Saturday, December 15, 2007
Meat is somewhat of a luxury for many people in the townships. It's not overly expensive, but when you don't have money for basic necessities meat is seen as a once-in-a-while food. Most families are lucky to have meat once or twice a week, and then it's mostly chicken. The grocery stores in the townships have huge freezer cases of frozen chicken, usually in 2 kg "braai packs." That's 4 1/2 pounds of chicken cut up into pieces for grilling or frying. They cost about R25 ($3.50), so it's affordable for many people, at least once a week. You can also buy live chickens on the side of the road, or freshly killed chickens at the local open markets for between R20 ($3) and R40 ($6), depending on size.
Grocery stores do not sell much red meat. They will have some basic cuts, like chops or ribs, and sausages and boerwors (thin sausages usually made of beef - boerwor translates to farmer sausage). Beef, pork and lamb/mutton all cost about the same, roughly R15-20 ($2-3) a pound for basic cuts and R25 ($3.50) a pound for better cuts.
You can also buy unexpected items that probably wouldn't sell well in Minneapolis. Packages of chicken necks are a big seller, and the Centre serves them quite often to the support group people. (I remember eating these as a kid - it took a lot of work to get the meat off but it was tasty.) The most bizarre is packaged chicken skin. I was told it makes great soup stock, which I can understand. It just looks very odd when you see it in the store.
Because meat is pricey compared to staple items, it's a big hit when served at year-end parties. I went to three parties this week - the Nyanga centre went out on Monday, the Centre had a closing lunch on Wednesday, and the clinic had its year-end lunch on Thursday. At each party we had a mix of small steaks, pork chops, and chicken, along with regular sausage and boerwors. The Nyanga group went to a local butchery called Mzoli's where you pick the meat you want and then have it grilled on site. They have a couple tables inside, but most people sit in a tent at the side of the building. It's quite a meeting place. Apparently, if you want to be seen in Guguletu it's the place to be. The meat is served in a big pile on a tray, and you just reach in and grab what you want (literally - Xhosa people traditionally eat most things with their hands. Yvonne told me once that they don't feel satisfied unless they personally handle their food. I've had a good laugh on a couple occasions when everyone around me has just a spoon to eat with and I'm diplomatically given a fork and knife). You can bring salads or other accompaniments. You can also bring your own drinks, alcoholic or otherwise. Guys will back their cars up against the tent and crank up the music, so it's definitely like a big party.
(In the first picture, Yvonne is the woman with her back to you. Next to her is her friend Kathy. Nomandla is the woman partially hidden behind Yvonne. In the second picture, from left to right is Charlie, Buyo, and Johanna. Nomandla, Charlie, Buyo and Johanna work at the Nyanga centre, now called Mercy Ministries. The tray in the middle of the table was a big pile of meat just 10 minutes earlier.)
At the Centre's lunch, it was similar. Spiwo bought the meat at a butchery just up the street and had them grill it and deliver it. The cooks made stiff pap (like polenta) and a nice tomato sauce for on top. Most of the staff were there, including all of Siyaya. I haven't seen people eat like that since college (oh, to be that young again!). It looked like a lot of food at the start but there wasn't a crumb left at the end.
The clinic's lunch was more sedate. We ate in the conference room, with tablecloths and decorations. The women all brought different salads, and someone brought a good lasagna. Of course, the big draw was the grilled meat, which went fast. I'm learning quickly that you have to get in early if you want to be assured of getting something.
Besides parties, I saw Mogise this week. I brought him an Open Arms parcel since he didn't show up to get one. He's been diagnosed with TB (which everyone suspected), but still hasn't received his CD4 count. It's the same old story of the clinic losing his paperwork and not treating him well. The good news is that he can get a social grant, if he can first get his ID papers sorted out. He needs to go to Social Services to do that but hasn't gone. I hope he can do that in the next week so that he can get the money he needs. And, that he'll get started on treatment so he can get better. I'd like to see him still alive when I leave in two months.
On a personal note, it's two days and counting before I head home for Christmas. I'll be away for about two weeks and am really looking forward to being with my wife and family. It will be very interesting to see if my dogs remember me. I know Abby's taken my spot on the bed, so she's due for a rude awakening on Tuesday night. And, I hope I can remember how to drive on the left and to stop at stop signs again. Yikes!
More to come.
Saturday, December 08, 2007
Things came to a head two weeks ago when Mogise called me to come to his house. I decided I had to formally close the relationship, so I agreed to meet him later that morning. I took Johanna with me to help translate if necessary. When we arrived, all of the family was there, including his aunt (his mother's sister). There was a long discussion in Xhosa between Johanna and the family first, at which point she was accused of telling me to stop supporting them. Then the aunt said God had led her to the house that day, that something was wrong and she needed to be there. She thanked me for what I had done and with great subtlety suggested I needed to continue. (The skeptic in me said Mogise called her after I told him I would come. She has not been to the house within the past 6 months that I know of, even after Mogise took Johanne and me to her house a couple months ago. And, it was pouring down rain that morning, so I don't think she would have normally picked that day to walk over a mile to Mogise's house.) Mogise then asked for some time alone with me to "explain things." I agreed, and everyone stepped out while we chatted.
He started by saying he knew that I had spent a lot of money on them, and that he knew it was more than I expected. Before he could go on with the stories, I stopped him and told him directly why I was moving on. I explained that he and his family had taken advantage of my generosity (with my tacit approval, of course - I know I helped create the problem), that he had lied to me on several occasions, including the last time I saw him when I gave him R50 for transport to Nyanga and back and the very next day he claimed he didn't have any money. I asked him where their money went - they are not paying their rent, I bought most (if not all) of their food and paid for their electricity and paraffin, and the brother is working but they never seem to have money. He couldn't tell me. I said I was disappointed that he had not followed through on our agreement that he would go to the clinic and get his HIV and TB sorted out and get his social grant application submitted. And, I closed by saying that I thought they needed to take back responsibility for their situation and not depend on me or anyone else to bail them out whenever they needed something (like food, electricity, bail, drain cleaning, clothes, blankets, or anything else).
I did make clear that I was speaking only personally. I explained that he could still come to the Centre, join the support group, get a daily meal, and be on the list for food parcels. I can't take that away from him and it would be wrong to do so.
I haven't seen or heard from Mogise or his family since that day almost three weeks ago. He has not come to the Centre, even though we've had two parcels since then. I will probably bring him one of the big parcels this coming week because he should have gotten one (and probably didn't know about it because neither he nor his family are using the Centre). If there's more to report, I'll do it in the next posting.
(Spiwo and I had an interesting discussion about this last week. I mentioned that I was having a hard time supporting people who, although challenged, didn't take responsibility for improving their situation even though they had the means to do so. He told me that we should talk about my definition of "means" and how I think it applies here. We moved onto a different topic before we could do that, but his comment forced me to go back and re-examine my perceptions and biases around who deserves help and who doesn't. I'm still not 100% ready to define my position, so I'll hold that to another posting. But it raises a question for all of us: Who would we help if given the chance, and, more importantly, who wouldn't we help?)
Yolanda is the 17 year-old girl raising her three siblings along with a cousin. Yvonne and I brought them another food parcel two weeks ago. It was amazing to see how her attitude has changed. She was smiling, if not happy, and didn't seem to have a care in the world. (Which is untrue, but she was hiding it very well.) We chatted for a few minutes and then left, Yvonne and I more encouraged that she'll make it through her challenges.
3. Loniso (whose name is really Wandiso, I think - the accents are tough sometimes)
Wandiso is the 14 year-old living in a shack in Phillipi. He comes to church every Sunday so I seem him regularly. I usually end up taking him home from church, so we've had a chance to talk a bit. I am very impressed by his maturity and smarts. He is the most down-to-earth kid I've met here, and if you didn't know it you'd swear he came from a stable, non-impoverished family. Of course, that's anything but the truth.
Last week when he came to church he told Johanna and I the latest twist in his family story. His mother had left town the week before to find work (I knew that, since I met her in Phillipi that day, along with Wandiso's great aunt. They seemed like nice people at the time). He had been on his own for the week, until Saturday came. His great aunt showed up with a "gentleman friend" and told Wandiso to find another place to sleep that night. He told us the "boyfriend" actually took him to his place to stay with his roommate, another grown man. Wandiso did stay there, even though he didn't know the guy. He was very worried that he would lose his shack to his great aunt and have no place to stay. (Johanna thinks, and I agree, that the great aunt sees that there's now food in the house and she wants to take over. Even if it means that the boy is cast out to fend for himself.)
Johanna and I took Wandiso home to check on things. The great aunt had left, and it was unclear if she'd be back. Johanna spoke to the neighbor and asked if she would take him in just in case he was kicked out that night again. She agreed, and we felt better that he wouldn't be placed with a complete stranger again. Wandiso was to report if anything bad happened.
We saw him again after the food parcel distribution (see below) and the aunt had not been back since the weekend. Johanna thought she'd probably returned to her shack so that she wouldn't have to watch over the boy and to keep her "freedom." Time will tell.
