From South Africa to Reefton--one nurse's journey: a South African nurse shares her sometimes painful, but ultimately rewarding journey from her home country to the isolated settlement of Reefton on the West Coast.
Subject: Nurses (Practice)
Nurses (Personal narratives)
Nurses (Social aspects)
Author: O'Connor, Teresa
Pub Date: 08/01/2009
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2009 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: August, 2009 Source Volume: 15 Source Issue: 7
Topic: Event Code: 200 Management dynamics; 290 Public affairs
Product: Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 206850923
Full Text: [ILLUSTRATION OMITTED]

Reefton, founded on gold, and later coal mining, can be a bleak place in midwin,ter, with the clouds clinging low over the nearby hills and steady rain creating surface flooding. Nestled in the Inangahua River valley, surrounded by the Victoria and Paparoa Ranges, it is the West Coast's only inland town, with a population of around 1000. It's a far cry from Port Edward, on South Africa's Kwa-Zulu Natal South Coast, 50 kilometres south of Durban. The winter temperatures there hover in the early to mid 20s, sub tropical crops, including coffee and bananas are grown, and the Indian Ocean laps the golden-sand beaches.

So what brought registered nurse and midwife Nomxolisi Ngxabani from Port Edward to Reefton? An advertisement in a South African nursing magazine for nurses to go to New Zealand was the beginning of the journey which saw Ngxabani uproot herself, her two girls, then aged 15 and seven, from Port Edward and plant themselves in Reefton.

"The way the advertisement painted New Zealand was that it was safe for children--they could go swimming in the river and you wouldn't have to worry. It is so important for a parent to know their children will be safe," Ngxabani, a widow, explained.

Another influence was New Zealanders' opposition to apartheid and the efforts being made to improve relationships between Maori and Pakeha in New Zealand.

Despite the opposition of her family and friends--"Why New Zealand?" they asked and suggested she join relatives and some of those she trained with who were nursing in England--she persisted in her desire to nurse in New Zealand. "I am not a follower. I wanted to take my own road and was happy to come to New Zealand."

She signed up with a nursing agency in Auckland. Gaining registration with the Nursing Council was relatively straightforward, though final hiccups meant the process had to be completed once she had arrived in New Zealand. She remains thankful to the agent she dealt with--"it was a very good experience for me. She went through all the steps with me."

There was no International English Language Test System to pass at that stage but it would not have troubled Ngxabani. She speaks sophisticated English, having learnt it from primary school, and her nursing training, at Holy Cross Hospital in Eastern Cape, South Africa, was taught entirely through English. Although she trained in a hospital, her specialty is primary health care.

There was a vacancy at Reefton Hospital and Ngxabani was interviewed over the phone, the interviewer reinforcing the view that Reefton would be a safe place for Ngxabani and her children. So, in March 2003, Ngxabani set off from Durban, arriving in Reefton via Johannesburg, Christchurch, Hokitika and Greymouth. She stayed overnight in Greymouth, which she had at first assumed was Reefton, and then was driven to her final destination. "To be honest it was a shock. I didn't expect it to be so small," she said of her first impressions of the place that was to become her home.

Accommodation in a Local backpackers was provided for four weeks and she then rented a house.

After three days to recover from travelling, she started work at Reefton Hospital. The hospital has five medical beds; ten aged-care beds, a mix of rest-home and hospital care; and provides an accident and emergency service, with cover from a GP or a rural nurse specialist. Its full complement of registered nurses (RNs) is 5.7 full-time equivalents (FTE) (it is not close to that at present), 3.25 enrolled nurse FTEs and six caregiver FTEs.

Everything was new to Ngxabani--patients, colleagues, ways of doing things, the smallness of the hospital. "I felt so lost. I was constantly forgetting names. Aged care was a very new experience for me. I had never nursed old people before. The fact I was expected to help out in accident and emergency was also different. And the fact everything was in the same building was strange. In South Africa, the public hospitals were large, with wards of 50 patients. But the nursing care and the nursing terms were the same and I was familiar with names of medicines," she said.

As well as contending with a totally new working and living environment, Nomxolisi had to adapt to Reefton's very cold winter that year. "Even the Locals were saying it was the coldest winter ever. Imagine how it was for me from South Africa! It was so cold in the fog."

And, hardest of all, was being away from her two children. She wanted to get settled before she introduced them to a very new and different life. "They were being cared for by relatives, so I knew they were well looked after and they were warm. I rang them as often as possible. My phone bills were very high for those first six months."

