By Nazneen Pilodia

We closed off a year of early morning lectures, long nights of studying,  and lots of hard work with a jam-packed exam week and left for Belgium the very next day. Fresh out of end-of-semester exam week, a highly anticipated foreign exchange mobility seemed to be the most exciting endeavour yet.

Not having much time to reflect on the progress we had made in our project or what exactly was expected of us working with the European partners, I left my mind completely open to explore new ideas, methodologies and experiences, adapting as the mobility went on.

Upon arrival in Antwerp, my colleagues and I were thankfully met by a familiar face after a few hours of wandering through the streets in an attempt to find our hostel. We were received with eagerness and great hospitality from locals. We were left to settle in and explore our surroundings by ourselves, in preparation for the CASO meeting which took place the following day at Karel de Grote University College. After a few bumps in the road regarding miscommunication, we met up with our supervisors and attended the meeting with enthusiasm and a fresh perspective. This was the first occasion where we had the opportunity to be introduced to the other participating universities and CASO members. At first I felt a sense of unfamiliarity which was soon replaced with captivation, as it was refreshing getting to know the multifaceted innovating projects which make up the CASO group as were watched members present their work and the progress they have made thus far.

Antwerp University Hospital

The agenda for the first week was set out by Veronique and Steph. For the next 3 days, the student partners attended a shadowing program in various medical wards at Antwerp University Hospital (UZA) where were given the assignment to observe and ask questions related to healthcare, culture and communication in a Belgian context. This was one of the highlights of my mobility. After being given a tour and briefed of the respective ward and duties of the nursing staff, I was partnered up with two Italian medical students and a specialist in hepatology. Language had been a barrier – however, 12 years of schooling in Afrikaans paid off –  I was able to understand and occasionally respond to the Dutch conversation. This was my first time being exposed to ‘first-world medicine’ and I was entirely in awe. Prior to this visitation, all I had to compare to was an overpopulated, understaffed and under-resourced third-world public healthcare system. However, I was not the only one left lost for words. After my best attempts at describing the daily scene at Groote Schuur Hospital my hosts were marveled too. I was able to share my personal experiences while gaining insight of theirs. This opportunity allowed me to compare and contrast the structure and standards of our healthcare systems, while being taught by extraordinary healthcare professionals.

In the evenings we attended lectures by social workers elaborating on projects targeting poverty reduction, diverse inclusion and social integration such as the City Pirates and Bindkracht. Our final activity was a scenic cycle tour through the city of Antwerp, I mean we were in a foreign country after all… Pitstops included architectural monuments and the home grounds of the Antwerp Streetboys and the Royal Antwerp Football club. We were given a chance to interact with both parties, discussing their community-based initiatives. We ended of the first week of the mobility with a spectacular dinner having gained tremendous insight as well as networking connections and friendships.

We embarked on the second week of our mobility with a trip to Breda to visit Avans Hogeschool. We were given a lecture on the education system applied in the Netherlands, a tour of the facilities as well as the GET Lab – where we had a chance to make use of the pioneering medical technology. The next day we were given the opportunity to view the facilities at the Amphia Ziekenhuis, in order to gain an understanding of the healthcare system applied in the Netherlands. This was the second highlight of my trip. I was allocated to shadow a specialist nurse in psychiatry. I gained insight on the levels of healthcare, the principles of health insurance, holistic care and managing patients while maintaining cultural and religious sensitivity – which I personally found to be the most profound. This experience made me especially appreciative for healthcare professionals that are kind, willing to teach and share their knowledge.

We returned to Karel de Grote University College for a teambuilding workshop and simulation training based on crew resource management. I was granted the chance to participate in a simulation with two nursing students, which I found to be quite exhalating. I was asked to play the role of an intern doctor on call and handle the patient to the best of my ability. The reason this 7 minute exercise exited me was that not only was it the first time I was in charge of treating a ‘patient’ but also, the simulation was extremely realistic and a change of events could occur at any moment. Only when in the situation can one understand what it feels like to have to rely on the knowledge gained thus far in training as well as going with a gut instinct. I got to identify my strong and weak points, practice being a part of a multidisciplinary team, applying my knowledge to a very realistic situation without the expense of doing any physical harm to a patient. This was definitely a training module I would consider, granted the opportunity, to incorporate into our curriculum.

We ended off our trip with an excursion to UZ Ghent, where we were in conversation with Dr Stephanie de Maesschalck discussing communication and diversity in health care, with specific reference to socio-economic status, ethnic minorities and language barriers. Thereafter, we visited a ‘wijkgezondheidscentrum’ which is equivalent to a community healthcare centre. It was enlightening to see how accessible these types facilities are, as well as the environmental-friendly initiatives in place. Our day ended with a walking tour through Ghent proudly hosted by Bea, during which we got to admire the astounding architecture of this beautiful city.

The vegetable garden used by clinic staff at the ‘Wijikgezondheidscentrum’.

As a future healthcare provider, I would like to think that this experience has changed me for the better. I believe that in order to truly understand something, you need to see it for yourself. This project may have started with us trying to gain an understanding of  communication and culture in a South African context, however it has proven to be much more than just that. I am now more aware of the effect that social and economic structure have on the components of a health system. I have gained understanding of concepts such as intersectionality, diversity, integration, assimilation, marginalisation, and segregation and their respective manifestations in how those that are privileged and those that are disadvantaged are impacted,  which is vastly relevant across the healthcare system. What I found to be most significant was that I was allowed to use my personal concept of culture to interrogate diversity, integration, assimilation, marginalisation and segregation of myself in a foreign setting as a sojourner. I was able to incorporate concepts such as cross-cultural psychology, culture shedding, culture shock in in daily situations and to a larger extent the influence that cultural factors have on the development and display of human behaviour in individuals (Berry, 1997). My trip may have been short-lived but it definitely opened my perspective to the way structures influence our culture and communication.

I would like to thank the CASO team for their efforts in making this experience possible.


  1. Berry, J.W. 1997. Immigration, acculturation and adaption. Applied psychology. 46(1), pp. 5-34.

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