4. Food parcels
This week was Open Arms' big food parcel distribution in honor of World AIDS Day and the upcoming Festive Season. (You don't see or hear "Merry Christmas" here because of all the religions practiced in Cape Town. Besides the Christians, there are Muslims, Hindu, Jewish, and probably others. So, people and businesses opt for the non-specific "Happy Festive Season." Political correctness wins out every time. Although I did see Father Christmas sitting for photos in the mall today. Thank God for capitalism.) These parcels are paid for by contributions from Open Arms' supporters and volunteers. It was a rousing success, albeit with a little drama mixed in.
We did the distribution on Tuesday 4 December. At the start of the day, everything was going according to plan. Kent, Open Arms' program director and his partner David came down to coordinate things. We'd already gotten the buckets and bags for the 300 parcels, and Kent and David had been to Makro (a warehouse store like Costco or Sam's Club) to make sure our order was being prepared correctly. So, it was All Systems Go at 9:00.
As with past distributions, the big unknowns are Makro's preparedness and transportation. The process at Makro went very smoothly and all of the food (over 9000 kilograms, or better than 10 tons!) was checked out and ready for loading by about 10:30. We had plenty of help, so it all came down to: The Truck.
We hired a guy from Guguletu who had a huge flat-bed truck. He was a little late, but he made it by the time we were ready to load so it wasn't a problem. We got everything on the truck fine, and by 11:15 we were ready to head to the Centre. That's when David noticed a flattened left rear tire. It looked okay, although the tires were in pretty rough shape to start with. I thought it would be okay, and others agreed, so off we went. I headed back to the Centre to get the buckets and bags set up while Kent and David went with the truck.
About halfway back to the Centre, I got the phone call. "The outside tire's come off and the inside tire is gone, too." The truck was parked on the side of a back road, with 10 tons of food and 300 frozen chickens in the blazing sun (did I mention it was 85 degrees?). We had no back-up truck, no pick-ups we could call to do shuttle loads, nothing. It looked bad. Frantic calls were made between about 6 different people to cobble together a plan. We went back to Makro and asked them for the names of some local truck drivers. Fortunately, they had a guy they often worked with, Anthony. Spiwo called and he agreed to send two trucks to help us out. Day saved.
Not so fast. The trucks didn't come and didn't come. Every time Spiwo or I called Anthony told us exactly what we wanted to hear. "Just 10 more minutes and we'll be there." Of course, 10 minutes turned in to 2 hours by the time the trucks actually appeared. It was now about 2:00 and we were supposed to start handing out parcels at 3:00. I knew we had at least 2 hours' of work off-loading the trucks and assembling the parcels, which meant starting the distributions closer to 5:00. It looked like a long night.
Then a great thing happened. We had about 25 people at the Centre when the trucks arrived, including all of Siyaya, some of the support group members, and friends and family members. Everyone took a position and away we went. We off-loaded the trucks with a fire brigade line, throwing bags of flour and mealie meal across the room to where the buckets were staged. We put everything else on the church stage and people made teams to take the items to the buckets. Everyone picked an item so there wouldn't be any confusion and nothing got missed. It looked like absolute chaos with so many people wandering around the space. But it was friendly and upbeat, and in the end every bucket was filled with no mistakes.
We started handing out the parcels at about 4:30. We had about 8 lists of people totaling more than 300 people, so we knew some people would miss out. We went through the support group, Yvonne's orphans, and most of the hospice patients. We also gave a parcel to the Centre staff, as well as members of the church congregation known to be in really dire need. When everything was done, we had about 5 extra parcels to set aside for people we missed. We locked the doors at 6:30 and went home, exhausted but very happy.
I'd like to thank a few people who were instrumental to the process: Kent and David, Xolani Gwangwa and his nephews and cousins, Spiwo and Zethu, Nomosizi (from the hospice), all of Siyaya, Johanna, Yvonne, Linda Helfet, and the other folks whose names I didn't get on the day. We couldn't have done it without you.
(By the way, Open Arms will be doing another food parcel distribution in April around the Easter holiday. If you want to sponsor a parcel, go to www.openarmsmn.org to learn more. Each parcel is $40 and I can guarantee you'll buy more than just food with it. You'll be buying hope for a family in real need.)
5. My brother's visit
My brother Jim came down for 5 days last week. Yes, it's a long way to come for 5 days but he's a bit crazy that way. We had a great time touring the countryside and working in the townships. We did the winelands, Cape Point, the penguins, the aquarium, the craft market, and too much food in the first three days. We came to the Centre with me on Monday and was able to interact with some of the staff, including the group at Nyanga. We also visited a couple homes so he could get a first-hand look at how people were living.
On Tuesday (food parcel day) he helped load the truck. When all of the food had to be moved from the broken-down truck to the new ones, he stayed to help do that. He then got to ride on the back of the truck as it went to the Centre. He told me afterwards that the driver got lost and they ended up in a not-so-nice part of Guguletu before someone showed them the right way to go. He then was with me as we assembled the parcels and gave them out.
He got to see a lot of things in 5 days, some unplanned. I hope he'll come back someday doing what most white South African's haven't done: meeting and learning from people who have great stories to tell.
Other than that, it's been a pretty typical couple weeks. I'm getting ready to head back home for Christmas and then for the last two months here. I'm excited to see my family and friends, but not so excited for the cold and snow (Minneapolis has actually had a normal winter so far instead of warm and dry days of the past few years. As I write this it's 1 degree there and 80 here. Yikes!). I'm starting to take orders from people at the Centre, so I expect to take full suitcases back with me.
Oh, and I can't forget that it was World AIDS Day last weekend (1 December). HIV/AIDS is still a major health crisis in the world. While South Africa has the highest percentage of cases (about 12% of the total population, and as high as 30% in some of the townships), India has the greatest number of people infected at nearly 6 million. China, Eastern Europe and Russia are also problem spots with high growth rates expected over the next several years. Most people who would benefit from treatment don't get it, either because they don't know how sick they are, don't know they're infected, or don't want to start treatment. Education and prevention are still the two things that will reverse the trends, and knowing your status is key to not spreading it. If you don't know your status, go find out. If you don't know how or where to go, ask your doctor, pharmacist, nurse, or local health department. If you need more information on the virus and how to protect yourself, call your local health department or an AIDS hotline in your area. It is up to all of us to solve this problem, for our sakes and our children's future.
More to come.
(One aside: it's been a strange night in Sea Point. First, there was a motorcycle parade, complete with cops on bikes. Now, a bagpipe group is marching past. Now all we need are the clowns.)
Thursday, November 22, 2007
Yvonne and I were delivering food parcels with two people from Minneapolis today. Aaron is a lecturer at the University of Minnesota. He is bringing some students here next May and is here doing some scouting for people to participate in his class discussions. Rebecca, his friend and a teacher, came along to see Cape Town and the townships to bring back stories for her sixth grade class. We went to the first house, the aunt of Shepherd and Loyiso (the two boys who are living on their own in Barcelona). We walked in and this scene immediately greeted us: Three women sitting quietly on their couches, listening while two young white men in white shirts and dark ties talked with them. Yes, the Mormons are in Guguletu. The four of us were quite shocked, as were the two guys. The auntie talked to Yvonne in isiXhosa, saying she was very confused and didn't know what was happening with these guys. She almost pleaded for us to stay, but Yvonne politely gave our regards and we quickly left.
It was a very surreal moment. I knew that Mormon missionaries came to South Africa, but I never expected to see them in the townships. That was pretty stupid of me since the majority of South Africans live in townships or rural areas. I feel a little bad that we didn't stop to say hello to our fellow countrymen (they didn't utter a sound while we were there, and we just basically dropped the food parcels and left). It might have been nice to see where they're staying and catch up on news from home. If they're around, though, chances are I'll see them again somewhere.
I also had another run-in with the man who won't take no for an answer. Today he brought his grandfather to the Centre. He wanted his grandfather to explain how bad things were at home because I wouldn't listen to him. He also wanted me to give money to his grandfather, as if I thought it wouldn't just be given to him when they left. I explained again how I understood their situation, that I knew they were struggling. I also told them, again, that I was focusing my efforts on people who did not have any income, didn't have any adults to help them, and didn't have any way to support themselves: Children and orphans. I told them I knew they had some income (his mother gets an old-age pension and his wife is working part-time) so things were better for them than for many others. I explained that I have dropped support for other people so that I could help more children. At one point, Sylvia, a woman who volunteers at the Centre and who knows a lot of the people in the area, interrupted us and told him that he didn't need any help because his wife works and he should stop bothering me. He didn't like that very much but he couldn't deny it.
When he continued to press me, I got a little angry. I told him the answer was no and I didn't expect to see him again asking for money. The requests got smaller and smaller (R200 to R100 to R50 to R20), until I said I had work to do and got up and left them. They then left, again unhappy and empty-handed.
I don't know how to handle the situation any differently. He has been called out by both Yvonne and Sylvia, and I've explained my position at least three times. I truly feel bad for him and his family, but they have means to live where many others don't. As the amounts got smaller, I saw that some of his pleading was to keep his dignity intact, that as the (presumed) head of the household he was trying to look good by bringing money home. I didn't think I could let that sway me or there'd be no end to the requests. I also feel bad for judging him, but I'm fairly certain that a portion of whatever I was to give him would go towards alcohol, which doesn't help his situation any. I'm sticking to my guns with this one. And watching my back as I go.
