Opinion & Analysis

Home-town girl makes it big in the Big Apple

A life of service: McFarland
 
A life of service: McFarland

Mmegi: Please tell us about your upbringing in Tonota.

Ditsapelo Mpotokwane-McFarland (DM-M): My childhood in Tonota was as simple and happy as could be. I was raised by my grandmother as our parents were employees at the Jubilee Hospital in Francistown. At my grandmother’s home, I grew up with my mother’s cousins as one happy family. As the oldest child in the family and like many Batswana children, I had the responsibility of helping with the care of my siblings.

I grew up in Tonota at a time when there was no electricity or running water. We fetched water from the Shashe River using buckets (Stanluk). We had no problem with that. We would swim in the river when it was flowing. It was fun. We used lanterns (mabone) that were fuelled with paraffin to light the house and do our school work and life went on. There was no technology of any kind. No computers to destroy our eyes. We were happy.

During the ploughing season, I would go to my grandmother’s lands to help with ploughing activities. Going to the lands was just not my cup of tea because I was afraid of darkness and the forest. I grew up in Tonota at a time when there was much talked about witches (baloi) opening people’s eyes in the dark when they were sleeping. That scared me up to now. As such, I would make an excuse to spend school holidays with my mother in Francistown under the bright city lights.

I loved fun, specifically singing and dancing. I was not afraid to sing solo and dance on the stage. I loved the stage and I still do. One thing nice, I was obedient, respectful, and doing very well at school. The friends I grew up with looked up to me as the life of the party. But I frequently got them into trouble and we were spanked.  Teachers loved me for this free spirit behaviour, specifically, Honourable KP Morake, my principal at Tonota Number 2 School. I was their child.

I was raised in the Anglican faith and I loved going to church every Sunday with my grandmother. I loved church music. It was uplifting. I still do.

I was raised very well, and as the saying goes, “It takes a community to raise a child.” Every older person in the Tonota community was my parent and could discipline me for unruly behaviour without fear that my parents could take action against them. My mother was a disciplinarian. She used a lash to put me right.

My childhood in Tonota ended when I transitioned to Moeng College in 1962 as a teenager for my secondary education.

Mmegi: What motivated you back then to pursue nursing as a career? 

DM-M: I grew up as a hospital child because of my parents’ employment at the Jubilee Hospital in Francistown. As such, my hospital life was already set up for me. I interacted a lot with the hospital people. My biggest attraction to nursing was how beautiful the nurses looked in their attire and the way they carried themselves with dignity and class. I envisioned myself being a nurse someday. The matron of the hospital used to ask me to join the nurses in singing Christmas carols to the patients. I had fun. I felt like I was a nurse myself.

When I was at Moeng, an advert was posted looking for people 18 years old to apply for nurse training in Lobatse. I was not yet 18-years-old, I was younger, but I had to be 18.  So, I sent my application stating my age as 18. I was accepted into training.  As a young nursing student, I had the fun of my life taking care of the sick walking proudly in that uniform I envied when I was a primary school girl. I was a Florence Nightingale Nurse.

Mmegi: How did you end up lecturing at the University of Botswana?

DM-M: After graduation with a Bachelor of Education degree in Nursing from the University of Botswana in 1983, I relocated to the USA following my marriage to an American national. After arriving in the USA, I registered for my Master of Nursing Science at Russell Sage College, Troy/Albany NY, specialising in Advanced Medical-Surgical Nursing and Nursing Administration. After a few positions as a staff nurse in US hospitals, I decided to go for a PhD so that I could transition to academia. In 1999, I graduated from Boston College with a Doctor of Philosophy with specialisation in Nursing Science and Women’s Health. Then I became convinced that this preparation qualifies for academia.  My husband had a standing contract with the Botswana government as a consultant to work on their midterm reviews. This gave me the opportunity to come to Botswana and seek employment at the University of Botswana as a lecturer. I held a lecturer position for two years as per my contract.

Mmegi: Then you took a big leap to become an academic in a competitive country like the United States. How did that transition occur, and how did you manage it? How are you coping now?

DM-M: Regarding the first part of your question – the transition - following my teaching experience at the University of Botswana, I convinced myself that I had gained a valuable platform to compete in a developed country. I had good ratings from my students at the University of Botswana. I had also formed a good relationship with the US visiting professors at the University of Botswana School of Nursing.  These visiting professors, including my husband who also was a professor, gave me useful tips on how to compete in the American labour market, specifically in academia.In terms of how I managed the transition, I felt prepared to face unknown challenges and to handle them the best possible way I could. I started by making a database search to determine which colleges or universities near where I lived offered PhD and were a good fit. I updated my CV, applied to several universities and went to several interviews. I then accepted an offer by one university that I was convinced was a good fit for me having been impressed by their catalogue.

In terms of how I am coping now, thriving in an environment different from what you are used to is not easy. I give credit to my late husband on how I am coping. He prepared me very well for academia in a foreign country. He said “whatever you do, bring something they don’t know, focus on your culture because they don’t know it and it will be a great education to your colleagues.” I took that advice very seriously. I remained an African and I focused my efforts on African cultures. That impressed the Western world and I received invitations to present at national and international forums. I was recently tasked with the responsibility to form and head a school-based diversity committee that would resonate with the university’s mandate for diversity, equity, and inclusivity for all members. 

