South Africa's Technikon Natal -- An Adventure for Chiropractic Educators

Having recently returned from a three month's teaching stint at the Technikon Natal in Durban, the Republic of South Africa, the school's need for comprehensive chiropractic teaching assistants became apparent to me. Because of limited numbers of students allowed by government support, the school's finances are strapped by institutional budgeting for high salaried personnel. The cost to import someone from overseas requires considerable front money, and a commitment of at least two years. The school has ample personnel for the basic and clinical sciences, but they need chiropractic educators.

South Africa is a new frontier in chiropractic. It has been expressed that South Africa will become the shining light of Africa. I'm more than 70 years old, and my roots and obligations are too great to take on such an adventure so late in life. For the young, not yet established chiropractor, this beautiful country would be an unequaled adventure.

At an international conference in London, England, a gentleman approached me and introduced himself as H.S. Liebenberg of South Africa, clinic director of Technikon Natal College of Chiropractic.

"I'm Dr. Lee Arnold from St. Petersburg, Florida," I said, introducing myself in turn. "When am I again going to be invited to South Africa?" I said wryly.

"You're invited," he responded without hesitation.

I was taken aback. "I'll have to check with the better half. For how long a period do you want me?"

"Three months minimum," came the reply.

I advised him that this would probably take some negotiating with my wife, grandmother of three grandchildren. We exchanged business cards.

That evening I asked my wife, "Bubs," if she'd like to go to South Africa in 1994. Without equivocation or mental reservation she said, "Yes."

"How does three months strike you?"

"Why not?" Bubs replied, "But I'll have to change some tennis dates."

We made our plans while still in England for our three month visit half way around the world. Although this was to be our fourth visit to South Africa, our interest grew as departure time drew near. But our excitement became tempered with the political realities. South Africa at the time was a country of great strife, poverty, and political unrest. Could we protect ourselves? Could we accept a more modest standard of living and forgo the conveniences we're accustomed to in the US?

Our children's reception of the news was underwhelming. Our son was less than happy; daughter Sandie was stoic. Why leave a comfortable home and safe country for unknown circumstances? No adequate explanation exists for those who have not visited South Africa, but, by and large, people who have been there usually yearn to return.

As in other countries, US citizens face stumbling blocks to employment in South Africa. To receive a green card, proof must be shown that your specialty is essential, and that no one in South Africa can fulfill your qualifications. A fax to the South Africa Registration Board and Technikon Natal, and a little help from the South African Embassy in Washington, D.C., and the deed was done.

On our arrival in Durban, South Africa, we were met at the airport by Dr. Liebenberg. He whisked us away to our new home, driving on the "wrong side" of the road. A condo had been reserved for us through the cooperation of a student at the Technikon. On our previous visits we had always stayed in four star hotels or practicing physicians' homes.

Dr. Liebenberg parked the car on a busy street and announced: "This is it." We looked at an eight-foot wall with a door on it and wondered what would be the next surprise. We walked through the door into a garden area with its native foliage, a "jump pool," and faced the front door of our condominium, barricaded with a steel rod door. To Bubs, who has spent most of her life in a country with screen windows and doors, this was a shock. "How do you keep the bugs out?"

"We don't, they were here first," Dr. Liebenberg replied.

"How about mosquitoes and malaria?" Bubs inquired.

"The mosquitoes here are not carriers, don't be concerned," Dr. Liebenberg assured.

"Don't tell me they don't bite," Bubs countered.

"Yes, but burn a coil at night and they will not be a bother."

He then whirled us away to a most modern grocery store, throwing groceries and supplies into a trolley (grocery cart) as if he were our personal butler.

"That will take care of your until you are orientated to the area," Dr. Liebenberg said. "Now I will show you some of our city." Bubs spoke up and said she wanted food, and that we could see the city some other time. In truth we had not eaten since British Airways feed us the previous evening. Within minutes we were sitting in a most elegant restaurant with the waiter, a student from the chiropractic department of the Technikon, taking our requests.

For me, it was quite simple to order, since I had hungered one more time to eat king klip, South Africa's indigenous fish. If you have never eaten king klip, this solely is worthy of the adventure to South Africa.

After dinner and returning to our new home, Dr. Liebenberg said he'd see me on campus the next day. "Oh yes," cautioned Dr. Liebenberg, "don't forget to lock all your doors."

Locking doors instantly became a prerequisite for safe keeping and sound sleep. All South Africans carry multiple keys for multiple doors. To lose your keys is a disaster. Leaving anything unlocked might result in total replacement of worldly goods. To some persons, unattended possessions are fair game, consequently the rule: "Lock it, or lose it."

