Saturday, January 26, 2008

Tough Decisions, No. 2

Well, summer came this week. It's been hot most of the week, with temperatures in the 90s. Thankfully the humidity is relatively low, and we get some nice breezes. It does cool off at night (into the 60s) so sleeping is fine. Of course, none of the office at the Centre are air conditioned so it gets a little tough to work in the afternoon. Especially after lunch. They should have nap time just like we did in kindergarten. At least the clinic pharmacy is air conditioned, even if it is kept at igloo levels.

We had 12 students from Bethel University (Minneapolis) at the Centre this week. They spent two days learning about our programs and visiting children. The other two days they were out doing service projects, like working in a community garden or spending time at a home for disabled children. They also spent three nights in Gugulethu with people in our congregation. From all reports they had a great experience. It was fun to hear about their experiences and how they will take it home to family and friends.

They did have one difficult visit. Yvonne and I took them to meet and talk with children in three households. The first two, Priscilla's foster home and Noloyulo, went fine, as they usually do. Then we went to see Yolanda. She is the 18 year-old taking care of two siblings and a cousin. After exchanging hellos, I asked her to talk about her challenges. She took a breath and then the tears came. She only lost her mother six months ago and is still figuring out how to cope. Yvonne and I, having been through this a few times, let her cry and regain her composure. The Bethel students, though, didn't know what to do. They ended up sitting quietly, too. Yolanda left the room for a couple minutes to wipe her eyes and collect herself, and when she came back she was back to her old self. (We found out later that she had not passed 10th grade last year and has to repeat it this year. That was adding to her stress, as it is a real possibility that she will not finish high school and be stuck in low-paying jobs, if she can even find one.)

We talked about this when we returned to the Centre. The students said it was very difficult to watch her cry and not know what to do. Their leader, Leon, asked what they would have done if that same scenario had happened at home. They agreed that they would have gotten up and hugged Yolanda and tried to take some of the pain away. When Leon asked why no one did that, people talked about not knowing if it was appropriate. It was interesting, in that we all set aside our normal ways of compassion and empathy even though we felt we should have done something. I think if it were to happen again the students would risk a cultural faux pas and give her a hug. I think I will, too.

I saw another difficult situation play out this week. Marvin, my friend who does the silk screening, has been diagnosed with TB for the third time. He started treatment last week and has been having some problems. Besides being weak from the TB and HIV, the new drugs have been causing him some side effects. He's not eating well and is having difficulty taking care of his house. The fact he has a 10 year-old son staying with him makes it worse, because he can't handle the cooking and washing and schoolwork.

Marvin has a brother in Botswana, a lawyer who has a good job. He has offered to take Marvin's son for an unlimited time so that Marvin can get healthy and try to get his business back on track. The decision has really torn at him – he wants to take care of his son very much but knows that the boy's quality of life will really suffer for the next several months. So, Marvin decided to take his brother's offer. He'll be taking his son to Botswana next week. I haven't asked his son how he feels. Chances are, he won't say too much. Kids get moved around a lot here as people get or lose jobs, get sick or healthy. (I also just found out that Ntombikayise, our technician in the pharmacy, took her 18 month-old boy to live with her sister in the Eastern Cape. She misses him a lot but she didn't have a choice because of the costs and lack of child care if he's sick. She is hoping to bring him back in March but there's no guarantee of that.)

I really feel for Marvin. But, he thinks it's the best decision for his son and I tend to agree. Marvin will need at least a couple months to regain his strength and he'll have a hard enough time caring just for himself. Hopefully they can be reunited again very soon.

More to come. (And five more weeks to go...)

Friday, January 18, 2008

Fluffy the puppy, RIP

I got word late yesterday that Fluffy did not survive his accident. The man who hit him took him to the vet yesterday. The vet said the operation to fix his foot would cost R1,500 and he would still have a problem walking. Lydia could not afford that. So, Fluffy died a few hours later.

The man who hit Fluffy told Lydia that he will buy her another dog. I don't know if that will really happen or not. If it does, hopefully they will tie this one in the yard.

More to come.

Wednesday, January 16, 2008

Tony Zappa, Veterinarian

It's been a very busy, physically exhausting week at the Centre. As I mentioned before, we have 12 students from the University of St. Thomas with us. They came last week for 2 days and were back this week for 3 days. They have been a real treat, some of the most mature college students I've met. They were all hand-selected for the trip, so we got the cream of the crop and it shows. They've spent 3 nights in Gugulethu, staying in the homes of 6 JL Zwane parisioners. It's worked out to be a great experience for both sides. They've been sharing meals and stories, learning about real, everyday life in the townships and America. I'm a little jealous that I haven't done that.

