Community Practice at Wits

The concept of Community-oriented Primary Care (COPC) started in the 1940s with a young doctor couple from Wits University – Drs Sidney and Emily Kark – setting up the Pholela Community Health Centre in Bulwer, Natal. They set it up with a bright medical aide, Edward Jali and his nurse wife, Amelia. Their efforts led to the development of a network of CHCs and new National Health Service for all South Africans. Unfortunately this was all cut short by the onset of apartheid in 1948. Their ideas, however, spread across the world, including Cuba and recently Brazil (Longlett, Kruse, & Wesley, 2001; Tollman, 1991). The South African government has been clearly inspired by Brazilian achievements. They have acknowledged this in the Green Paper on National Health Insurance and have modeled the policies of Primary Health Care (PHC) Re-engineering and PHC Outreach Teams on Brazilian. It is unfortunate that the Karks (and Wits) contribution is not being celebrated (National Department of Health, 2011).

We believe that Health (and community) is in ALL policies, and so we have been keen to engage across the university, in ALL faculties. We feel that “Community Practice” has the potential to focus interest from across the university in helping its graduates practice in the community – appropriately in learning and as real world leaders. The University of Witwatersrand has important values that need nurturing across the various faculties but in an integrated and purposeful manner. The University of Witwatersrand values social engagement and responsiveness, moreso with perceptions of ivory-towered academia needing to be destroyed. Responsiveness must include accountability, both inwards and outwards. This can only be achieved by provocative debate and critical engagement in a spirit of collegiality.

This needs freedom of thought balanced by responsibility for action. It is all too easy for the university to feel besieged by the ‘mess out there’ and retreat to behind the ‘walls’ of the university. The university needs to locate independent enquiry in a context of trust where Intellectual excellence is respected for its integrity, where academic freedom and institutional autonomy are not seen as cover for sabotage of a changing society but part of the richness of our diversity and an arsenal in our countries resilience that is capable of meeting local challenges and engaging globally. The university has many parts trying to reach out and be applicable in the real world. The pity is that it is often fragmented and struggling. We feel that Chiawelo Community Practice can be the locus for something bigger……

We are proposing the Wits Kark-Jali Centre for African Community Practice

Draft Aim: Service development, Teaching, Research and Advocacy for inter-sectoral and multi-disciplinary professional practice in the community.

Draft Motto: Practice in the community…. changing paradigms

Future Programme

  • Research
  • Service Development
  • Professional community-based service learning / teaching;
  • Advocacy of Community Practice – attracting outside funding / structure for delivery of academic programmes
  • Support African organization of Community Practice

Whilst funding is viewed as a critical Wits factor in setting up a centre, we believe that people are more important. Motivated people can make this happen. Nonetheless the team, based on the Jozi Family Medicine Syndicate, has funding till February 2014 and is actively seeking out further funding.