Understanding Health Care Access in Rural South Africa

In November and December 2015, Abigail Neely, assistant professor of Geography and Arun Ponshumnugam ’17 spent three weeks in South Africa conducting an in-depth survey and gathering GPS data about health care access in rural South Africa.  Dr. Neely has been working in the Pholela region of KwaZulu-Natal, South Africa for close to a decade, but it was Arun’s first trip.  This research was funded by the Mellon Foundation through the Leslie Center for the Humanities and by the John Sloan Dickey Center for International Understanding, both at Dartmouth.  Below are some thoughts and reflections of Arun’s.


Conducting fieldwork in South Africa was an adventuresome and intellectual endeavor. Reading academic journals and Geography books on fieldwork, I have wondered for years what Geography fieldwork actually looks like. I have since learned a bit of the intricacies of fieldwork through Professor Abigail Neely’s research in Kwazulu-Natal, South Africa.  We studied how people access healthcare and why do they do it the way they do.  Our work involved surveying approximately a hundred households on family history of illnesses and discussing how they approached healthcare for each ailment. South Africa provides its citizens with free healthcare through public clinics and hospitals. However, through our work, we have realized that the patients pay a large price for healthcare by means of transportation costs, wait times and simply navigating the complex system. The project combined my biggest passions, Geography and medicine, and not only allowed me to see both disciplines in new lights but has allowed me to conceptualize how I can combine these disciplines in my life.


I have learned from the experience that fieldwork, and research in general, is just as much about cultivating relationships as it is about creating knowledge; we spent hours talking to “gogos” (Zulu for grandmothers) and visiting homes and through these interactions, we and our project benefitted. The fieldwork also gave me opportunities to think deeper about issues of race, inequality and poverty. In talking to patients battling HIV, discussing the legacies of Apartheid with Black, Indian and White South Africans and seeing the racial divisions quite physically engrained in the geography, I now approach the same social issues with a bit more experience and audacity. I am grateful for such an experience that has allowed me to explore the art of knowledge creation and the beautiful country of South Africa.