One of the things these students did was raise money for a special food parcel drive. They raised $8,000 with the plan to feed 200 families. So, yesterday we spent the full day making this happen. We started the day at Makro, basically watching the cashier check out our items. Makro did a great job this time - they had everything pulled for us and on carts, ready to wheel out the door. About an hour and R42,000 later we were ready to go.

Too bad the truck wasn't.

I just don't understand how truck companies survive here. I set an appointment for 10:00 and confirmed it again on Monday. Apparently, our driver showed up at 8:45. He couldn't find us (since Makro didn't open until 9:00 and we weren't there yet!) so he decided to take someone else's order. When it came time for our delivery, there was no truck to be found. I called the company owner, and it was the same old song and dance as in December. "We'll be there just now" (translated: we're a couple minutes away) was the mantra of the morning. Unfortunately, it took 90 minutes of "just now" before our truck arrived. I was a little smarter this time and built in a time buffer, but it still would have been great to have that time back. At least this guy knew how to quickly load a truck. We had everything on board in less than 30 minutes and were on our way.

Back at the Centre, it was controlled chaos as usual. We did the usual fire brigade to offload, and it was fun to watch young adults who had never thrown a bag of flour figure out how to do it without killing themselves. Siyaya and other staff helped fill the buckets, and we were done in record time. We ended up making 180 parcels, due to some hidden costs and exchange rate hedging.

After a good lunch it was distribution time. Unlike December's program, this one was focused on people in the hospice program and a special list of "grannies" that Spiwo developed. The grannies are home-bound women who are still raising children and grandchildren, many of who are struggling with HIV/AIDS. Also different was that fact that no one came to get their parcels. We had to deliver every one. In the end it was good, though, because the students were able to ride along and meet many more people and see many more homes than I originally planned. They all came back with a good perspective of what reality is like for people in Gugulethu, but also how little it takes for people to survive, and quite happily with gratitude, at that.

My muscles were really creaking this morning, even more than in December. I didn't feel so bad, though, when I saw the bigger 20 year-old guys walking slowly and stiffly. We all agreed that the Centre should have a masseuse on call for parcel days.

The students head back to Minnesota on Saturday. I hope they can all come again and spend more time.

I had a sad experience this afternoon. I took a food parcel to Lydia. She is really struggling, partly because last month about 6 or 7 of her family moved into her mother's house unexpectedly. They now have about 10 people there, and no one is working. They are trying to survive on an old age pension and a couple child-care grants. Needless to say, it's not a happy situation. But that's not the sad event of today.

Lydia got a puppy for Christmas. I don't know the breed, but it will grow to the size and look of a small beige German Shepherd. I'm not sure if it's officially hers or Neo's (her son). But, Fluffy is a welcome addition to the family and they've already fallen in love with it. Today the dog was playing outside, unleashed of course, and it ran in front of a car. Fortunately, the car was able to brake in time. Unfortunately, the puppy's back left paw got caught under a tire. All of the skin and muscle on the top of the foot is gone, and from around the ankle as well. It looks really bad.

There are no emergency vets here, so Lydia asked me to look at it. When she took the bandages off, my first thought was that foot needed to come off. The tendons and ankle bone are clearly visible, and the skin around the toes is gone. The foot was still sandy and dirty, and infection is a real possibility. I told her that I didn't think the puppy had a good chance, but if we could clean and dress the wound it might help until she can get to a vet tomorrow morning. About this time the man who hit Fluffy came back to the house. He had been to a pharmacy and bought some medical soap, antibiotic ointment and a bandage. So, we took Fluffy outside and carefully cleaned out his foot. I cleaned, he screamed. It was very sad. I got out as much sand as I could, and then proceeded to lather on the ointment. It smelled disgusting, so it must be good (how's that for a pharmacist's recommendation?). I wrapped it as best I could, trying to keep the skin flaps together and covering the open spots. At one point I considered putting in some stitches, but Lydia didn't have a needle and thread. That was probably a good thing, for both Fluffy and me.

The man is going to take Fluffy to the vet in the morning. I hope he's still alive and that the foot can be saved. I have a bad feeling, though, and if there's any chance of a bad result it would be best to put it down now. A crippled dog would not fare well in the rough and tumble world of township canines.

There are two somewhat remarkable things about this situation, to me:
1. How one hurt dog can raise emotions that become buried after seeing despair every single day. I'm embarrassed to say that I haven't felt that much sadness in quite a while, even though I see and talk to people in sad and dire situations all the time. Maybe it's because Fluffy didn't have way to help itself and was totally reliant on us humans to survive. Maybe it's because Fluffy is barely three months old and totally innocent to the ways of the world. Maybe it's because I've been here too long and stopped really seeing the despair and innocence in people's eyes. It's shaken me up a little, and I'll have to come to grips with that.

