Your world becomes small and familiar with its own rules, and yes, it gives you satisfaction.

Transcription

1 Anna-Marie Bruwer

2 This remarkable lady has provided medical leadership across the globe, was elected Woman of the ear, and now enjoys a quiet retirement in Riebeek Kasteel I was born in Potgietersrust and grew up in the northern suburbs of Cape Town. There was nothing during those years to indicate that I would one day have a career in nursing. On the contrary, my high school days at DF Malan were filled with taking music as an extra subject after school, doing athletics and playing tennis and netball, not only for the school team but also for the town club. During lunch breaks I sat doing homework because I did not have the time after school. No wonder everyone, with the exception of my mother who thought my maths was great and that I should do commerce, expected me to make sport my career. THE BEGINNING YEARS I did not know what I wanted to do and, in desperation, in January 1966, at the age of 16 years and three months, I enrolled as a nursing student at Karl Bremer Hospital in Bellville. My mother was not impressed. The training was for three years during which time I experienced dying patients, saw a lot of blood, as well as pain, while getting used to tired feet, and also enjoying the camaraderie of nurses and health workers. In this situation you somehow just carry on. Your world becomes small and familiar with its own rules, and yes, it gives you satisfaction. I left Karl Bremer Hospital and went north to HF Verwoerd Hospital in Pretoria to do my midwifery training. I was still not 20 years old. I found that babies were fun as did my classmates. We all decided to do psychiatric nursing at Weskoppies Hospital after our midwifery training. By now my friends had become engaged to be married, one after the other, and I found that I was no longer satisfied with nursing. I wanted more. The University of Pretoria offered the first graduate programme for trained nurses, and I enrolled while still busy with my training in Psychiatric Nursing. This meant that I attended extramural evening lectures. Doing night duty over weekends and attending fulltime university was the beginning of my academic career. Three years later I obtained my Bachelor s degree in Nursing Education and Administration. I continued studying part time for the next 11 years and completed my Doctoral degree in 1986, specialising in Quality Management. THE PSYCHIATRIC YEARS After completing my degree and while still working at Weskoppies Hospital as a nursing sister, I received a phone call from the Head Office of the then National Department of Health - they needed a graduate psychiatric nurse to head up the psychiatric training in the country and would I like to apply? Now this was not necessarily a compliment because at that stage there were only three of us. I decided to join them and skipped about four promotion ranks - I was 24 years old. My mother was not happy that I worked with psychiatric patients. The next 12 years were a tremendous learning experience. The state of psychiatry still leaned heavily towards custodial care. After reforming the training, I went on to structuring the community services, moving patients out of the hospital and introducing therapeutic care. After that I did planning and the commissioning of new psychiatric hospitals and eventually at the age of 32, I became the Chief Nursing Officer of the Department of Health - the most senior position in nursing. During this time health services were changing and South Africa was transforming. I interfaced with most other state departments, doing technical aid projects in Malawi and Iran in collaboration with Foreign Affairs, travelled to the deep rural areas and got to know the then Homelands, thus developing new skills other than washing patients. After 13 years at Head Office I decided to go home back to Cape Town I transferred to Tygerberg Hospital as the Chief Matron.

3 My academic studies had taken me all over the world, where I participated in international congresses and networked with other leaders in the field of quality management. My years at Head Office helped me to develop into not only an experienced nurse but also into a health administrator - all of which I would need later in my career. ACADEMIC HEALTH CARE I arrived at Tygerberg Hospital when I was 38 years old and so I was back in a general hospital. It was here that I bumped into all the ward sisters who had trained me as a student nurse some 20 years earlier. By this time they were Zone Matrons overseeing a couple of wards. I can but wonder what they thought about the vast number of patients they had to service. The hospital had beds and nurses. During the eight years which I spent there, there were a number of issues including the struggle to cope with downsizing and trade unionists who were learning their trade on site. Nelson Mandela was also a patient in the hospital. From macro-management skills I had to change to micro-management skills. I was required to re-engineer, remodel and retrain staff. A call from national level asked me to assist in my professional capacity with preparing for the new South Africa and to stand for election to the National Board of the Professional Nursing Association. This culminated in my being elected as President - a task which, on the eve of the new South Africa, did not make my responsibilities at Tygerberg Hospital any easier. My further election to the SA Nursing Council did not help either. But those were difficult years and we all had to walk the extra mile to prepare for the new regime - actually, for me, this meant flying the extra mile, because all meetings were held in Pretoria and I had to attend them after working hours. I became a familiar face on the 17h00 flights to Johannesburg, returning at 23h00, three to four times a week. My duty at Tygerberg Hospital started at 07h30 in the morning. During this time the nursing profession celebrated 100 years of state registration and as President I had a very busy time was an exceptional year. This was also the year when I was nominated as Woman of the Year. What great publicity this was for the nursing profession. INTERFACING WITH THE POLITICIANS Having reached the top of the nursing hierarchy, served as an elected member of both professional nursing bodies, completed my formal studies and researched/published at international level, made me ask what next. By then the scene in the public service was not positive, with early retirement packages being offered to all. A chance remark from my secretary drew my attention to an advertisement in the newspaper. I applied and three months later I was appointed as Public Service Commissioner of the Western Cape Government when Mr Mandela was State President. The four-year contract appointment had the implication of another four rank promotion putting me on a par with Heads of State Departments. It was an interesting time of restructuring the state departments to meet the needs of the new South Africa. Working with politicians, however, did not satisfy my scientific training and when my contract ended I retired from the public service in South Africa. I served the nation for 30 years. DARKEST AFRICA I was visiting my sister in Johannesburg, enjoying a cup of coffee in a coffee shop, when we started a conversation with a gentlemen sitting next to us. He complained that he had difficulty finding staff to reopen a copper mine in the south of the DRC. A month later my sister was appointed to a position heading up 40 schools and I became the health administrator for three hospitals with community services. The DRC is a beautiful country but after the political take-over in the 1960s, nothing was left of the health services which had been developed by the Belgians. We tackled this problem with soap, bleach and limited resources, all sourced from South Africa. We spent a year there, and celebrated the turn of the century with a bottle of coke in one hand and our feet in the Congo river. A week before President Kabila was murdered, the locals came to warn us that trouble was brewing. My