Notes on Durban, South Africa

To me, South Africa is not a third-world nation. True, the country has 20 million people who cannot read or write, but it also has the world's greatest abundance of precious metals. There are four predominant cultures: white, black, colored, and Indian. Durban is a modern seaport located on the Indian Ocean a few hundred miles north of Capetown. Durban's climate is semi-tropical, similar to the weather found in St. Petersburg, Florida. Durban is a very large metropolis, with excellent roads and transportation. The beaches of South Africa are basically free of commercial enterprises, and are reserved for public use. Surfing, swimming, and fishing are prevalent. If you plan a visit, please do not take heavy clothing, for it will look good only in the closet. If you travel the Garden Route south from Durban to Capetown, you will see all the majesty of Hawaii, abundant flowers, macadamia, cashew nuts, pineapple, bananas, sugar cane, corn and wheat fields, to name but a few of the sights.

Like Americans, South Africans are sports-minded. They like golf and tennis, but particularly love rugby. Attending a rugby game will turn your head forever. Stands are filled for international competitions. After a rugby game, fans do not grasp their belongings and exit. Instead, the inner field becomes a play ground for children and the outer areas become one huge braai (barbecue), a grander and more elaborate version of tailgate parties.

South Africans observe daily tea breaks (after 4 p.m. it's other than tea). The people with whom we had opportunity to associate are totally family orientated. I found that the children are disciplined and courteous to elders.

On the political scene President de Klerk had recognized the previously banned anti-apartheid organization, the African National Congress (ANC), and released ANC Deputy Chief Nelson Mandela after 27 and one-half years of political imprisonment. By June of 1991, the parliament rescinded apartheid laws on ownership of property and the Registration Act (which had classified all South Africans at birth by race). By February 1993 nonwhite were in the cabinet.

Bubs and I would awake in our new South African home to early morning CNN news and Sky news from London telling of terrible conditions within South Africa. There was a planned march that started a few blocks from where we were living, which went off without a hitch, yet the reports from London and the US were of chaos and unrest. We watched our local TV for the latest within South Africa, for news of disturbances, and read the papers cover to cover to learn of terrible happenings: we experienced none.

There was much political haranguing prior to the election. For two months we were requested by various knowledgeable people including our embassy, not to go out at night unless we were in well lighted areas where signs were printed in English. We were cautioned to join no political parties and voice no political affiliation or views.

Voting Day

After learning of the long lines to vote, curiosity got the best of us and we ventured out by car to see for ourselves. To our surprise, the street of Durban were the quietest of the two previous months. The polling lines ran for blocks: black, colored, white, and Indian standing in 90 degree weather. For most it was the privilege to vote the first time.

The ANC and Mandela won sweeping victories in the 1994 elections, Mandela and de Klerk were shown on TV raising each other's hands and stating, "We are one country." On May 10, 1994, Mandela was sworn in as president. There had been prediction of upheaval from around the world. Instead, residents resumed the quest for life. Since there was no uprising, looting or chaos, and nothing to report, South Africa had one of the greatest massive exodus of news media in the history of any country. Our final month passed with calmness, work and enjoyment of the beauty of South Africa.

Technikon Natal

In 1962 the South African government's commission of inquiry into chiropractic produced an extremely negative and biased report. Chiropractors were referred to as being under-educated; it reported there was no scientific basis for the profession to be granted constitutional status. Fortunately, the report was not given much credence, otherwise chiropractic in South Africa may well have experienced a slow but inevitable demise.

It was in 1971 when the first chiropractic legislation was tabled in the South Africa Parliament. This legislation, although granting the profession legal recognition, proved to be extremely restrictive. It neither opened the chiropractic register (other than for current practitioners and students enrolled at overseas colleges at that time), nor did it make provision for chiropractic education in South Africa. Basically, this would mean that chiropractors would not be registered.

In 1982 a major revision of the 1971 legislation was passed that set the scene, once the profession had properly placed its house in order, for the normalization of the chiropractic profession in South Africa. It included education for chiropractors at a local level.

In 1985 parliament passed further legislation. It resulted in the opening of the chiropractic register, wherein provision was made for the establishment of chiropractic educational facilities within government subsidized tertiary educational institutions.

Eight educational institutions expressed interest to offer the chiropractic program. After careful consideration by the Chiropractic Association of South Africa and the Statutory Registering Council, it was decided that the Durban Technikon Natal would be the most appropriate place to inaugurate such a program.