2. How people living in the most desperate of situations can still have the capacity to love and care for a pet. These are people who often don't know where their next meal will come from, yet they take a portion to feed their dogs and cats. And no, we shouldn't deny them the opportunity to pass their love and caring onto an animal if they so choose. It may be difficult, but the unconditional love and affection they get in return may be the only comfort they receive all day.

More to come.

Saturday, January 12, 2008

Back to Normal

Well, after the events of last week I'm happy to say this week was fairly normal. The T-Mobile saga is still continuing, with additional international roaming charges still showing up (I guess there's a delay because of how networks bill each other. And they're supposed to be technology companies?). But, we're moving on.

Of course, by normal I mean that the poverty and illnesses still continue. I spoke with two people yesterday, two I'm fairly close to (and won't name for confidentiality reasons), and they are both battling significant diseases on top of their HIV/AIDS. One is dealing with breast cancer and is due to have surgery on Monday next week (14 January). She's lost some weight since I saw her before Christmas, and she's feeling very run-down. She's very worried for her children, who have their own challenges. I'm hoping she comes through the surgery well and gets good news on the tumor.

The second person just found out that he has TB. For the third time. He looks very thin and weak, which would be expected since he hasn't really eaten in several days. He should get the results of sensitivity tests next week to show which medications will be needed. I'm hoping he can take the basic regimen again, because it's only 6 months long. If he ends up with drug-resistant TB it will be at least 9 months, and could be as long as 12. He's also worried about his son, a bright 10 year-old. He asked if I thought his son should go to stay with his mother (the child's grandmother - his mother died from HIV a few years ago) for a month or two so that he can get stronger. I really didn't have a good answer - sure, it would be good, but sending the boy to a different part of town where he doesn't know anyone could create all kinds of new problems. I've learned the law of unintended consequences is multiplied in Gugulethu, and it's very, very hard to predict what could result from seemingly simple decisions.

I've also had to reopen the bank over the past couple days. It seems people have been waiting for me, including my pal Maxwell (from the hospice). I don't mind, really, it's just that some folks have come to depend on me to a level I'm uncomfortable with. I honestly don't know what they'll do when I'm gone for good - if you believe their stories they will not have food or clothes for days to weeks at a time. I know that's an exaggeration, and that people will survive just like they did before I came. But it is stopping some people and making them think.

The Centre has been hosting some students from the University of St. Thomas (Minneapolis) this week. They are spending two weeks in Cape Town as part of a theology class. Their objectives are to study how God exists in South Africa, how people have dealt with religious issues during and after apartheid and how AIDS has impacted the work of the Church. Their days run from 8am to 8pm or later, with all kinds of reading and movies and lectures. I'm very glad I'm not in the class! They spent two days around the Centre learning what we do and hearing Spiwo's thoughts on "Where is God" in the context of the townships and South Africa's history. (Actually, he spoke more about "Who is God." This seems to be the basis for many of the world's disagreements these days. I have to admit wrestling with this question myself on many occasions, and I still haven't found an answer.) The students also saw the clinic and spent some time touring the township. Next week they stay with township families for three days, which should give them a unique perspective on real life here. They also raised money for food parcels, so we're having another food parcel day on Tuesday. Let's hope we don't have any truck issues this time!

The clinic is slowly starting to get busy with people returning from holiday. Most people returned last weekend and the rest will probably come back this weekend. So far it's been okay, and I'm hoping this coming week won;t be too out-of-control.

More to come.

Friday, January 04, 2008

I'm Baaaack!

Boy, was that a fast two weeks! I had a great time at home, even if it did snow every other day the whole time. I shoveled more snow in two weeks than I did all of last year. Okay, maybe not, but it sure felt like it. The cool weather was a refreshing change from summer heat - I'm not sure which is worse, an unheated apartment in the winter or an uncooled one in the summer. My wife recognized me at the airport, which was a good sign (my hair was a bit longer than usual, but that didn't seem to matter). The dogs weren't sure what to make of me for the first couple days, but they eventually settled into the old routines of tug-o-war and treats.

Re-entry into America wasn't as bad this time as it was when we moved back from Johannesburg. I don't think I was gone long enough. It is amazing, though, at just how many options we have for food, clothes, and a whole lot of stuff we buy but don't really need. I walked through the malls with new eyes, regularly saying to myself "That looks nice but I don't need it." That's a big change for me - in the past if I saw a nice shirt, I'd buy it. Even if I had one kinda like it already. Now I just think I'll wear the old one and move on.