(Oh, and Happy Thanksgiving to everyone. Since there is no turkey to found in South Africa, I had to settle for half a BBQ chicken from the grocery store. Not even close to the same effect.)
More to come.
Tuesday, November 20, 2007
Yvonne and I met a new child-headed household last week. We "found" them after two women came to the Centre to report them. These women live across the street from the kids' house and often give them small amounts of food, whatever they can afford that day. They knew that they couldn't carry on like that, so they came to us to get help.
There are four children in the house. The head, Yolanda, is a 17 year-old girl in grade 11. She has a 14 year-old sister and an 8 year-old brother. There's also an 8 year-old boy who is their cousin - his mother is their 31 year-old sister. Their mother died from HIV last year, and the 31 year-old sister left home about 7 years ago and has not been back (her son has lived with the grandmother, the other kids' mother, almost since birth). Yvonne, Johanna and I went to the house to see their situation and find out what they needed. We had to wait a few minutes while Yolanda was located. When she came in, she started out smiling but within seconds was sobbing, saying that she couldn't take the pressure anymore. She was thinking about leaving or committing suicide, it was so much. Johanna did a great job of soothing her and listening, giving her hope and encouragement that things were going to get better.
Yolanda helped make a list of items they needed. Besides food (they had almost nothing in the house), there were things like washcloths (they all shared one), deodorant (sharing), soap (sharing), toothpaste, toothbrushes, you name it. It was probably the most I've ever bought for any one group at one time, but it was like stocking a house for the first time. When we came back Yolanda was cleaning the house and had a smile again. I think she could see for the first time that she wasn't alone, that other people would help look after her and her siblings.
During Johanna's discussion with Yolanda, she mentioned that the kids in the house behind them were also in trouble. They live with an uncle, but he drinks and can be quite abusive. He's not working, so they also have almost nothing at home. Yolanda tries to share what little she has, and I'm sure some of what we bought went there. Fine by me.
We're due to go back in the next couple days, and I hope things will still be somewhat positive.
There was also a funeral this week, the first in quite some time. Jerome, the new drummer in Siyaya, lost his mother about two weeks ago to HIV/AIDS. She was hospitalized for a long time, better than 6 weeks, and finally succumbed. The funeral was very nice, very musical. Siyaya did about 4 songs, and Jerome played with them. He also plays in a marimba group (a marimba is like a xylophone but sounds almost like Jamaican steel drums), so they also played some songs with Jerome. He said afterwards that it was like his mother was there listening to him, and it gave him comfort to do it.
Because Spiwo was officiating, it was a short service, only an hour. Even the graveside service was shorter than usual. (That was good because the sun is very strong now and my pate cannot handle more than 10 minutes. Darn Minnesota skin.) It was all just as poignant as usual, though. It's hard not to be when almost everyone we bury is 40 or under.
I had my first real experience with ungratefulness this past week. A man came to see me last week to ask for money to buy food. He had caught me outside of church the Sunday before, and because I was in a hurry I gave him R100 and told him to come back so we could talk more. He came back on Monday and asked for R300 more. I told him I didn't have that much and gave him another R100. He pushed it across the desk at me and said "That's not enough. I can't live on that." I was really taken aback at this. No one has ever done that before. They take what is offered with gratitude because they know that I'm trying to help and if they don't take what's offered they get nothing. Not this guy. I upped the amount to R200 and he took it and left.
He came back on Wednesday, this time asking for R500. His son has some kind of skin infection on his scalp and he wanted to take him to a private doctor for treatment. The R500 would apparently pay for a week's worth of treatment. I asked a lot of questions about why he needed a private doctor when he could get free care at a government clinic (like Brown's Farm), and tried to find out what would happen after the week was up. He didn't have any good answers. I refused his request and told him he should take his son to Brown's Farm where a good doctor would see him and prescribe a good treatment. Fortunately, Zethu was at the Centre and I had her come and speak to him. She told him to bring his son in, too. He left, empty-handed and unhappy.
On Thursday Zethu told me that they had had trouble with this guy before. He was part of the support group but was asked to leave because of his behavior and alcohol use. She told me to be careful with him and not give him money.
Well, he was back on Friday asking for money again. And again, I said no. And again he left unhappy.
Today, he was back. He still wants money for the doctor. He has not taken his son to Brown's Farm yet. I also learned that his mother gets an old age pension (R800 a month) so the family has some income to live on. He tried to argue that I don't know his situation and that I must come to his house so that I can understand it. I said, I know your situation because it's the same as many people I talk to. I tried to explain that I am supporting many children who have no money, no old age pension, no social grants to live on. He tried to use his son as leverage, at one point saying he was going to give me his son to look after. I said no, your son has a father and money in the home, and I am not going to take care of him. I did give him R100 to cover taxi fare and some small incidentals, at which point Yvonne took notice and told him in no uncertain terms that he is not to ask for money from me, that I am supporting children and orphans who have nothing. That didn't make him happy, but he better understood my points. I don't think it's the last I'll see of him, and I'll keep posting about future interactions.
I also had a couple of small interactions with Mogise and his family. His brother called me on Tuesday to say that the old man came and fixed their drains again, and that he'd be back on Wednesday morning for the money. I said, "Well, did you expect me to pay for that? Because I didn't agree to it." There was a pause on the phone while Livingstone collected his thoughts and he said we'd have to talk about it. I agreed, and left it. I didn't get another call until yesterday when Mogise phoned. He asked if I was coming around. I said no, I hadn't planned on it. He said that he had nothing to eat and wanted to know if I was bringing anything. I said no, that now that his sister and brother were both working that I wasn't going to support them any longer. He informed me that his sister is not working any longer - "I thought she told you." No, she didn't. He also said the plumber was still after them for his money, so apparently that hasn't been sorted out yet. Then Mogise asked if I could get the kitchen staff to box up his meal (he could still come and get the HIV support group meal) and give it to one of the neighbor boys. I said no, that if he wanted his meal he had to come and get it, and that he should start coming to the support group meetings.
This is exactly what frustrates me about that family and their situation. Mogise makes almost no moves to improve his lot in life. He wants to live like a king but takes no responsibility for making it happen. His family, some very nice people, are not holding him accountable and are not cutting off the other people leeching from them. They must stand up and work as a group to get back on track or they will be struggling for a long, long time.
This week I'm helping a lecturer from the University of Minnesota meet some people in preparation for a three-week "study abroad" class he's doing here next May. He has a friend with him, too. It's been nice catching up with people who share the same accent and know the same culture as me. They even brought me six Nut Goodies! (I told him my fee for a tour was one, and they brought a bagful.) That, plus coordinating a program for St. Thomas, planning some year-end functions, working on Siyaya's US tour, and writing letters for Spiwo and Zethu is keeping me busy. That's good, but it means I actually have to work at home, something I swore I wouldn't do here. Oh well, it's not much and it makes time fly by.
The title for this posting comes from a conversation I had recently with a woman from New York, Linda Mayo-Perez. She runs a cemetery in Queens, a very nice one from the way she tells it. She made the comment that tombstones have our birth dates and death dates on them, but what everyone talks about and reflects on is the little dash between them. What we do in the time that dash defines makes up our lives and our persons. That really struck a chord with me. So, I've decided to start living the dash. I want to make more conscious decisions about what I do and why. It's not about 12-hour days and 100,000 air miles for the sake of showing how much I can get done. It has to be about making (and taking) time to enjoy life and make a difference. That's my resolution for 2008 and beyond.
More to come.
Monday, November 12, 2007
This past week I've had to make two difficult decisions, which I know will have great impact on the people affected. The first is kind of complicated, the second is just sad.
Mogise is the subject of the first decision. Over the past month I've thought a lot about the support they've been getting. In spite of all the food and money they've received, the family, and especially Mogise, have not really moved ahead. They have not tried to improve their situation, even though two in the house are now reportedly working. Mogise, especially, wants all the trappings of a rich life without lifting a finger to get it. When I bring them food, they always ask for more, as if what they get is either not enough or not good enough (and I buy a mix of things they need to survive, plus a few extras). They also continually ask for money for electricity, or paraffin, or plumbing, or something else. I don't know where they spend the money they earn, but it's not going towards their household needs (I don't want to think it's going towards drugs and alcohol, but I know it is from first-hand experience).
So, after agonizing over the situation last week, I had a long talk with Yvonne about it. I told her I thought it was time to stop supporting them. She's been there enough to know what's happening, and she agreed it was the best thing. She's known the family for many years, and has dealt with other problems in the past. I also spoke with Johanna, since she is a distant cousin, and she also agreed that it was time. Where Yvonne said it might be good to meet with them and explain why my support is stopping, Johanna said it wasn't necessary, that I didn't owe them an explanation. A couple of the women at the Nyanga centre who know them also thought it was a good idea to stop, and I trust their opinions because they have the ear to the ground even more than Yvonne and Joanne.