In every situation there are challenges and one has to develop ways of coping with those challenges positively and respectfully. One of the challenges we face as people from foreign countries is language. The majority come from English-speaking countries, but the English we speak is different from the American English. We also come from different cultural backgrounds, which presents challenges with the accents. As such, one has to learn to understand and be understood as well, respectfully.

Mmegi: We are aware that your specialisation is in the area of cancer, especially cervical cancer. Why did you make that conscious choice?

DM-M: When I was working as a staff nurse in American hospitals, most of my patients were cancer patients. I did not know much about cancer. When I applied for a PhD, I was required to submit a recent record of statistics as my statistics from the University of Botswana were dated. I then applied to the University of Massachusetts in Amherst to take a statistics course.

I also decided to register for ‘Epidemiology of Cancer’ course so as to broaden my knowledge about cancer. In this class, we had to pick a topic, study it and present to class. While I was still struggling with finding the topic, my instructor said, “take cervical cancer. It is the hot topic now.” That was back in 1995. I went into the literature to learn more about the disease. I realised that cervical cancer was a public health problem for women globally but more so in developing countries. I became motivated to know about the situation of cervical cancer in Botswana as a developing country. There was no research on cervical cancer in Botswana at that time. The only two papers that appeared were in the form of reviews of hospital records indicating the number of people diagnosed with and the number who died from cancer in selected hospitals in a particular year. These papers were written in the 1970s when I was still a student nurse. I decided then to make cervical cancer my doctoral dissertation topic. I took cervical cancer research to the women in Botswana interviewing them about their knowledge and perceptions of cervical cancer and screening, using the Health Belief Model.  The Health Belief Model purports that for one to take preventive action about a particular disease or condition such as cervical cancer, they must believe that they are susceptible or likely to contract that disease, they must believe in the seriousness of the disease if caught and left untreated, they must believe in the benefits of the preventive action (e.g. Pap smear), and they must also believe that the benefits of taking a preventive action about this particular illness outweigh the barriers.  This is the first study that was published in Botswana and the first that was cited by the World Health Organisation (WHO) in their publications. I have since then studied cervical cancer using different methodological approaches and presented my findings at national and international forums by invitation.

Mmegi: This month of October is Breast Cancer Awareness month. Of what is the significance of that to you?

DM-M: This is an annual campaign to increase awareness of breast cancer, with the goal to show every woman that her life is important. It also ensures that every woman has access to education, screening, treatment, and support. From my perspective as a nurse who has studied cancer and has taken care of cancer patients, I find this campaign very significant in that it sensitises most importantly, policymakers to ensure that policies are in place for every woman in Botswana to make informed choices regarding their health. According to WHO, breast cancer is by far the most common cancer in women worldwide. Most of these cases occur in low and middle-income countries such as Botswana, where most women with breast cancer are diagnosed in late stages due mainly to lack of awareness on early detection and barriers to health services. Evidence has shown that awareness surrounding breast cancer is important as early detection can catch the disease when it is most treatable. I subscribe to that.

Mmegi: What is your message to the women of Botswana during this month dedicated to breast cancer?

DM-M: Know your breasts. If you see something unusual in the size of your breast, consult the health care providers.  If you see something unusual in the appearance of your breast, consult the healthcare providers. Do breast self-examination every month. If you detect lumps or unusual hardness, see your healthcare providers. This refers to women of all ages. Your male partners also can develop breast cancer, pay attention to them as well.

Mmegi: You have just been recognised as a Fellow of the New York Academy of Medicine. Congratulations are in order here! What does this prestigious acknowledgement mean to you?

DM-M: It means a lot to me, to my family, colleagues and friends. I feel greatly honoured and elevated. I believe the academy has realised my potential to contribute to its mandate of equitable healthcare for all. This nomination also supports my commitment as a tenured professor to community service. I am presently extending my work to include women of sub-Saharan African descent living in New York City in the prevention and early detection of cervical cancer.  I also feel that I have done a great honour to my country Botswana by flying its flag proudly from across the Atlantic Ocean.

Mmegi: You may be aware that Botswana is experiencing an unprecedented spate of Gender-Based Violence incidents lately. What is your comment on this unfortunate state of affairs?

DM-M: I feel men in Botswana should be the main focus of the intervention. They should learn to control their emotions. They should consider this lockdown an opportunity to spend time with and know their families. Serious laws should be in effect to protect women, not just provision of shelters. The community should be educated on signs of abuse and given the mandate to report them. Neighbourhood watches should not only be for criminals but for abusive men as well.

Mmegi: What is your message to a young girl in Tonota who comes from a poor family and does not know what the future holds for her?

DM-M: The first questions would be, “What do you want your life to be like as you grow up?” Who do you see in your community that you would like to be like?” Her responses will give me an idea. I will then let her know that I started from humble beginnings. I grew up in the village just like she did. I fetched water from the river. I had dreams. I had people to role model after who could help me realise my dreams. I will end by saying, “You may not see clearly what the future holds for you. But there are many opportunities in life. I was at some point where you are now. I would like to see you go out there and grab those opportunities. Identify people who can take you along that path, role models and mentors. I am available if you feel I can take you there.”