Ready, Set, Go: Start of Work and Homestays

After 5 days in Durban, Elizabeth, Lauren, and I set off for our placement in Manguzi, a rural town about 9km from the South African border with Mozambique. What we thought would be a 4 hour bus ride to get here actually took 7 hours. The bus was hot and crowded with people coming back from Durban to their rural communities. We drove through the beautiful South African countryside and saw small villages, mountains, lots and lots of sugar cane fields, a paper making factory, pineapple fields, a massive dam, one elephant, and lots of monkeys, chicken, cows, and goats.

Manguzi is a bigger town than I thought it would be. We were surprised when we got off the bus at all of the people milling about the market. Our host mama is very nice and friendly. She is a young, single mother with a daughter in middle school. She shares a house with her sister and her sister's young son, and most of the rest of her family lives in houses nearby. The family has been very welcoming and has been helping us with our very limited Zulu. We don't have running water at the house, which has been an adjustment. It is making us very aware of exactly how much water we use.

We started our work at the hospital this week. It is an interesting dynamic because we are coming in as foreigners without specific trainings or qualifications. Thus far, we have been shadowing doctors and trying to help out where we can. Sometimes it is hard not feeling very useful, but at a very base level we are trying to be respectful and (as Zed puts it) “affirm the humanity” of the people we are interacting.

Thursday, May 26, 2011
“We had out second day of work today. We all went to a meeting with all of the doctors this morning. Lauren spent the day in the female ward and got to see a C-section. Elizabeth was in the maternity wing, and I was in peads for the morning and then speech and occupational therapy for the afternoon. Overall, it went well. In peads, I observed a doctor making morning rounds of the ward. So many children were malnourished. After the round was finished, the doctor suggested that I go to the "allied health" wind, where they have speech & occupational therapy and physios, as well as dentists and some other services in another building. I helped one of the speech therapists monitor the infants in the neonatal unit. She was checking their vitals and if they can suck/latch for breast feeding. After that, I spent most of my time with one of the occupational therapists. I observed some of her treatment, helped her organize the office, and went to a "stim" session for children in the peads ward. We worked on their gross and fine motor skills by playing games. At there request, I taught them the hokey pokey and the macarena. It was great to see the kids so happy because I had been on wards when they were evaluated in the morning. Based on some suspicious injuries, several of the kids (who are as young as 8) have probably been sexually abused.

Overall, it was a good first day. The hardest part is feeling somewhat useless. We are all learning a lot, but we are unqualified and do not speak Zulu, so it is hard for us to be very useful. The nurses translate, but I would love to communicate with patients more.”

Friday, May 27, 2011
I spent the morning in the female ward. There are so many patients with advanced HIV, TB, meningitis, and other opportunistic infections. It is sad to see so many young women dying just as their lives should be getting started. There is a somber air around the ward as the patients wait with for the doctor to see them. Many labor with each breath and watch with gaunt eyes and timid smiles as the doctor approaches them. I follow quietly behind, trying my best to offer an encouraging smile through my face mask.

While rushing through rounds and setting up the hospital ward for the weekend, one of the doctors had to make a decision about allocating the last units of blood the hospital had left, as the hospital was about to run out of blood. The hospital is larger and more well equipped than I expected, but it is still limited by scarce resources and challenges in infrastructure. For example, I went to the lab to print test results for a patient who was supposed to be discharged that afternoon and referred to another hospital. The printer was broken when I went to the lad, delaying the process until it was fixed or someone was able to make official copies of the results. As is constantly the case, you make due with what you can.

Transportation is another huge challenge for patients. The hospital has a fantastic network of clinics nearby, so patients are able to get treated by busy clinic nurses on staff, and doctors when they visit the clinics periodically. However, reaching medical care at the hospital or a clinic is often a journey. The hospital does have a bus that picks patients up at the clinics, but it fills up quickly and often because of timing, patients can only ride it one way, needing to find and pay for alternative transportation to or from treatment.

In the afternoon, I was working with the pediatric “stim group” again. Several of the children remmebered me from yesterday and had called me back to visit them when I walked past the playground coming back from work. The "stim group" is such a nice break for the kids. They stop being patients and being sick and get a chance to play, which is not only fun but also important for their development and overall well being. I love hearing them laughing and seeing them enjoy some time outside of the ward.

While I was working with the "stim group," I got a call from Elizabeth. OPD (Out Patient Department) had a patient from Mozambique and needed a translator. I was trying to explain and ask him about a hernia in Portuguese, which was challenging. My Portuguese is so incredibly rusty after not taking it since the fall. He got the point though and it was nice to be able to put my foreign language skills to use.

"Stylin" in Cape Town

Cape Town is a beautiful city in the southwestern part of the country. During our three days there, we managed to visit many important places in and around the city.