The syllabus covered five years of education, plus the sixth year pre-registration residency program. A delegation was sent to leading chiropractic colleges in the US, Canada, United Kingdom and Australia on a fact finding mission regarding current thinking and teaching approaches employed in the foremost chiropractic academic institutions in the world. Subsequent to this fact finding mission, a memorandum was submitted to the department of Health and Welfare of the South African government, resulting in acceptance of the chiropractic syllabus by the minister of education.

In the interim, Dr. A.G. Till, chairman of the Educational Standards Committee of the Statutory Council, enrolled in the Chiropractic Science Residency program at the Canadian Memorial College of Chiropractic with a view to obtaining an update in knowledge consistent with current thinking and practices in chiropractic education. Dr. Till spent three years in Canada, plus another year teaching at the Royal Melbourne Institute of Technology in Australia, prior to returning to South Africa to become the principle of the newly formed Department of Chiropractic at Technikon Natal in 1989. In 1991 Dr. H.S. Liebenberg joined the newly formed staff as clinical director of Technikon Natal.

The first two years of the chiropractic program are taught by the health sciences faculty of the departments of anatomy, biology, physiology, and chemistry, and are compatible with the first two years of medical education in South Africa. During the third year, course work is in the clinical sciences.

The present head of the chiropractic department at Technikon Natal is Dr. A.G. Till. The clinical director is Dr. H.S. Liebenberg; there are six qualified chiropractic clinic supervisors; two medical doctors; one physiotherapist; and four qualified chiropractic lecturers, excluding specialist lecturing staff for the two years of basic sciences. Also neurosurgeons, orthopaedic surgeons, vascular surgeons, and radiologists lecture to the interns and residents on a regular basis.

Each student is required to complete an individual research program at a master's level prior to graduation, under the auspices of Technikon Natal's department of research. A master's diploma is awarded in Technology, Chiropractic, which will change to a master's degree program within the next two years. The total enrollment in each class can be no larger than 35 students. It is one of the most prestigious, sought-after programs within the Technikon, with applications of approximately 300 willing students. At the present time there are 149 chiropractic students enrolled.

There exists 119 registered chiropractors in all of South Africa, a significant sign that chiropractic is flourishing with room for growth. We were privileged to witness the honoring of the first graduating class.

At the present time the chiropractic department of the Technikon is suffering from lack of numbers of qualified South African chiropractic educators. The past unstable political position this country has experienced has not been conducive to overseas academics wanting to voyage to live and teach in South Africa. The cost to import a qualified lecturer has to be carefully scrutinized because of limited budget. Now that democracy reigns, the situation should be enhanced.

Drs. Till and Liebenberg are two of the most dedicated, hard working, considerate men I have ever known. There is not a moment in a day that they do not take the time to solve any one of the problems that might arise within a department. From a personal view, it is my belief we will work them into oblivion if additional qualified people are not found. Not once have I ever heard of their complaining of being overworked or abused. They are committed professionals and welcome the opportunity to broaden the horizon of the curriculum. They strive always for the betterment of their qualified students in chiropractic.

I would be remiss if I did not say something about the student body. My primary duties were teaching procedures of examination and practice, and also supervising and assisting interns in the clinic from 8 a.m. to 4 p.m. The clinic in its first year (with 13 interns) cared for 1,400 new patients. The interns are well organized, professional young people, disciplined with proper documentation in quality and follow-up care. They willingly accept advice and recommendations. As an outsider, I was welcomed at every turn. Bubs and I were included in college student affairs and many personal endeavors were extended to us.

If you wish to be on the frontier of chiropractic education and enjoy a venture of a new emerging nation, I suggest that you think seriously about expressing your desire to serve the profession within the Technikon Natal.

If you have reluctance to go to South Africa as a educator, please call me and I will try to dispel your anxiety. Chiropractic is not the same all over the world, so you must adjust to other ways. The South African chiropractic profession is on the move. Technikon has progressed further in these few sparse years than has been comparatively achieved in 50 years in the US. This is your challenge. They need and want your help. Do you want an experience that you will live and relive the rest of your life? Act quickly.

If you are interested in applying for a position, permanent or temporary, please contact:

Dr. A.G. Hill
Head, Department of Chiropractic
Technikon Natal
Durban, South Africa
Fax: 011 27 031 22 3632

Lee Arnold, DC
266 N. Boca Ciega Pt.
St. Petersburg, FL 33708
Phone: (813) 398-5890
Fax: (813) 398-5890