At the grocery store, it was almost paralyzing at times. I'm used to having just a few yoghurt choices. I must have stood in Cub's dairy aisle for five minutes trying to pick from the 30 brands they have. Fruit on top or on the bottom? Fat free, low fat, or regular? Low calorie or with sugar? Custard-style or normal? Yikes!

I did some price comparisons on clothes and food. South Africa is actually cheaper on most basic items, which surprised me. For example, coloured t-shirts: they were $5 at Target and are only $3.50 at Woolworths (the upscale store). I can get them for under $3 elsewhere if I bother to look around. The same is true for slacks, shirts, and non-name brand items (Levis are outrageously expensive, but store brands aren't). Most food items are cheaper here, including milk, bread, meat, and most canned goods. Of course, non-commodity items are much cheaper in the U.S. Electronics, books, and cars are all much cheaper. And the U.S. stores have broader selections than South Africa, with higher quality. The biggest economic difference is salaries, which are 1/3 to 1/2 the amount here. So, even with the low cost of basic items, it's an expensive place to live if paid locally in Rand.

I spent a couple hours at the Centre today catching up on some e-mails and getting the new gossip. Not much had happened while I was gone, except one key passing. Mama Bopape's husband, who was struggling with a whole host of conditions including diabetes, high blood pressure and TB, apparently had a stroke and died on December 26th. He had been having a very difficult time with his health since about June 2007. I visited him in August and he was pretty weak and very thin. In November he had a spell of very low blood sugar and was hospitalized for a couple days. I saw him not long before I left and he was doing much better. We had a nice conversation, and he seemed to be more mobile than in the past few months. I spoke with Mama Nqo today and she said he was continuing to improve, but suddenly changed just before Christmas and never recovered. To add insult to injury, his sister also died last week (on the 31st), very unexpectedly although she had had HIV for a long time. Needless to say, there was a lot of sadness in the house. Funeral services are tomorrow and I expect there will be a lot of crying.

I also had a little excitement when I got back to my apartment. A friend from Minneapolis and his partner had been using the second bedroom in my apartment while I was away, starting about 4 days after I left. When I got back, I was surprised to see my bedroom in disarray. The closets were open, clothes were all over the floor, and items had been taken off my bookcase. When I asked my friend if he saw that, he said "Yes, and I thought it was a little funny. But, we thought that maybe you left in a hurry and didn't pick it up."

As you've no doubt guessed, I had a burglary. They must have had keys, as there were no signs of forced entry and the windows were all closed and locked from the inside. How they would have had keys I don't know, since I had both sets with me in Minneapolis. And my keys rarely left my pocket while I was here, except when I'd occasionally leave them in my backpack at the Centre (and no one could see them). It's possible someone took them and had copies made, but I think it's more likely that a previous tenant's keys got swiped or copied or that the security guards had a set. I did a quick inventory, and except for R1000 and my GPS device, nothing else appeared to be missing. I got away lucky.

Or so I thought.

Today, Cindy called me to say our cell phone account had been put on hold because the balance was extremely high. Like $7,100 high. She asked if I had my US cell phone, which I did because I used it while I was in Minneapolis. But, I forgot about my Blackberry (for those of you not up on technology, it's a small device you use to get e-mail when away from home, and it can also act as a cell phone). Sure enough, it's gone. In the two weeks I was away, someone made over 78 hours of cell phone calls from my Blackberry, each one at about $1.50 a minute. That's over 3 full days of phone calls. I managed to get some of it discounted, but it was still an expensive lesson.

A word to the wise: check your cell phone contract for you liability if your phone is lost or stolen. T-Mobile told me today that the customer is liable as long as the phone is not reported missing. Being 10,000 miles away from your phone for two weeks is no excuse. If you go away and don't take your phone, leave it with a friend or take the SIM card out of it so it's unusable.

It really could have been worse. If they truly had keys, they could have come when I was sleeping or any day when I was working. They didn't get my computer (I took it home with me), and they didn't steal the TV, stereo, DVD player, or a number of small items I had. Heck, they could have come back on several different days and cleaned out everything. When Cindy and I lived in Johannesburg we'd hear about whole houses being emptied, including carpets and curtains and woodwork. I now have new locks and no one else has keys, so I feel pretty safe and secure.

I have some busy days coming up. I know Yvonne is looking forward to having me back, so there should be some good stories there. There are two college groups coming in January, one from the University of St. Thomas and another from Bethel University (both, coincidentally, from the Twin Cities). And, a third group is coming in early February, this one from Belfast. All that plus covering at least one week's vacation for Tami at the clinic in addition to my normal schedule. My last two months (8 1/2 weeks but who's counting?) should go very fast.

More to come.