Public Health in Practice: Lessons from Life Choices South Africa

Our visit to Life Choices in Cape Town was one of the most meaningful parts of my study abroad experience. From the very beginning, the staff set the tone with a warm and lively welcome. They had us get up, dance, and wave our arms and legs around while shouting numerous random phrases. It felt silly, but it broke the ice right away and showed how much vibrance the team brought into their work. That energy carried through the entire visit, even as we talked about some of the hardest realities facing South Africa today. We were given an inside look at the country’s public health challenges: including HIV, TB, poverty, sexual and reproductive health, and gender-based violence. What made the visit so impactful was how Life Choices approaches all of these issues in a way that is youth-centered and rooted in the community. Staff explained how they work to address not just health outcomes, but also the social determinants that affect them. Hearing from people on the ground about what it actually takes to provide care in these communities opened my eyes to the scale of the challenges. One of the most striking parts of the visit for me was learning how much US international aid affects the work being done there. Staff told us about the difficulties they face in securing funding and how other organizations have shut down after cuts to foreign aid budgets. As an American, that was tough to hear. I felt a sense of responsibility knowing that decisions made by my own country could cause such hardship to others abroad. The Life Choices staff spoke honestly, but without resentment, and it was clear how much they cared about continuing their work despite the obstacles.

The visit also connected directly to things I had studied in my classes at home. At Michigan, I’ve researched HIV in South Africa, and while there I focused on nutrition in the context of HIV. At Life Choices, I got to see one of their Health4Life mobile clinics in action and even went through their HIV counseling and testing protocol myself, playing the role of a patient. Experiencing firsthand how the staff walk people through the process was eye-opening.

They weren’t just giving out medical advice, instead they focused on explaining things in a culturally sensitive way that patients could understand and actually apply to their daily lives. It showed me what effective, community-based public health really looks like. Another powerful part of the visit was learning about the prevalence of gender-based violence in South Africa. Before then, I hadn’t realized how widespread and serious the issue was. Life Choices offers a wide range of support for women and children affected by GBV, including counseling and legal services. So many of their programs are designed around youth in particular, with the goal of breaking cycles of poverty and violence by supporting the next generation of South Africans.

By the end of the visit, I knew I didn’t want this to just be a memory from my study abroad experience. It aligned too closely with my own interests in global health and humanitarian work. When I returned to the US, I reached out to Life Choices to see if there was a way I could keep contributing. Now, I work with them remotely on research and learning briefs for their Health4Life mobile clinics, helping to archive and evaluate their programs. Being able to stay connected to their work has been incredibly meaningful, and it continues to shape how I see my role in public health moving forward. South Africa is such a beautiful country with so many amazing things to experience, but I am most grateful that I had the opportunity to learn about the realities and hardships that so many people face there, and to be able to contribute, even in a very small way, to the work being done to address them.