I have been keeping a journal with reflections on our experiences. Here are a few highlights from my journaling about Cape Town:

On Robben Island

Monday, May 16, 2011
“The highlights of the day were learning from the tour guides at Robben Island and conversations the view on the ferry ride back to Cape Town. Our tour guides were fantastic! Craige, a self-described young “coloured” South African and member of the “lucky generation,” gave a unique perspective on apartheid and race relations in South Africa. He thinks that significant social profess has been made, but the difficulty is that apartheid played on common weaknesses in the human nature/condition. Through physically separating people and engraining discriminatory ideas in the education system, the system taught the children growing up in it to be racist. All four South African racial groups, white, black, coloured, and Indian/Asian, had perceived notions or prejudices against the other groups. Changes has been made and continues, but the process of healing and opening people’s minds takes time. Craige’s generation is “lucky” to have grown up as apartheid was ended and the New South Africa began. But (naturally) there is still much more that this young country needs to do to move forward from its painful and difficult past.
Our tour guide inside the prison itself was a former inmate, who was arrested as a young student leader during the Soweto uprisings. He served five years in prison on Robben Island. At the end of the tour, I asked him why he chooses to do this work. First, he said he wants to thank the international community who protested, sanctioned, and used outside pressure to help tear down the apartheid system. Second, he said his work is part of a healing process for him, his therapy. The prison and his stories were somber, inspiring, and moving. However, there were moments when I felt unsure, almost guilty about all of the foreign tourists snapping pictures as he talked at this deeply important place in South African history.
Since arriving, I have continually asked myself why I am here and what the implications are of my being here? What was my role today as an American tourist? What will my role be once I begin my work at the hospital? And, what will my role be in seven weeks once I leave South Africa? I am constantly ruminating on these questions in an attempt to keep challenging myself and pushing myself to fully engage in this experience. As I prepared to come to South Africa, I was continually aware of the need for humility, open mindedness, and a respect for the people I meet here. This respect was a lesson that Zed began to teach us the moment we arrived here. Loading our luggage into the van at Oliver Tambo airport in Johannesburg, several men said “high ladies” and moved to take our luggage and load it into the car for a fee (although it was unclear exactly what they were going to do with the luggage). Zed looked at them and firmly said, “No, thank you.” Regardless of the fact that they were (in the words of Zed) “trying to hustle us,” it is important that we acknowledge their humanity and understand that they have been pushed to do this by lack of resources and/or desperation. This does not mean that we should allow ourselves to be taken advantage of. However, we always need to understand the humanity of those around us.
The guides told us the purpose of Robben Island is to be a place of learning. It is there as a memorial to honor the great leaders and activists who suffered there. However, above all, it a place meant to pass of the lessons of apartheid, so these important and challenging lessons can be shared and remembered. They were clear to state that Robben Island is explicitly a place of learning and remembrance, not a place where hatred or anger is perpetuated…
…The views of Cape Town by boat were stunning. The fog lifted as we neared the harbor, and you could see the flat, green, majestic top of Table Mountain. The sun was also starting to set, illuminating the clouds and the water. Cape Town is really a breathtaking city!"

The view of Cape Town as we took the ferry back from Robben Island

May 18, 2011
Two other highlights stand out from our jam packed three days in Cape Town: visiting the Cape of Good Hope/Cape Point and climbing Table Mountain. Cape Point is the southern most point in Africa and the place where the Atlantic and Indian Oceans meet. It was a warm, clear day, and the view was absolutely spectacular! The currents of the Atlantic and Pacific Oceans met, forming a subtle white line in the water and clashing shades of blue as the waters of different oceans rushes into each other. Cape Point itself is strong and weathered, home to a lighthouse and a lonely little building perched far down on the cliff. Although the fog did not impeded our vision, it waited on the water and merged on the clouds with on the horizon.
Cape Point, like Table Mountain, is an interesting mixture of incredible natural beauty and a carefully designed experience with shops, restaurants, and over priced t-shirts and souvenirs. This rather touristy atmosphere was part of the reason I was really glad Tom, Elizabeth, and I were able to hike up Table Mountain.
Because of heavy fog on one side of the mountain, we took a longer path that zig zagged up the mountain. We hiked for about two hours from the cable car base station to reach the top of the mountain. It was a challenging hike up a well-worn path with steep stone steps. About half way up the mountain we took a long break during which we shared some of our fears about the summer and challenges we anticipate. In the end, the hike ended up being about a lot more than just a physical challenge. It was very rewarding to finally reach the top and great to be able to experience the mountain in such a genuine, natural way - with few other people and without the shops and restaurant at the top of the mountain which felt a little out of place.

