Why did we leave?

5 July 2007

“Are you excited?” We were often asked this before we left. No, not really; sad probably best summed me up. How did it come to be that here we are, leaving family and friends, for a job on the other side of the world, when there is still so much we could contribute to South Africa?

We’ve been through the reasons for leaving so many times before. It was not a hasty decision - there was no ‘eureka’ moment when we knew we were doing the right thing. There were points for and points against; some days we’d seriously question if we were doing the right thing; other days we were certain that the move was for the best. The main reason revolves around my work – nursing staff shortages made my job more and more difficult to provide the quality of care I was happy with. I looked around for other options in SA but eventually decided to leave: the problems in medicine in SA are pretty deep-set and unlikely to get any better. The time for the family to move was now – although Chloe at 9 and Gabi at 11 have a few more years before high school, Jaime is 13 and moving for her in a few years time might be much more disruptive than it is now.

We hope that opportunities for them will be better overseas. SA is still a very polarised society – in terms of race and gender; on a personal level, we’re very kind and friendly, but on a societal level, we’re mean and violent. Our travels have shown us that there’re places where societies live harmoniously – in fact, it’s more the norm than the exception. Societal cohesiveness is not possible where there are such great disparities as exist in SA.

Violence is often cited as the reason for people leaving. Yes, it is there, in abundance. It hasn’t changed much in the last 10 years and those of us who are privileged, can cocoon ourselves reasonably well from it. There are many murders, rapes and assaults; but what about the 12 000 people who die on our roads each year? And the eastern Cape roads are the worst of all: unfenced roads, cattle roaming around, unliscenced drivers, not to mention the accepted ethic of driving with more alcohol than blood in their veins. I’m sure visitors are horrified when they see toddlers standing on the front passenger seats, hands on dashboard while mother drives unbuckled around town!

On the medical front, we’ve seen huge advances – no more measles, (initially) less gastroenteritis and malnutrition – since the ANC took over. But this has all been negated by AIDS. AIDS denialists should just spend a day with us in a hospital; I hadn’t come across a case of AIDS prior to my leaving for Canada in 1990, now at least 60% of the children in our wards are HIV positive, most with AIDS. Government bungling over AIDS policy hasn’t made things any better. As a paediatric department, we’d probably have more impact on health by ignoring the sick children and put all our resources into preventing the newborns becoming infected. Of course, this is just not possible. The AIDS epidemic will likely peak when about 25% of the population of 45 million people are infected. In choosing a partner, a sexually active adult takes on the whole sexual history of that partner – not only the partner, but the partner’s partners.

Antiretrovirals have made a huge impact on the lives of those with AIDS. Chronically sick, wasted people with ongoing diarrhoea and tuberculosis, regain their weight and become well. I had the misfortune of having to take ARVs for a month over Christmas 2006 after sticking myself accidentally with a needle after taking blood from a child with AIDS and cancer; after a few weeks I felt awful, and stopped a few days before the month was up. In our department of about 12 doctors, we’d have one or two who would need ARVs every 6 months. The risks of contracting AIDS without ARVs in this situation are in fact very low, but significant.

On the political front, we’re much better off now than we were in 1990. I cannot get too upset anymore about a possible Zumu presidency. Sure, there’s lots of corruption and nepotism, but probably no more than before. At leadership levels, the ANC have some very capable people in position; it’s at the bureaucratic level that things fall down completely. Working with the incompetence of many officials is very frustrating. This is not likely to improve anytime soon.

Education is still pretty good in the ex-model C schools, but abysmal in the township schools. It was very telling that during the recent teachers strike, the teaching continued in the good schools, and was non-existent in the poor schools. Some performance related pay scales are urgently required; this will not sit well with the unions though!

Having said all this, SA has been our home; we do not want to leave. Our families have been here for centuries, our roots are here, not in Canada, not in Australia, not in England. We found life in Canada very different from what we were used to, not just the environment and the climate, but the way of life and the people. People are wonderful in Canada, very friendly and kind, but with a different history. We can expect the same in Australia. But when we drive past a school (on the left side of the road), we can expect to see children playing cricket or rugby (no, probably Aussie football in the part of Australia where we’re going). As adults, Jeanne-Marie and I will likely always be immigrants; hopefully our children can assimilate and build their own history there, in much the same way as our ancestors did those centuries ago in SA.

We asked our children if we were doing the right thing.

“Yes,” said Chloe, “because of Education, Crime and AIDS”
“Yes.” Jaime this time. “For the same reasons”
“50-50,” said Gabi, “I’m going to miss my friends”

We’re all going to miss our friends, not to mention our families! Imagine what a move like this would have been like a century or two ago – no telephones, no SMS, no e-mail, and no Skype! The world is so much smaller now, not only is it easier to travel, but it’s so much easier to keep in touch. A move like this is not nearly as difficult; and, anyway, it need not be forever!