So, I'm not going there this week. I expect that by Thursday I'll get a call or that Mogise will come to the Centre. If so, I'll tell him then. He and his family can still get support from the Centre (like a daily meal if he ever comes for it), but not from me personally.
This was probably the most difficult decision I've made since being here. I know full well that the family has limited income and will struggle to find sufficient food. They told me they are not paying their rent, and having to spend more on food and electricity means they will get further behind, increasing the risk that they'll lose their house. Their plumbing problems are still there, with no attempts being made to fix it. I could easily spend a few thousand rand over the next three months, but they would be in exactly the same situation that they are in now (after being supported for four months).
On a positive note, Mogise finally went to the clinic to get his HIV status evaluated and start the process for a disability grant. That only took three months of prodding. Now he has to carry through on the application process, which will be his next big test.
The second decision happened just today, and involves Maxwell from the hospice program. I've written about Maxwell before – he's the guy who asks for money just about every week, for everything from taxi fares to food to electricity to birthday presents. It's not a lot of money at one time, but over the months it's added up to about R3000. Maxwell has a job and gets paid, unlike all of the other people I'm supporting or “lending” money to.
In August and October Maxwell and I had a talk and I told him I would not lend him money any more. I explained that I was supporting many people now, all of whom were not working, and I couldn't afford to carry him from paycheck to paycheck. Both times he said he understood and that he would not ask any more. And both times, he came asking and I caved in. (It's tough to say no when the reason is that the baby has no food.) Well, last week we had the same discussion again, and I told him I was serious this time. Again, I got the promise that it was the last time.
When I got a note from him today asking for R150 for food and electricity, I decided enough was enough. I didn't go to him like I normally would have done, just to see what would happen. He came to my office late in the afternoon and asked if I saw his note. I said I did, and the answer was no. I explained why, as I had done before. He said he understood and that today would really be the last time. I said no, last week was the last time, just like you agreed to then. He pushed, I held fast. Finally, after about 10 minutes, he left my office, unhappy and unsure what to do next.
Now, in the larger context of things, R150 is not much. But what I've been learning is that it's easy for people to stop taking responsibility for their own actions when they know someone is willing to be a backstop for them. Almost all of the other people I'm working with are doing something to improve their own situation. One is working a day or two a week as her health allows. Another is trying to start a business. A third person is in school trying to build his future. I can't continue to give money to someone who will not manage his own situation. And, who somehow has money for cigarettes and liquor (I'm not judging, just wondering about priorities).
So, life continues to be a balance of challenges and opportunities, successes and failures. We'll see what tomorrow brings.
I had a great experience last week which helped balance some of the negative ones. I was host to a group of 24 Americans on a trip set up by the Plowshares Institute out of Connecticut. Plowshares does work with conflict transformation, consulting with governments around the world to deal with past problems and bring new solutions to conflicts. Bob Evans, the founder of Plowshares, also coordinates trips to the developing world so that people can see what is happening for themselves. They've been to Cuba, Indonesia, China, and South Africa in the past.
I set up a three-hour experience for them that included some discussions with Yvonne and Johanna, field trips to people's homes, and time with Spiwo and Edwin. The people they met with on the field trips were all HIV-positive, unemployed, and have considerable challenges just surviving. But, they all have great stories of hope and encouragement and really are good role models for how to deal with real life. After all that we had an excellent lunch at the Centre and they left with their heads spinning.
This morning I met with a couple of the people to follow up on some things related to Siyaya's planned US tour next year. They told me that everyone really enjoyed the visit and they felt it was a highlight of the trip. The group also collected some money for the Centre – we were one of only two organizations they have money to, and it was because they could tell we were actually making a difference. That made me feel good.
I also had a strange experience yesterday. It is initiation time again, when young men venture off into the bush (or the empty fields around the townships) for their ritual circumcision and isolation experience. One of Yvonne's sons is included in this season's class, and she's been running around like mad making all the arrangements.
It came out late last week that one of her son's friends had gone to initiation school but no one in his family was supporting him through the process. Family members are supposed to be bringing food and providing moral support, but no one had come to see this boy in nine days. He was very hungry and bordering on dehydration when Yvonne found out. About that same time, her ex-husband (and her son's father) Zacharias decided to help the boy, providing him with food and moving him into his son's hut where he'd be safer. Because Yvonne cannot see her son or his friend (part of the ritual, she's not even supposed to see the huts or they risk not becoming real men) she asked me to go and talk to them to see if they were okay.
So, yesterday I was led to her son's hut and I spent a little time with them. This is really, really rare, than a white man, a foreigner, is allowed to participate in the initiation ritual in any way. I met the young men, who were covered from head to toe in white make-up (which was either dried mud or thick calamine lotion). They are not allowed to have contact with anyone, so to shake hands the hold one end of a long stick and I grabbed the other end. We chatted for a few minutes, and I could see that things were better because they were eating and appeared happy. Then the fireworks started.
Before we got to the field, we had tried to find the unsupported boy's mother to get a sense for that the situation was. Yvonne couldn't find her, but she did find the mother's brother (the boy's uncle). She brought him with us so that we could find the right field. He came with me to the hut and talked to the boys and me about what was happening. Yvonne's ex-husband had been away from the site, and when he came back he started to argue with the uncle about why he wasn't around. He told me “I don't know this guy, don't know where he's been, now he comes here and acts like he's involved.” Then he told the uncle, “Why didn't you come when he told you he was going to initiation school? I'm not working but I took it upon myself to help him because he has nothing.” The uncle claimed not to know the boy was there, but the boy said that he told the uncle he was going. And round and round it went. It never got heated, because that would have been bad form during the initiation time, but it certainly got pointed. The uncle knew he was in the wrong, even though he didn't want to admit it and didn't have any way to fix it (he's unemployed, too).
Needless to say, tensions were high. But, it eventually cooled down and I walked out with Zacharias. I told him I would help where I can and we agreed to talk later. It turns out the boy has even less than nothing, so he will need simple basics in order to leave the camp. Another name added to the ever-growing list of needy children
More to come.
Monday, November 05, 2007
1. We got new plants for the garden last week. Gone are the spinach and lettuce, in are the tomatoes and green peppers. I'm a little concerned about the tomatoes, since it will now only rain once a week or less. The guys are watering, so hopefully they'll have enough moisture to actually make a fruit.
(And no, I will not say to-mah-to. If Webster had wanted it pronounced that way he'd have put an h in the word.)
2. I had my first day all alone in the pharmacy last Tuesday. Kayise left ill on Monday, most likely from food poisoning. She literally ran out of the pharmacy mid-sentence, and spent the afternoon in the treatment room full of anti-nausea medication. I knew she'd be out on Tuesday, so I was expecting Tami and I to deal with things. Well, he decided to skip work. So, it was just me. And, if I do say it myself, things went swimmingly. Fortunately it was light for a Tuesday (normally the busiest day of the week) and everyone was in a good mood. No one complained if they had to wait a few minutes extra, and I only had one person look really confused when I spoke with her. Another patient helped translate, and she left satisfied. It was a real confidence booster for me, and even though I hope to not have a repeat performance it's good to know I could handle it.
3. The Nyanga centre is starting to take shape. This is a sister project of JL Zwane, not really linked to it but based on it. Yvonne and Johanna are getting it started, and there are 4-5 women who are coming everyday to carry out the programs. They've given it the name Mercy Ministries. They intend to do a lot of community outreach (like Yvonne does), have an after-school meal program for kids, and start an HIV support group for people in their area (New Cross Roads). Their only limitation is funding – they have none. I've been buying supplies for the food program (right now just soup ingredients, cookies, juice, and basic staples like flour and sugar), and they supplement those with vegetables they get from a local farmer (he gives them a pickup truck load every week, which the both use and distribute to needy families around them). We're trying to figure out ways to get contributions, and if they stick with it I'm sure they will one.
4. I also learned more about township house plumbing systems than I ever wanted to know. Think about where you live: Chances are, your sinks and toilets connect to a drain line in your house or apartment that is directly connected to the municipal sewer line. Well, in Mogise's house they have it a little different. Since the floors are concrete and the walls are brick, with no stud walls, there's no place to run pipes. So, the sink and toilet drains come through the exterior wall and open up into small square drain boxes set in the ground next to the house. These drains are connected to a pipe in the backyard, which is connected to the sewer pipe coming in from the street. The vent pipe, which in your house would come up through your walls and out your roof, sits in the middle of the backyard, coming up at a slant so that it sits wide open at a 45-degree angle about 6 inches out of the ground. Needless to say, they have blockages in their system quite regularly, either from kids putting stuff down the vent pipe or from normal, run of the mill drainage. That causes the drainage to back up through the drains in the yard, and the vent pipe, until their back yard is a pool of sewage (at least it doesn't come back into the house). You can use your imagination on what it looks and smells like. And there is a family living in a shack in the yard, which complicates things just a little.