Cape Point / The Cape of Good Hope - "Where Two Oceans Meet"

May 21, 2011
We are currently in Durban for our last few days together as a big group before we start our work. Durban is a large costal city in the province of KwaZulu-Natal. The city feels distinctly different from Johannesburg and Cape Town. We are also getting acclimated to South Africa and moving away from the role of just tourists. The trip is shifting as we begin to prepare for our internships with orientations, lectures, and Zulu lessons. Early Tuesday morning we are leaving Durban to go to the hospitals we are working in for the next five weeks. I will be working at a hospital in a very rural part of KwaZulu-Natal - very close to the border with Mozambique. I was very excited to realize upon arrival that I will have an opportunity to practice speaking Portuguese with doctors and patients from Mozambique. Given the fact that the majority of the patients at the hospital will be speaking Zulu and minimal English, it will be great to be able to communicate with some patients more easily.

Sawubona, South Africa!

Sunday, May 15, 2011

Today was our first real day in South Africa. We spent the day in Johannesburg, a large, lively city full of contradictions. Smoggy clouds coated the city in a haze, blocking the persistent sun. The seven of us piled into our white van to begin our exploration and were slightly unnerved when Zed, our program director, pulled out onto the right side of the road. Later in the day at our backpackers lodge, I mentioned that we all thought it was a little strange being on the opposite side of the road. Andy, a fellow traveler, quickly chimed in, “You mean you were driving on the correct side of the road.

We drove along the “golden highway” around Johannesburg towards Soweto. Along the way, we passed massive mine dumps, large piles of earth that had been left as the land around the city was combed for diamonds and gold. Some of these imposing masses were long untouched and over grown, a reminder of the region’s mining history.
Driving around Johannesburg, there were clear pockets of poverty – tiny overcrowded tin roofed shacks, people huddled around burning rubbish in a neglected lot. However, there were also tidy brick houses behind wrought iron gates and large industrial buildings for local companies as well as more familiar brands like Tuperware and FedEx.

Driving through the townships, Jocelyn pointed out a noticeable difference from the United States: despite apparent economic hardship, all the areas we visited were filled with people – older men bundled in winter jackets, children playing outside homes, and large groups of women dressed in neatly pressed “church uniforms” of white, green, or blue. I compared this vibrant scene to parts of downtown Durham, which are also economically depressed, yet largely boarded up, abandoned, and devoid of people.

Apart from touring the city, our goal for the day was to visit two significant sites in the Soweto Township: the Hector Pieterson Memorial and Mandela House. Hector Pieterrson was killed in the student uprisings in Soweto on June 16, 1976. In a monumental moment in the anti-apartheid movement, the black students of Soweto protested the mandated teaching in Afrikaans. Young students were shot by policemen in what many consider an unprovoked and unjust attack. In the period following June 16th, violence continued and Soweto was in lockdown. Hundreds of people, including many children, were killed during this time.

Hector Pieterson was the first student killed and became a symbol of the brutality of the apartheid system. As I went through the museum, my mind continually wandered back to the Mississippi Delta. Jessica and I had many similar experiences last summer working for the Delta Center for Culture and Learning, where we learned about the Civil Rights Movement and visited many important places in the movement. There are so many parallels between the movements in both countries.

Our next stop in Soweto was Mandela House, where Nelson Mandela lived with his first wife and later with his second wife Winnie. They had a modest brick house, which was recently restored and turned into a museum. Our friendly tour guide was a South African university student volunteering as a part of his degree in tourism. He shared stories about the Mandelas and explained the different artifacts in their house. Perhaps the most intriguing is a signed certificate from different officials in the state of Michigan who apologized to Mr. Mandela for any role the CIA may have played in his arrest that lead to his 27 year imprisonment on Robin Island. The CIA allegedly provided the South African government with important information that lead to his arrest. All the tour guides at Mandela House were sure to mention the fact that former President George H. W. Bush refused to sign this apology.

After Mandela House, we had a delicious lunch at a local restaurant called Wandies Place. We met the owner Wandie, as well as other staff members who were very welcoming and offered us a buffet of fantastic food. There were many familiar dishes with local twists. We had chicken, beef, potatoes, a fermented millet dish, pumpkin, a local type of sweet potatoes, pop (essentially grits) with tomato sauce or chili, liver, trite (chitlins/intestines), a special local sausage, and other dishes. During the meal, we chatted with Zed and watched a political rally for the African National Congress (ANC). This is the political party in power led by current South African President Jacob Zuma. He was trying to energize voters before municipal elections next week.

Our brief time in Johannesburg ends early tomorrow morning when we fly to Cape Town. Overall, it has been a fantastic start to the trip. Our first week here is pretty structured, allowing us a chance to get acclimated before starting our internships. We have a chance to visit local attractions and landmarks, learn about the history and culture, learn some Zulu, and importantly, learn how to get around and gain some street smarts in South Africa.


*Pictures and updates from our time in Cape Town are coming soon!

**For anyone who has been following this (aka my family), I apologize for not doing a better job chronicling my semester at UNC. Between overloading with classes, my job, and joining the water polo team, I did not have nearly as much free time as I thought. Overall, it was a great semester that challenged me socially, intellectually, and academically to step outside of my comfort zone and the type of things I usually do. At times it was difficult balancing life on both campuses, but I really enjoyed the opportunity to try something new.