Children bullied at school

As well as the coldness of Reefton's winter, Nomxolisi also had to endure a metaphorical chill from some Locals, as did her children, who joined her in ,July 2003. "They were bullied at school for quite some time because they were different. They were the first black kids there. They are tough kids and did not want me so say anything about their situation."

She also experienced racism from some patients who did want her to touch them, who would say "Call another nurse"; others were not friendly at first; and there were some tensions initially with some staff. Two Zimbabwean nurses came to Reefton soon after Nomxotisi and she felt a sense of kinship with them and was sad when they left earlier this year.

Nomxolisi is remarkably free of bitterness about the prejudice she and her family experienced. "I understand where they were coming from. We were new to their environment and they had never had to deal with this situation before. They were going through something themselves."

She does not like the word racism--"I don't like it. I know that is what it is, but I am not a victim of it. Whatever attitude they have, it is their problem. People too often just see the face and make no effort to see the person behind the face."

She says some white South Africans who have come to Reefton with the current mining development, have brought their prejudices with them.

While she betrays no bitterness, the experiences she and her children had--and still occasionally have--are clearly painful. "It hurts. And there are aLso things unspoken--you know a person's attitude towards you."

'Painful experiences strengthen you'

White she considered moving for her children's sake, they urged her to stay, all mindful they might welt have the same experiences elsewhere. She is proud of how the children coped and believes the negative experiences have strengthened them. "To move from your comfort zone--I was not from a very disadvantaged background--to a place where nobody knows you, as painful as that may be, it strengthens you and adds to your life experience. If you let it influence you negatively, you could be running all your life."

Despite the indignity of blatant prejudice, Ngxabani has not regretted coming to Reefton--"it has grown into me". Her older daughter, Zikona, is engaged to a local man, and they live in Christchurch with their two-year-old son, and Sipelele, now 13, is very happy at Reefton Area School, with many friends and hopes of becoming a surgeon.

There have been those who have supported her, who have been there for her, who have provided a listening ear. She is a great believer in the power of communication to help illuminate difficulties between people or to help heal any hurt. "I believe so much in communication. Talking about things is so helpful."

From a Methodist background in South Africa, her faith has provided strength, comfort and a community in Reefton. "The Union Church here played an important part in making me feel accepted. My faith keeps me going."

White she still tongs for home, she has "no regrets whatsoever" about her move. "I still feel it was the right decision and my family at home even say it was a good move for me. I've got used to this place and the people and I like it here. It was my choice to come--nobody forced me--and I wanted to stick with that choice."

Ngxabani and her family return home every year. "It's almost unbelievable but I miss Reefton," she says, laughing. "I can't put my finger on anything special But nobody bothers me here and it is a more carefree lifestyle. And South Africa is too hot for my liking now!"

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But, like so many immigrants, she is caught between two countries and is unsure whether she will eventually return to South Africa.

She greatly enjoys her work at Reefton Hospital, where she acts as clinical charge nurse, when the incumbent is away. She works eight shifts a fortnight and says there is little difference in her pay here and in South Africa, when the cost of living is taken into consideration.

At some stage she would like to move to a larger hospital "for a change and to further my nursing career': This month she is undertaking a triage course in Wellington and would like to do the PRIME (primary response in medical emergencies) training at some stage. But for now she is content to continue working in Reefton.

"Aged care was a branch of nursing that was new to me but l just love it now. I feet part of the team. I don't like hearing people say 'local' and 'foreign' nurses. We are nurses in Reefton and we are a team and I feel I am part of the team."

She is a very important part of the team, according to the hospital's clinical services manager Barbara Smith. "Her standard of nursing is very high. I have no concerns about her professional practice in any way. And it was the same for the Zimbabwean nurses. Health services in Reefton would struggle without the contribution of overseas nurses. I'm not sure if the people of Reefton realise that, but it's overseas nurses who are keeping the system going in many parts of New Zealand."

Smith said Ngxabani was greatly respected by the patients. "I would hate it if she decided to leave. The qualities she brings are just right for here. It is fantastic to have her."

Before the end of the year, Smith hopes to boost the number of RNs, thanks to three more overseas nurses who have been recruited. A Finnish nurse, and two males nurses, one from the Philippines and one from Swaziland, have accepted positions at the hospital.

"Locals say with the influx of overseas workers to the mines here, Reefton has become more broad minded and more welcoming," Smith said.

Hopefully that will be the case for the next group of overseas-trained nurses. Ngxabani, with her combination of dignity, courage, faith and professionalism, has experienced both a small town's prejudice and its embrace. Hopefully it wilt be only the latter the next overseas nurses experience when they arrive to contribute to Reefton's--and ultimately New Zealand's--health care services.

By co-editor Teresa O'Connor
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