Now, normally this wouldn't be a problem. You'd hire a plumber to come and unblock the line, which should take maybe 10 minutes. Or, you go to an equipment rental place and get a snake and clean it out yourself. Not here. Two weeks ago Mogise's brother Livingstone hired a guy to clean out the drains. All he had were rigid cast-iron rods that ended up putting a few little holes in the pipe. Livingstone had to dig out the main pipe and uncouple the line from the house, getting covered in sewage in the meantime. Only then could the hired guy use his rods to relieve the blockage. He pulled out a few pieces of metal that someone had put down the vent, along with some food wrappers and other assorted effluvium. The drains worked like new again.
For one week. They are now blocked again. Which wouldn't be so bad, except that the entire family has had some, um, gastrointestinal distress lately (probably spread by the cesspool in their back yard). Last week Johanna and I put some caustic soda (which I think is potassium hydroxide, or lye) in the vent, enough to unblock about 20 kitchen drains. I'm hoping that it worked but am not holding my breath. Ultimately, their pipes need to be replaced, which will be expensive and time consuming. I'll let you know if that ever happens.
5. On a more positive, less odious note, Halloween was last week. It is not widely celebrated here. You can find decorations in the stores, and even some bagged candy (which they sell year-round). But, my sense is that it's a white person's holiday and there was no sign of it in the townships. I had a little fun anyway and bought lollipops for the after-school program kids. I'm sure they had no idea why they got them, but were happy all the same.
6. Marvin is moving ahead with his plans to make traditional Xhosa clothing. He's also gotten an order for some chair backs and armrest covers, so things are really looking up for him. He's taking some space in the Nyanga centre so he doesn't have to work on his bed at home, and I'm hoping some other people from the HIV support group do sign on to work with him. Once he gets his first pieces back I'll post a picture.
7. I learned one aspect of what having a teenage daughter must be like. Noluyolo, the 16 year-old raising her brother, was in need of some toiletries last week. She made me a list and off to the store I went. The deodorant, toothpaste and soap were easy, as were the feminine hygiene items. What threw me were the body spray and hair oil. She gave me specific brands to buy, which was helpful, but only if I could actually find the items in the store. Imagine me, a middle-aged white guy with only half a head of hair, wandering the aisles looking for Dark and Lovely hair oil conditioner and Exclamation body spray. I was a little scared to ask for help, so I just wandered around until I figured out what was what. Then it was a matter of quantity: Just how much body spray does a girl use in a month? One can? Ten? I figured two was a safe bet. Fortunately, the check-out girl didn't seem to care what I was buying and I escaped without too much embarrassment.
That's it for today. Happy Guy Fawkes Day to all. (If you don't know what this is, it's a British holiday. In 1605 Guy Fawkes and a group of English Roman Catholics attempted to blow up Parliament to protest Protestant rule. Someone sent a warning letter to Lord Monteagle and the plot was foiled just before Guy Fawkes tried to light the fuse. Now, every November 5th Britons burn Guy Fawkes in effigy and light fireworks. I think it's just another excuse to blow stuff up and scare the dogs.)
More to come.
Thursday, October 25, 2007
When I saw Marvin on Tuesday, he said the tailor had been impressed with his work and that he might be able to generate some orders. Marvin was chuffed (excited), as you can imagine. I saw him again today, sitting outside copying designs off of the church facade so he could create some new screens. He looked strong and happy, quite a turnaround from a month ago. He is now a man with a mission, a purpose. He can see his way out of his difficult situation, and at the same time he can see a way to help other people succeed and improve. He has put together a plan for moving ahead, one that requires about R25,000. I think we can scale that back and take in chunks, and I'm hoping to give him some support for one of those chunks. If anyone wants to join me, let me know.
By the way, he is making me a Xhosa outfit, too. When I get it I'll post a picture. Maybe I'll even do a dance.
I met two other amazing people this week. The fact that they were both 14 is beyond belief.
1. Jerome lives with his 10 year-old brother just a couple blocks from the Centre. His mother is alive but is currently in hospital (I don't know why, except that it's HIV-related). His brother is HIV-positive and is not doing well right now. Jerome was already known around the Centre because he plays in a marimba group with one of the youth leaders. When Yvonne found out about his mother's situation, and the fact that the two kids were now on their own, she asked for help in getting them some food. No problem with me. I picked up some groceries and we gave them to Jerome this week. You could tell it took a load off his mind, because he was able to smile again.
Yesterday I got another lesson about having a purpose, courtesy of Jerome. Siyaya was practicing, like they do most days. The difference was they had a drummer. They've been struggling to find a permanent drummer for the past couple months, so most days you don't hear any percussion, just voices. Well, this new drummer sounded great, like he had been there since the beginning. Edwin popped in my office and asked if I knew who the drummer was. When I said no, he smiled and said "it's Jerome!" "Jerome, the boy Jerome?" I asked. "Yes!" came the reply. Apparently he was able to transfer his marimba skills to the drums, and he was sitting in with the group. I'm not sure he'll ultimately be able to do it full time (he's still in school), but having the opportunity to play with a professional group is great experience. Jerome has a purpose, and he's making the most of it.
2. Yaniso lives in Phillipi, near the clinic. His teacher called Yvonne and said he needed help, so she met with him earlier in the week. He was essentially abandoned by his mother a couple weeks ago, which was not the first time. Apparently, he, his mother and his grandmother used to live together but the two women had many arguments. His grandmother left a while back, and his mother decided to take off last week. She left him with nothing: no food, no money, only one change of clothes.
Yvonne bought him some clothes, including a new school uniform, and some food and hygiene basics. I bought him some other items to get him set for a couple weeks. His mother is supposed to be coming back soon and hopefully Yvonne will be able to meet with her to see what's happening.
Yaniso is inspiring. With all he's going through, he's keeping positive and hopeful. He is a bright boy, with a natural friendliness that is beyond his years. I think he will go far, assuming he has an opportunity to. As long as Yvonne is involved, he will.
I also saw Mogise this week. He is back home, out on bail. He was charged with housebreaking and theft. He said there's no cause for his arrest and he's confident it will be thrown out. We'll see. His sister found a job last week, so there are now two people working. If it stays that way, my time with them will be short-lived. And I'm very okay with that. There are plenty of other people who need help.
More to come.
My morning walk took me almost to the edge of the village. It was early, about 8:00, but already things were happening. Kids were walking to school, the local shop was opening for business, and farmers were leading their animals to the fields. No one seemed to mind a stranger taking pictures, and I took my time capturing memories.
I waved to everyone I saw and everyone waved back. The kids in the picture above laughed at first, but when they saw my camera they immediately posed for a shot. Then they ran away, just like kids do.
I wandered up to people I hadn't met just to say hello, and had a couple nice conversations. The woman in this picture is Spiwo's first cousin (their fathers were brothers). She was making breakfast, corn meal porridge. She told me about her family and how she has four children, none of them hers, living with her. The children are all orphans from others in her family. She also told me that 75% of the villagers were related to each other, which I could understand because there are only a handful of surnames in the town.
On my way back to the house I was reminded of a line from a bad Tom Selleck movie from around 1984 (High Road to China, I think): "The oxen are slow, but the Earth is patient." This picture says it all. It's a man and his son working a team of oxen to plow his small field. His wife (or maybe his mother, it was hard to tell) and a small girl were also there. In the US, he'd have a small tractor pulling a plow rig, making it a 10 minute job. In Malungeni, he had four oxen pulling a single blade plow that he had to physically keep in line. Considering the fields were really wet, he has having to man-handle the plow something awful to keep it where he wanted it. And of course the oxen weren't exactly easy to steer (nice pun, I know).
I was mesmerized watching him, all the time wondering how it's possible in 2007 that people would still be dependent on such antiquated equipment. But then, I see women every day in Guguletu and Phillipi washing clothes in tubs, scrubbing the pants and shirts with brushes or just against themselves. I see people in homes cooking over wood fires or oil stoves because they can't afford or don't have electricity. I see men using horse-driven carts to haul scrap metal down city streets because they don't drive and can't hire a truck. It's as if Malungeni, Guguletu and all the predominantly black areas are caught in a time warp, where the 1800s intersects with the 21st century. Where an Internet cafe can sit next to a woman selling meat cooked over a wood fire. Where a proper house with a satellite dish sits in front of a shack with no electricity, heat or water. It's the juxtapositions that make understanding life here both intellectually fascinating and emotionally hard.
I also noticed something Spiwo had mentioned to me. There are no cemeteries in Malungeni. People are buried on their homestead. This man was working his field while overseen by a close relative. There's no doubt that the relative was nourishing the farmer, both physically and spiritually.
Spiwo and I headed to the airport in the afternoon. We left directly from Mththa, heading to Cape Town via Johannesburg. I had a little chuckle looking at the flight schedule - there are only two flights in and out of the airport per day, but they them posted on a sign board about 4 feet square, like they were planning to have 100 flights a day next week. There was an airport bar, though, and a cafe (that didn't serve any food - go figure). We had a nice ride in a medium-sized prop plane before landing in the first world again and picking up our jet for the journey home.
Saturday morning I had a long, hot shower. And I only felt a little guilty.
More to come.
