Background

Nearly 40 years ago at All Saints Mission Hospital in the heart of rural Transkei we began to turn around our approach to the problem of infant malnutrition. It lead to an exciting discovery of how to talk to the people around us about better health. This required major changes to the professional roles we, doctors and nurses, had acquired in our training and in our encounters with those we hoped to help.

I have recovered these themes and images from flip charts I made during our workshops. Those days were like a honeymoon for health education in South Africa - an inspiring marriage of hearts and minds from all around the country that in the end did not work out.

At All Saints Hospital we joined up with Mount Ayliff Hospital to begin the Health Education Project (1971-74). This lead to the formation of the Transkei Health Education Association and Journal (1975). Nationwide there was the South African National Council for Health Education and its annual conferences (1977-84) under the charismatic leadership of the late Dr Renate Westphal. What was so special about the movement was the enthusiasm and thirst for guidance from grassroots health workers.

People used to ask, sometimes critically, What is this Health Education? Where is this Discipline? Where are the Textbooks? We wanted to see cadres of health educationists whose training concentrated on communication skills, but always backed by highly qualified specialists in what today is called an integrated model. This was a worldwide trend, but then, in South Africa, it was unpopular with the top nursing professionals of the time.

Meanwhile, by listening to the problems and experiences of the communities we worked among, we discovered the reality of problem- and community-based learning long before those terms became fashionable.

Offering good health care depends on doing simple things well. I hope this presentation highlights that simplicity and shows that "health education" is not an add-on, but begins within our professional attitudes.

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