. JOURNAL OF THE PAN AFRICAN ANTHROPOLOGICAL ASSOCIATION Number 2 Volume VII September 2000, pp. 137-157