Wednesday, October 24, 2007
Imagine the worst gravel road you've ever driven on. Add potholes and rocks the size of your fist (or larger). Then, for good measure, have it rain. Now, imagine 20 miles of this, sick in an ambulance, heading to a place you don't want to go to. You've just experienced a trip to the local hospital for Malungeni and the surrounding villages.
(During the ride I was amazed to see many children walking to school barefoot. Now, there was a steady drizzle or light rain and the temperature was only about 55 F. The water in the puddles and on the grass on the roadsides had to be cold. But, it's likely that these children did not own shoes, or that they had to share with someone else in the family. Spiwo told me once that he didn't get his first pair of shoes until grade 6 (age 12), and Xolani was 15 before he had his own pair. I cannot imagine sitting in school all day with cold feet, but that's another aspect of reality in Malungeni.)
Canzibe Hospital is a government hospital. It was built in the 1960s and was probably somewhat up-to-date back then. Unfortunately, almost nothing has changed in the place since then, except over 40 years of use and deterioration. It is probably the worst health care facility I've ever seen, including hospitals in about 10 other countries.
The hospital campus houses the hospital proper, a tuberculosis (TB) ward (separated from the mail hospital for infection control), an outpatient clinic, and an HIV clinic. There are also separate buildings for physical therapy (PT) and rehab, and a dormitory for staff (since most of them live quite a distance away and don't have transportation). None of the buildings are connected, so if a patient needs to move from the hospital to PT they must travel outside down an unpaved path (kind of like the road), rain or shine, hot or cold. It had been raining for two weeks straight before we arrived and every piece of ground was mud. I cannot imagine having to maneuver the paths in a wheelchair.
We started our tour by meeting the hospital manager and a couple members of her staff. I'm not sure who they thought we were, but we were treated like honoured guests. (I don't know why. We showed up unannounced and explained that we just wanted to look around. Was it the foreign accent?) She assigned the nursing director to take us around and encouraged us to ask questions. I didn't take any pictures, more out of respect for the patients than anything. I now wish I had.
We started in the TB ward. This building has 8 patient rooms:
- 1 for children that holds about 6 cribs
- 3 for women, including 1 room for acutely ill people (8 beds) and 2 rooms for people who are "better" and soon to be discharged (8 beds each)
- 3 for men, with the same configuration and bed counts as the women
- 1 isolation room for people with multi-drug resistant (MDR) or extensively drug resistant (XDR) TB (6 beds)
Of the 60 total beds, 46 were occupied. There were only 2 children and no isolation cases, and most of the adults were in the "getting better" wards.
The wards are nothing more than large open rooms with beds positioned about 3 feet from each other. The two post-acute wards are separated only by a short wall, maybe 5 feet high. There are no curtains between the beds, so privacy is non-existent. There's no TV or radio, save a single TV set under the door as you enter the building. If you're lucky enough to feel good, you can sit in the hallway and watch a fuzzy showing of a soap opera or the news. If you don't feel good, you're stuck in your bed with only your thoughts to keep you company. All of the equipment in the wards is old and probably original. It is in such bad shape that much of it has Condemned written in it. I wondered if that label was really more applicable to the patients.
One other interesting thing was that all of the windows were wide open. Again, it was cold and rainy that morning. The wards were filled with sick people, many with suppressed immune systems (I'll estimate that at least half of the patients also have HIV), bundled up to their eyeballs to avoid the chills. I'm assuming they needed the airflow for odor control, but it couldn't have been helping the treatment too much.
We also got to see the kitchen. The TB ward has its own so that no food or equipment is passed back to the main hospital. It was horrible. Most of the equipment doesn't work. There were two stoves that were non-functional, and the one that did work only had 4 working burners out of 6. The sick was small and in a rotting cabinet. The pantry was small and pretty bare. People were just finishing breakfast when we were there - it was a plate of gray-tan porridge. Oliver Twist would have passed.
Before we moved on we were asked to wash our hands to avoid contaminating the other areas. Great idea. Of course, we couldn't dry them since there were no towels. One of the nurses jokingly said, "We air dry our hands here." It doesn't say much for infection control when you either can't get the germs off or they end up on your pants legs.
Next stop: the main hospital building. This houses the casualty department (i.e., the ER), x-ray, the lab, and the pharmacy. There is also an outpatient clinic for people with TB and a dental room. Casualty was small, 4 rooms, but fairly well stocked with equipment. There were two doctors there, both from outside South Africa (I was told that the longest a South African doctor has ever stayed there is 11 days. Yes, days.) It also has a small outpatient surgery area where they do circumcisions and some minor gynecological procedures (yes, abortion is legal here).
The x-ray department is the most state-of-the-art area due to the recent delivery of new stationary and portable x-ray equipment. It was all labeled "A Gift from the People of Japan" which tells me the government didn't buy it. All of the x-rays can be digitally scanned for storage and reading. The x-ray technician was very proud of his equipment and explained in great detail how he lays people down and takes their pictures. Unfortunately, if you need an x-ray after 5:00 pm or on the weekends you're out of luck. The department is closed. You can come back in the morning or on Monday.
The lab was also fairly modern. They can do basic chemistries (glucose, electrolytes, pregnancy) and some microscopy. The rest they send out and wait about a week for the results. They have a brand new machine that will more than double their capabilities, but it has not yet been calibrated and validated. The manager was confident that it would happen very soon.
The pharmacy was small, about 8 feet by 12 feet. There were two people there, a full-time pharmacist and a volunteer from the Netherlands who was working there for a few months. They had everything we have at Brown's Farm CHC, just less of it. They had taken over an old church building on the campus for storage so they may have had plenty of inventory. Unfortunately, patients have to wait outside for their medications, and there is no space available for counseling. I'm sure compliance is poor, as it is at Brown's Farm (even with our attempts at education. Well, at least I try).
After we finished there we headed for the hospital wards. Their small building houses the main surgical suite, the main kitchen, and six wards:
- men's medical (6 beds)
- men's surgical (6 beds)
- women's medical (6 beds)
- women's surgical (6 beds)
- pediatrics (6 beds)
- maternity (3 beds)
The medical and surgical wards were as spartan as the TB wards. Most of the patients looked as if they didn't want to be there, in a bad way. The pediatrics ward was a little bit better, only because the mothers got to be with their children so the kids were calm. But it was the maternity ward that got me.
The unit is split into two areas. One is the labor and delivery unit, and the other is the ward for mothers who have problem pregnancies. The ward is colourful, only because the beds actually have salmon-coloured bedspreeds. One of the nurses said it was the only ward that the government cares about, since women and children are a big focus for the health department right now. The labor and delivery area has three beds that serve as the pre- and post-delivery area and three beds in the birthing room. Only one of the birthing beds is actually the right model, but they make do with the ones that aren't.
The birthing procedure is very different in the government hospitals. Mothers usually arrive in labour. Hopefully they had some kind of antenatal (pre-natal) care, but in half the cases there was none. They are quickly tested for HIV so that drugs can be given if necessary to protect the baby. They wait until they're ready to give birth and are then moved into the birthing room. Many women deliver standing up or squatting, so the beds are shorter and higher than normal. after the baby is delivered, mother and baby are moved together into the post-delivery area. They stay there for 6 to 8 hours, during which time they are taught to breast feed (if they can - HIV-positive women are discouraged from doing so). If everything is okay at that point, they are sent home. There's no mandatory 24-hour stay, no baskets of goodies or balloon bouquets. It's time to put the baby in a carrier and walk back to the village.
The unit delivers about 8-10 births a day, so it's not unusual for all of the beds to be full. In fact, if women come in September or October, the busy time of the year, some of them will be delivering in the hallway. Needless to say, it's not an ideal set up.
The other thing that got me about the maternity unit was the horrible bathroom conditions. The doors on the toilet rooms were broken and hanging on one hinge. The toilets lacked seats (which is pretty common here) and toilet paper was usually absent. The shower facilities were so dirty and moldy that I wouldn't risk using them. I don't know what these women would think about the single-room birthing suites that most U.S. hospitals have. They'd probably want to move in permanently.
The last stop on our tour was the HIV clinic. This comprises two trailers, each about the size of a big semi truck trailer and configured into three small treatment rooms. The waiting area is outside between the two trailers. The clinic sees about 30-50 patients a day, more on the days medications are passed out. They have 190 patients on anti-HIV medications, which is a good number but probably only 20% of what they should have. Most patients are not seeking care, some because they're scared, some because they don't know to, and some because they believe in traditional medicines. Thus, the infection keeps being passed on and people keep dying by the scores.
In short, I'm glad I saw Canzibe but I was more glad I could leave. It is truly a depressing place, one where most people just go to die. There are two other hospitals serving the villages around Mthatha, and the situation is no better at them. The nurses are demoralized, there is a constant staff shortage and supplies are very difficult to come by. I asked when last a health department official was there and the nursing director told me no one has ever been there. If they came they might know how bad it is and be compelled to do something about it.
Or, it's more likely they'd just ignore it like they have at other hospitals. There was a major scandal at a hospital not far from Mthatha where the rate of infant deaths was exceedingly high. The person who reported it was fired, and the deputy minister of health was let go after she went there unannounced to investigate. There is no political will here to fix the problems with the public health facilities, and people will continue to die as a result.
