Lessons From Life and Work in Manguzi

June 6th and 12th, 2011

“Ikanda, amahlombe, isifuba, ukhalo, andolo, zinzwani, andolo, zinzwani.” The children sang together, happily pointing to the appropriate body parts. We were singing the Zulu version of head, shoulders, knees, and toes, which when literally translated is actually head, shoulders, chest, hips, knees, feet. I could now pronounce the words appropriately and had six new words to add to my gradually increasing Zulu vocabulary.

It was a sunny Monday afternoon and Kooli, one of the translators, and I were singing in a circle with a smiling group of pediatric patients. This stimulation or as we usually called it “stim group” took place most weekday afternoons. The group was designed to engage patients physically and intellectually, to practice fine and gross motor skills. My favorite part of the group, however, is that it allows the children not to be patients in a hospital. Instead, they get to be outside, spending time with other children, learning, being active, and having fun.

One of the challenging aspects of our work at the hospital is that we don’t have a specific assignment, department, or supervisor. We are here to learn and part of that learning is figuring out how we want to allocate our time and make meaning out of our experience here. This is a challenge for American college students. We are used to feeling useful, to having specific tasks and achieving them. At the hospital, we are foreign students who are unable to speak Zulu, have minimal medical training, and very limited (if any) professional skills applicable to this setting. Unlike last summer, this is not a summer of service. Although we very much want to help, there is very little we are qualified to do. Instead we are here to learn.

I think there is often a perception amongst American college students that if we go abroad, we will walk into a new situation and finds lots to do, many places where we can be helpful during our short international stay. We are coming into communities facing such daunting and overwhelming international challenges like HIV/AIDS, TB, poverty, rural isolation, lack of infrastructure, and limited education. Surely, we are needed somewhere, right?

Sometimes international volunteers are needed, and sometimes they are not. In our case, the hospital is not in dire need of the limited help we are qualified to offer. But Lauren, Elizabeth, and I have talked about how really that is a good thing. After all, how would we feel if the situation were different, we were really needed, and then we had to leave after 5 weeks, reopening a gap that we had briefly filed?

.Manguzi Hospital faces many challenges, particularly limited resources, but it is well organized with a dedicated staff. On our first day at work, I told one of the doctors that one of my goals for the summer was to get a sense for how rural hospitals like Manguzi work. The doctor smiled and chuckled at me, “Things are crazy around here, but things kind of just work. Somehow the hospital keeps functioning.”

During my time in Manguzi, I have been lucky to see many of the different ways the hospital works. Each morning, we attend the doctors’ meeting where doctors are brief on newly admitted patients and general hospital updates from the medical manager, matrons (senior nurses), and department heads. Several times a week different doctors will give professional development lectures on topics like diabetic emergencies or the co-infection of HIV and hepatitis B. After the morning meeting, doctors head off to do rounds in their assigned wards. I have shadowed doctors in the maternity, pediatrics, and female wards. I have also observed the nutritionist, shadowed doctors in the Out Patient Department (OPD), and watched surgeries.

But I have been spending most of my time in the Allied Therapy wing, which houses speech therapy, physio therapy (physical therapy), and occupational therapy. The speech and occupational therapists work with lots of children with special needs, intellectual impairment, disabilities, and developmental delays. It has been fascinating to learn about signs of physical and cognitive delays, strategies to overcome disabilities, etc. It can also be heart breaking at times. Many of the children’s families cannot afford to take their children to regular therapy or to provide resources to help them overcome their disabilities. Therapists here in Manguzi need to be creative and resourceful to overcome both systemic and individual challenges faced by the patients and health professionals throughout the local community.

I am learning by being here, observing, asking questions, talking with people, and making comparisons. I am very grateful to be here! The opportunities and experiences I am having here are incredible and unparalleled. I am trying to be a sponge and to really soak up this experience. This is an experience that is not only valuable now, but it will gain meaning as I reflect on it and process it in the future. I am sharpening a new lens with which to view challenges of health, poverty, disease, wealth disparities, race relations, language, cultural identities, and much more.

I am proud of the way I have adapted to be able to cope with adversity and situations beyond my control. At work I have had to balance a desire to learn with an understanding of where I fit in at the hospital. I have learned about personal relationships through managing work relationships at the hospital, relationships with our host family and community members, and my relationships with other Robertsons, my family, and people at home. I am learning to communicate in many different ways, notably when I do not speak Zulu and when I am a continent away from many of the people who are most important to me. I am learning about human connections and respect through the generosity and hospitality of my host family and new friends in Manguzi. I am learning about the unique mixture of cultures in South Africa and the ways that these cultures fit together (or sometimes don’t) to form the South African national identity. I am learning about the legacy of a brutally difficult past, something I was able to see domestically last summer in the Mississippi Delta. I am learning to live abroad, so far away (in so many ways) from the life I know.