CUADRO 12 TIPO DE

As discussed in chapter 4, black nurses occupied a unique position within South African society. They were westernised in their education and work, yet they were also very much part of the African community and tradition they were born and raised in. It is therefore important to investigate black nurses’ social role in the second half of the twentieth century.

5.5.1 The social status of black nurses in comparison with the social status of the black population in the 1970s and 1980s

The urbanisation of the South African population commenced at the beginning of the twentieth century, continued during the 1970s and is still proceeding at the start of the twenty-first century. In 1904, 10% of black (compared with 53% of white) South Africans lived in cities. By 1980, urbanisation had escalated to 33% of the black (and 88% of the white) population, and in the year 2000, 47% of the black population were urbanised (in comparison to 90% of the white population). The increased rate of urbanisation and the growth in the African population had an influence on health-care delivery (and therefore nursing) in South Africa. Although a more favourable infant mortality rate (less than 100 per 1000 live births by the 1980s) was observed, the health of black people in general was declining in the 1980s, placing a greater burden on the South African health-care system (Hunt 1991:2–4; Liebenberg 1996:480–482; Rispel & Schneider 1989:22).

The greater burden on the health care system was in part due to the housing conditions which prevailed. Despite the rapid urbanisation of black people, the apartheid government did not spend large amounts of money on providing adequate housing in the townships. The scarcity of suitable housing created a situation which made it very expensive to buy or rent. Poor people could not afford it and therefore had to make alternative housing arrangements. For example, the population of Katlehong increased from 95 000 in 1970 to 200 000 in 1980. Despite this large increase in numbers, only 100 houses were built in the area during the period 1973–1979. Therefore people resorted to building makeshift, informal dwellings. This type of home increased within two years from 8 000 to a total of 24 000 in Katlehong alone. Similar conditions were evident in Soweto where 23 000 informal houses were counted in 1982. Poor housing

negatively influenced the health of the residents, which placed a greater burden on the health care system and therefore nurses. From these examples, the researcher deduces that the situation was similar in other black townships in South Africa. African people did not accept these conditions and established civic organisations which protested against the expensive rent system and the government’s destruction of informal houses. In these protest actions, black women played an important role (Nieftadogien 2006:59–61).

The social conditions described in the previous two paragraphs had an influence on black professional nurses: they lived in the townships and therefore had the options of either paying for expensive housing or living in an informal house. Thus the nurses themselves were vulnerable to ill health due to poor housing. In addition, the ill health of the community made the nurses, who nursed them, more vulnerable to diseases such as tuberculosis. The location of townships away from the inner cities meant that nurses had long distances to travel between their homes and their places of work. Despite these circumstances, black nurses formed part of the newly developed black middle class. They were considered social elite (Marks 1991:2, 6; Rispel & Schneider 1989:9).

The black nurses’ tertiary education separated them from the working class. In fact, many black nurses distanced themselves from the working-class man. This social divide assisted the government in creating a new black middle class. This in part explains why black nurses remained in the profession despite the difficult working conditions and low salary. Black nurses were caught in the middle: on the one hand, they were placed in socially superior positions in their communities; on the other hand, the community expected them to participate in the protests against the very government which had enhanced their social standing (Marks 1991:5; Rispel & Schneider 1989:9, 18, 22–23).

5.5.2 The social status of black nurses in the 1990s

Some things change; others remain the same. This statement is relevant to the social status of black South African nurses in the 1990s. Teaching and nursing, as in previous decades, remained the two important professions available to black women (Van der Merwe 1999:1273).

Even in the last decade of the twentieth century, black professional nurses were still caught between their traditional African way of life and the values of the Western-styled nursing profession. However, a slight shift in focus occurred. In interviews with black nurses, Van der Merwe (1999:1272) discovered that rural black nurses in particular felt more oppressed by their culture than by their race. By using their education and personal qualities, black nurses had learned to empower themselves by creating their own type of freedom. Yet, in their roles as black women, they had less power and more domestic responsibilities than their male counterparts. In this regard, many had little or no support from their husbands (Van der Merwe 1999:1276–1277).

In chapter 4, sub-section 4.5.4 of this dissertation, the entrance of married women into

the nursing profession was discussed. The Second World War had necessitated an increase in nursing numbers and therefore married women were allowed to enter the profession in greater numbers. By the 1970s, married women comprised 66% of the nursing corps and, in 1990, 51,8% of working nurses reported having children (SANA 1980:57–58; SAVV 1990:25; Searle 1975:57; South African Information Service 1961:10). In the light of the discussion in this and the previous paragraph, it must be acknowledged that the responsibilities of home, children and work, with little support from their husbands, must have placed a heavy burden on the shoulders of black nurses.

Throughout this dissertation, the point is made that black nurses were regarded as a social and educated elite within the black communities of South Africa. One may ask if this still holds true at the end of the twentieth century and, if so, what yardstick black nurses used to measure this perceived status. Horwitz (2007:135) interviewed black nurses who trained at Baragwanath hospital in the 1940s. From these interviews it was evident that, even during the apartheid era, black nurses based their perception of a professional image on that of Florence Nightingale and Henrietta Stockdale. Years later (when interviewed in 2004), they were of the same opinion: one of the most important status symbols was the white nursing uniform worn by nurses which was associated with increased status and commanded respect from others. The nurses stated that the patient had to see “some glowing person” taking care of them. And finally: the white uniform challenged the stereotypical view that all black people are “dirty”. The emotional connection with the nurses’ white uniform is still ongoing, as illustrated by

discussions held at the 2011 Nursing Summit, where it was proposed that nurses should retain the white uniform worn in previous decades (FPNL 2011; Horwitz 2007:133–135; Kitshoff 2011).

5.6 THE EFFECT OF SECONDARY AND TERTIARY EDUCATION ON BLACK