After another long, bumpy ride we arrived back at the house. It was now time to head into Mthatha and make sure everything was lined up for the food parcels. Spiwo still hadn't found a truck, so that was top on the list. He wanted to first stop at a hardware store and check on windows for the new church, so we went to a local supplier. There in the parking lot was a truck for hire, just like it was waiting for us. The only concern was that it was an open bed truck and it was raining. But, we made a plan and bought a plastic sheet to cover everything. It was all set.
After checking on the windows we went to the food store. As we drove in the parking lot, Spiwo spotted another truck for hire, this one with an enclosed bed. It was available, and actually cheaper than the other. We worked out an arrangement with the first truck and they left. So everything worked out there. Not quite the same story inside. To Spiwo's shock, nothing had been pulled yet. The manager on duty didn't even know about our order. They got it figured out, though, and we left feeling okay that it was going to work. Back to the ranch.
A few hours later, the truck arrived. We had ordered 72 of the following:
- 12.5 kg (27 pounds) of flour
- 12.5kg of samp (a form of whole-kernel corn used like beans)
- 12.5 kg of mealie meal (corn meal)
- 10 kg (22 pounds) of sugar
- 12.5 kg of rice
- 5 kg (11 pounds) of beans
- six-pack of long-life milk (the kind that comes in a box)
It was a ton of food. Actually, six tons. These parcels would feed a typical family for 2 to 4 weeks, which was a long time when a food supply was not guaranteed.
Using a fire brigade line, we had the truck unloaded in about 20 minutes. By the time we were done people were starting to queue up for the 4:00 start time. There was a sense of celebration in the air, even with the drizzle. At 4:00 Spiwo started reading names, and a group of local boys would make a pile of the various items (the had it all choreographed so that the pile would be exactly the same in every case). It was then up to the recipient to figure out how to get it home.
It was actually fun to watch. A large number of wheelbarrows had miraculously materialized, and most people loaded up their items and walked off. Others brought along a group of friends or family and simply divided the load. A number of women carried items on their heads, just like you see in National Geographic. I tried doing this with the bag of samp, helping a woman who lived about 200 yards up the road. It took all of my balancing ability to not fall over. She carried two items on her head, and even managed to pick up her baby halfway up the road. I was in awe.
After 40 minutes, it was all over. Only three parcels were left over, from people who didn't come. Their food would go to others in need.
We had a guest for dinner that night. Spiwo had met Francis a few years ago. He's a magistrate in the Eastern Cape, similar to what we'd call a district attorney. He was born into a very poor, dysfunctional family. His mother left when he was a young boy and he never knew her. His father was around but not a large part of his life. He was raised by his grandmother, along with a couple other children. His grandmother had a fruit stand outside the courthouse in their city, and Francis used to help her before and after school. He said he used to watch the men in their robes and wonder what it would be like to be one of them. His grandmother constantly encouraged him and made sure he finished school. He struggled to get accepted to university, but with a tenacious spirit he managed to get in and be accepted to the law track.
His first day at work came before he actually graduated. He only went to ask for a job. It so happened that there was a crisis in the court that day and no prosecutors were on duty. The woman in the office asked him if he was really a lawyer, and when he showed her his transcripts she said to "go home and get your robe and report for work." He was trying cases that afternoon. In the very same courthouse outside which he once sold fruit. In the very same robes that his idols wore. He was ultimately promoted to magistrate and now manages the district that Mthatha is in.
His story was very inspirational. Spiwo is trying to being him to Cape Town to speak at church. I would be happy to hear his story again.
After dinner it was time again for reading and sleeping.
Next up: Finishing up and heading home.
Tuesday, October 23, 2007
We started the day by visiting the local primary school. It's a public school, fully supported by government. The building is fairly new and in decent shape. It has four classrooms, plus one room that serves as a classroom/office/teacher prep room. It's set on a large piece of land, so the kids have room to play during their break periods. The school is for children in grades R (kindergarten) through 9; high school is a distance away. There is a uniform, blue sweaters over white shirts and either blue skirts or slacks, and most of the kids had one on (I'm assuming those that didn't couldn't afford them).
Class sizes were about 30-35. Three grades are combined into one room. Grade R was by itself, then grades 1 to 3, 4 to 6 and 7 to 9 were put together. There's a single teacher for each grade combination, making it almost like an old one-room schoolhouse.
I was impressed with the desks and equipment in the classrooms, and the presence of books and workbooks. I haven't seen this at the other schools I've been to. However, even though it sounds ideal it has its issues:
1. Truancy is very high. A lot of kids drop out after grade 8 or 9, most because they either don't see the point in finishing or because they have family responsibilities that keep them home. I also saw children just hanging around every day, with no excuse for not being in school.
2. Teacher attendance is hit or miss. There are apparently days when the only people in school are the children. Spiwo and others think this is because the teachers are not educated well enough to handle the higher grades and more complex subjects. (Under the apartheid regime, blacks were taught in separate schools that lacked basic materials and used lesser-trained teachers. Blacks were only educated to grade 8, which was enough to give them skills to be a labourer in the mines or factories. Teachers obviously went on to higher education, but again it was not to the level of the white students. Now that the curricula are standardized and the blacks are being held to the white standards, the teachers are finding it difficult to handle the higher grades because they never went through them.) They are also paid quite poorly, so many stay home because they can.
As you can imagine, these problems are creating real barriers to the kids' abilities to move up and out of their rural existence. There's also a lack of technology and lessons on its applications. The kids have never seen computers, let alone use one. And the Internet is just something they've maybe read about (I helped a teenage student at the Centre yesterday who had never heard of the Internet. He would definitely be lost in an American school). And again, no one seems to be standing up for them and forcing teachers or the government to make it right.
The school was started by Thozama Gozo about 10 years ago. She had a daughter who was not performing in school and Mrs. Gozo knew something had to be done. She started the school in a rented space, but due to a lack of funds it soon landed in her house. She had about 20 children then, sleeping in four bedrooms along with her biological children. Eventually she was able to move it to a private building. About 3 years ago the government found out what she was doing and came through with funds to build a proper school on a large campus. The students now number 240 and the school is maxed out. The age range is from 6 to 21 - even though she isn't supposed to keep them after 19, she said since there's no place for them to go she ends up keeping them longer.
The school's objectives are to teach the children normal subjects as far as they can go and to train them on a marketable skill. Most of the kids learn needlework (sewing), art, or beadwork. She is starting a woodworking program right now, with a focus on cabinetry. She tries to customize programs, though. She has a couple students who are sports prodigies, so these kids spend their time improving their skills with the goal of joining a semi-pro team and earning a living that way.
Because there aren't homes for learning disabled adults, Mrs. Goza is now planning for a group home nearby the school campus. When the children reach 21, they can move to the group home and get a job. She still has a lot of work to do, but if the school is any indication I think she'll have the home running in no time.
From Tsolo we went to Xolani's village, Elucwecwe, outside the city of Ngcobo (I can't print a pronunciation guide for these, because the "c"s are click sounds. El-you-tswe-tswe and Ntso-boh would be close). Elucwecwe is a picturesque village, situated in green rolling hills. As with all things rural, though, the beauty comes with a price. This village is not electrified, and most homes do not have running water. There are taps, but they only work part of the time and people are forced to walk to the river for water. As in Malungeni, the homes are mostly rondevals with some square side buildings thrown in. Heat and cooking is done over fires - one of Xolani's family's rondevals has a fire circle in the middle of the room where they make a wood fire. Seeing this and smelling the ever-present smoke and soot and you quickly realize why asthma is the one of the biggest health problems in the rural areas.
We actually went to two homesteads in Elucwecwe, because Xolani had a split childhood. It's a very interesting story:
Xolani's mother was not married to his father. His father was the village chief and already had a wife and family when he met Xolani's mother. She was the daughter of a white, Jewish shopkeeper in the area, who married a local black woman. This makes Xolani's mother both coloured and part-Jewish, two things Xolani didn't know about until he was in his teens. (Xolani's sisters actually have the facial features of a European lineage and a lighter skin colour. They probably would have been classified as Coloured in the apartheid era.) His father, the chief, was very wealthy with lots of animals and a large homestead (the two rondevals pictured left are just part of his buildings. Look at their size in relation to the car, and then look at the mother's, above). Food was never an issue. The chief had 6 children with his wife, the last of whom was born in 1964. He then had 5 children with Xolani's mother; Xolani is the youngest, born in 1976. All of the children lived with their father, while Xolani's mother lived on the other side of the hill (it's not very far as the crow flies, but it's a long distance relationship-wise). Her homestead is the one pictured above.
It was only when the chief died in 1987 that Xolani and his siblings drifted back to their mother. For a long time growing up Xolani and his siblings felt that their mother had abandoned them since she played no real role in their young lives. It was only when they moved to her small homestead that they discovered the sacrifice she made in trying to give them a better life. He told me that "for a long time we thought our mother did not love us, then as we grew older we understood she did what was best for us."
