Award-Winning Film Traces Global Roots of Southern Healthcare

Karin Shapiro, associate professor of the practice in African and African American Studies and History, is now an award-winning filmmaker. Her powerful documentary, A Road Out, just earned Best Historical Film at the Toronto International Women Film Festival. 

Uncovering a surprising connection between rural South Africa and the American South, the film traces how community health models that were developed during the 1940s and early 1950s helped lay the groundwork for public health efforts in the United States following World War II.

“In South Africa’s KwaZulu-Natal region, early healthcare innovators worked closely with Zulu communities, recognizing that poverty, racism and social conditions were inseparable from health outcomes,” explains Shapiro. “They focused on the community, not just the individual patients, making local involvement central to research, prevention and care while writing about the ‘structural determinants of health’ in exactly those terms during the 1950s.” 

When these health workers later fled apartheid and reunited in central North Carolina, at Duke and UNC-Chapel Hill, they carried those ideas across borders and introduced the concept of lay health advisors to public health researchers and practitioners in North Carolina and beyond. Their prototypical health center at Polela, South Africa, inspired American physicians to launch the country’s first community health center in Mound Bayou, Mississippi — a town founded by formerly enslaved people. 

Through a compelling blend of archival footage, interviews and personal stories, A Road Out shows how bold thinking and shared humanity can cross continents and offer a powerful reminder of what’s possible when healthcare is rooted in equity, trust and community.