4 sister left first and I followed just in time. ARABIAN NIGHTS So many of my life s events have had to do with chance. A phone call from a nursing agency asking me to assist with the screening of nurses who were going to work overseas took me to the Table Bay Hotel one morning. At the end of the day I left to pack my bags to travel to the Middle East. And so my career started as Director of Quality Management (QM). For the first time this afforded me the opportunity of applying my doctoral thesis, albeit in another country. I was based in Tabuk, Saudi Arabia, a small military town south of the Jordanian border. The 600 bed hospital was well equipped with South African nurses in charge of the wards and a South African doctor doing heart operations. Just sometimes one is lucky to be the right person in the right place at the right time and I think I came close to it. Although everyone predicted that QM could not be implemented due to the nature of the Arabic culture and a military, male environment, I had no complaints. Eighteen months from ground zero to international accreditation made us famous. Two wars were on the go only a few miles away. The QM programme was rolled out to all military hospitals and I was part of the team doing auditing and training. This gave me the opportunity to see a country which is not accessible to all. I am still asked to visit once a year and to come and set things straight. Apart from the job satisfaction that I experienced, there was the other side to living in a country which is not very hospitable to infidel women. Fortunately I worked very hard and being older and wiser I did not miss not having a social life. My weekly trip to the supermarket was in an abaya and my head had to be covered. The highlight was a hamburger at Macdonald s. For time out from the job, and armed with a letter of permission issued by the hospital, I would fly to Jeddah for a weekend, staying in a five-star hotel. This gave me a chance to visit all the modern shops, again in my abaya and with my head covered. Every six months I got a lift with my married friend and we travelled by car over the mountains to spend a weekend in Agaba, Jordan. This was a real treat. My annual holiday took me home to South Africa. This holiday month was usually spent getting my life in order so that I could leave the country for another year. When I realized that it was becoming an effort to come home on holiday due to all the arrangements which had to be made, I started wondering whether it would not be easier to stay put. Then, when I noticed that I was not understanding the jokes my friends were making, I knew it was time to say good bye to the Arabian nights. I was not sorry to bid farewell to the climate; 55 C and 90% humidity is too much for a woman of my age. FINDING MY SOUL IN RIEBEEK VALLEY My instruction to my sister was clear - buy a black car and meet me at the airport. After more than ten years of not being allowed to drive a car, and after a lifetime of driving white Government Garage cars, I wanted to experience the freedom of driving from the airport. All ex-patriots have difficulty in adjusting when they come home and so did I. Getting a dog solved my problems. Yela (Arabic for fast ), a dachshund, soon ran my life. The fact that she fell in love with my sister meant having to visit her in Riebeek Kasteel often. Yela got company - Galas (Arabic for finished ) - another dachshund. To cut a long story short, I then moved in with my sister and the two dogs. My mother would have been very happy. Since returning home, the health services have featured often in the media. It was then that I decided that, instead of criticising, I should offer my assistance. Well, easier said than done! However, I did lecture at the University for a year, and in 2013 I also completed a project of auditing the 124 subsidised frail-care homes for the Department of Social Development. In this year's programme 142 private homes are being tackled; an exercise which will take me from Koekenaap to Plettenberg Bay. Life in Riebeek Kasteel is now all I want. Making excursions to places where my expertise is needed is fine,

5 as this does not take me away from home for a long period of time. Yela and Galas would not put up with my absence. This article is re-printed from the SAARP Bulletin with permission of the editor and Doctor Bruwer