Xolani's three sisters still live in Elucwecwe; his brother passed away in 2006. One of his sisters is a traditional healer (she's in the middle in this picture), and the others are working as wives and mothers. Xolani recently found out he has a half-brother from his mother's first marriage, although he doesn't talk a lot about him.
Xolani is one of the nicest guys you'll ever meet. He is always smiling, and is usually at the centre of a conversation about soccer or other sports. Even though he only completed the eighth grade, he is an astute businessman with a small taxi business in Gugulethu. He had a difficult time with school, not because he isn't smart but because the demands of the household got in the way. For most of his school years he could only attend classes every other day. This is for two reasons:
1. He and his brother had to take turns caring for the animals
2. He and his brother had to take turns wearing the school uniform and shoes
I can only imagine how far he could have gone with a high school diploma and college education. Maybe some day he'll be able to do that.
When we got back to the house, we joined a meeting Spiwo was having with some of Malungeni's local leaders, including the village chief and the school principal. The subject of the meeting was a proposal the chief is making to an international volunteer program to bring people to Malungeni. They would help with several income-generating projects in the village, as well as with the school and another pre-school program that's run from the community centre. It was an interesting discussion, with Spiwo driving home the point that the community must take charge and drive progress. He is very worried that the people will not work with the volunteers and the programs will just fall flat. The meeting finished with everyone agreeing the proposal needed to move forward and that the chief would drive things. We ended up finishing the proposal on Friday and bringing it back to Cape Town for faxing.
The chief's story is also dramatic. He is a young man, maybe 30 years old. He inherited the post upon the death of his father a few months ago. His father was apparently well respected and had his hands on the pulse of the community. He had a vision for moving Malungeni forward and was usually able to rally the people to support that vision. His son, the new chief, is quiet, almost withdrawn, as if he doesn't really want the post. Spiwo thinks that he may not get the support his father had because then he will fail and the chiefdom will be available for someone else to assume. Considering the chief gets the spoils from contributions to the community, it's a job worth having and several people would vie for it. The next few months will be key, especially this proposal which will bring a couple hundred Americans and lots of skills to the community. I hope he can make it work.
After a nice dinner it was time for reading and sleeping. I didn't work out all week, and got 8 hours of solid sleep every night. I haven't done that in many, many years and it felt great.
Next up: Don't Get Sick in Malungeni - A Visit to the Local Hospital (don't panic Mom, it was just a tour)
Monday, October 22, 2007
This was the day to relax, since there wasn't much happening. We did have to go into Mthatha to make arrangements for the food parcel distribution on Thursday, but other than that it was easy living. So we started the day by driving around the village to get acquainted with the surroundings.
Spiwo and I first went to the site of the new church that he's building (with the support of some US-based churches). It's an impressive brick building that will have a main hall and round entry area where they can have a pre-school or Sunday school. Spiwo was a little concerned about how the roof was put on. Originally it was supposed to rest on the brick walls like a normal roof would do. However, the builder didn't think that would work so he constructed a frame out of beams and built the roof on that. That created a sizable gap between the top of the walls and the roof that will have to be bricked in. The builder thinks this will take about 18,000 more bricks at a cost of about R30,000 ($4,300) plus labour. Financing that is going to be tricky, but Spiwo seems to have a way in mind. In any case, there's several months of work left to be done before the church is ready for its dedication.
I also had the chance to look closer at the homes. Historically, Xhosa people have lived in round houses called rondevals. Most are about 20 feet in diameter and are made of bricks with plaster overcoats. There are still some in the village that were made from sticks laid horizontally with mud placed in-between. These don't hold up nearly as well as the brick ones, though. The bricks were traditionally made of mud from regular soil and dried in the sun. Sometime back the people learned to add cement to the mud and it made for a much stronger brick. Now the homes are expected to last for decades. (There are brickyards along the river just outside Mthatha. The men take the thick soil from the river banks and press their bricks, allowing them to dry in the sun. The bricks have a deep red color. Sadly, while the bricks are pretty the river banks are being destroyed by all the excavation. Erosion will probably occur soon, and the brick makers will need to move elsewhere.)
The older rondevals have thatched roofs made of grass cut from the local fields. Newer ones, or those with roofs that need replacing, have corrugated zinc roofs. (Note the two in the picture above - one has a thatch roof and the other a zinc roof.) The zinc allows the homeowner to collect the rain using gutters and pipes to shunt the water to huge holding tanks. One tank probably has enough water for a month, given that they homes don't have showers or toilets (or washing machines, or dishwashers, or any other modern appliance). Accompanying the rondevals are small rectangular, one- or two-room structrures. Sometimes they act as a bridge between two rondevals, and other times they sit on their own.
The great thing about the villages I saw is that people take the time to paint their homes. This is very different than Cape Town, where many of the homes' exteriors are faded, peeling, or just run down. Every home is a different colour - orange, turquoise, yellow, white, blue - so they create quite a nice picture when seen from afar. Almost nice enough for a postcard. And, there are very few power lines to obstruct the view.
Because, of course, not all villages have electricity. Malungeni is lucky. They had power lines installed about 4 years ago. Now, assuming they can afford the power, every house has light at night. I noticed a couple TV antennae, but only a couple. I never heard music coming from any of the homes, so I'm guessing most people don't have radios, either. It was very peaceful walking the roads, with only the sheep and goats making noise.
Most everyone in Malungeni has land. They are granted property by the village chief. He decides who gets land and how much they receive. Most people appear to have a plot that's about 20 yards by 50 yards, maybe a little bigger. Some have considerable more. In any case, the plots are large enough to have a vegetable garden and keep some animals. People with the smaller plots usually have chickens, goats, and/or sheep. The folks with the larger plots can also add cows (steers, really) and horses. Again, this is assuming people can afford them. Chickens, bought as chicks, cost about R2 ($0.30) each. Sheep and goats run about R700 ($100) each. Cows are about R5000 ($750), as are horses. Feeding is not too expensive, since nearly everyone takes their animals to communal pastures to graze. Because of the limited grazing area and the number of animals, the fields are seriously overgrazed. But, since there's no alternative, people keep on using them.
The fact that people have land and can grow some food makes it quite different than Cape Town. Here, having land is not guaranteed. If you do have it, you have a very small plot with just your house. You can't grow anything on it, and you certainly can't keep a cow there. Sure, you can sell your plot and house to make money, but chances are you will never get a title deed again in your life. Some people do raise goats in the township, but only because they can wander through the trash heaps on the side of the road and get their food. If it were me, I'd rather be in the rural area where I have a chance at survival.
(Spiwo has talked with people who have a differing viewpoint. The best, or worst, reason to be in Cape Town came from a young man who moved here from the Eastern Cape a few years ago. He said, "When you live in a rural area and have nothing, you have nothing. When you live in Cape Town and have nothing, at least you know you can find a rubbish bin that has pizza in it." That just about says it all.)
After the church, Spiwo took me to meet his mother. She lives just up the road from the bunkhouse. She has two rondevals and a large house on her property. We found her in bed, not because she was sick but because it was cold and rainy outside and she wanted to be warm. She is a very pleasant woman, with a friendly manner and a great smile. Spiwo has been trying to get her to move somewhere better but she doesn't want to go.
After that we headed into Mthatha. Thebo came along with Spiwo and I just to have something to do. Since Spiwo had about an hour's worth of errands to run, he dropped Thebo and I at the shopping mall to look around. That took about 5 minutes, so we headed outside to walk around the town. Mthatha is a decent sized city, relative to the area, but it's still small, about the size of downtown St. Paul. For being a big city there are surprisingly few big city stores there, certainly not any chains that exist in Cape Town. Most of the shops are independant, family-owned stores, many originating our of Durban (which is only a few hundred kilometers away). To say that the assortment of products is eclectic wouldn't describe it. A store can have clothes, bikes, stereos and stoves, all in a space the size of my living room. They're more like surplus stores than proper shops, with everything crammed into small spaces.
I also saw something I haven't seen in Cape Town: a row of men with wheelbarrows waiting to help people with their purchases. Most people arrive in Mthatha by taxi, minibuses that hold 12-15 people. When they finish shopping, they need to haul their packages back to the taxi rank to catch a ride home. The wheelbarrow men are available for hire, for a few Rand, to be the mule and cart. The taxi drivers pile everything on top of the vans - we saw more than one with 25kg bags of mealie (corn) meal and flour with mattresses stacked on top of that. And they still drove at breakneck speeds down the rural roads. Yikes!
When Spiwo picked us up we headed over to the store to sort out the food for the parcels. We arranged to have the items pulled and ready for us on Thursday. Spiwo was a little worried about finding a truck to haul the goods to Malungeni, but he "had people working on it" so everything seemed to be under control. We headed back home to have a leisurely afternoon.
When we arrived we found that Xolani, the Centre's driver, and Niwo, the man who handles fumigation at the Centre, had arrived from Cape Town. They drove, taking about 15 hours to reach Malungeni. Niwo is going to teach the house's caretaker the proper ways to handle pest control. Xolani came to help with the food parcel program (and to drive Niwo). So, we have a pretty active house now. Xolani has offered to drive around tomorrow, which should be a very interesting day.
Next up: Schools, reunions and future plans.