Saturday, December 31, 2011

South Africa in One Post

Unfortunately, this entry sums up all of my time in Africa, so sorry ahead of time for the sheer length.  Many of these paragraphs are directly from a previous post I wrote for a travel website called, and to view that entire post you can go to their website under guest blog entries.  There are also some pictures from the area there.  

My time in South Africa has been incredible so far, visually, emotionally, mentally, and even physically.  I don’t know where to start with the sheer wonder of the landscape.  Off the 13 hour plane from New York, after several connections, I felt like I had stepped into Florida.  Palm like trees, ocean breeze, nothing like the Africa advertised on television.  After a sojourn at a nearby hostel playing a game called bitong (not sure if the spelling is right), like bocce ball, and watching cricket, we made out way exploring the area.  As we entered the townships I saw the first signs of visual poverty here.  Shacks with dirt floors, the poignant smell of urine and body odor, kids playing in garbage heaps, garbage and glass cemented into the rocky, dirt paths leading to some of the houses; these sights and smells defined poverty for me.  Though the American advertisements are incomplete- South Africa is one of the most developed and modernized parts of Africa, and although shantytowns exist, most of the area where we are staying has highways, cities, shops, supermarkets, and industrialized infrastructure.  Even stranger is that across the way from the poorest and most dangerous township lies a township lined with standard, government funded housing with pristinely paved roads.  The landscape looks like an old American suburb, except without the white picket fence and smiling families, child in hand.  Dogs lie as guards outside houses as kids run up and down the street as some mothers wash clothes or sit inside with their family watching television.  Amazingly, despite living in almost destitute conditions, almost every house I have visited has had a sound system and television.  Satellites poke out of the shacks’ roofs, and one day I saw a house with cardboard lining the outside wall.  Yet only minutes away by car lies an amazing downtown area with stores lining the streets, and a pristine beach waiting for the feet of tourists and their open checkbooks.

            Our work project here involves studying public health through an NGO called PlettAid, as we follow around home based caregivers and record psychosocial data regarding the patients’ moods before and after our arrival.  Unfortunately recording the patients’ moods can be difficult, especially with the language barrier.  In the townships, the two main languages spoken are Afrikaans and Xhosa, and while some of the people know English, many do not.  Often I find myself entering a home and feeling like an intruder because I am unable to communicate with that person- other than a simple hello and goodbye I know little of either language, and the clicks in Xhosa especially make it different than other dialects.  So every day we report to one of the clinics depending on where the patients live, but everyone was assigned a different clinic, so while I am with some of the people in the group, others work at different clinics.  We wait there every morning as residents file in and sit down, usually pretty full during the week, and as our caregivers arrive we either visit patients at their homes or go to another clinic with a patient using van transport.  Here are some anecdotes that I hope shed light on the biggest learning moments of my time in South Africa thus far. 

            The walls of my clinic are lined with signs and promotions regarding HIV/AIDS- free condom signs, family support organizations, and responsibilities and rights of the patients jump out from the white painted walls.  People fill the waiting area to see the sole Sister in the clinic.  On one of my first home visits, a talkative man asked me about America and where I lived.  What struck me was how he talked as if all of America were rich, and if all of the country looked as it did on television.  I assured it didn’t, and it made me think that when I first came to Africa I thought of the moving images of impoverished children clothes in rags peering at me through the screen.  But all of Africa is completely different- within each country, and within each region even city the landscape changes.  Shack towns to standardized, white government housing to supermarkets and tourist filled beaches.  Just like the US, all of Africa does not resemble television commercials. 

            Another huge part of the experience here involves immediate signs of both globalization and westernization.  From American Dracula movies to huge sound systems to blaring Rihanna pop music, I have found that even halfway around the world I can’t escape American culture.  Nike sweatpants, Hong Kong tee shirts, even a Washington D.C. sweatshirt that one of the caregivers wore.  I saw a man with an Eminem hat, Lil Wayne blazoned across a man’s wall outside his house, signs lie everywhere.  Inside one patient’s house, an older woman with high blood pressure, a poster of the pop star Jennifer Lopez resides right over her bed, and in that same visit I heard Pink Panther music from the South African radio frequency.  One of the most striking and stunning forms of globalization, and especially the world influence of corporations is the Coca Cola logos paraded next to the store names.  Little food stores and barbershops litter the townships, and many of the food stores have their names flaunted next to the global Coca Cola logo.  My caregiver explained to me that they pay less to have their signs made by the Coca Cola Company, so as they advertise their store name to township families Coca Cola reaches its arm further across the world.

            One of my most poignant and shocking experiences of the public health aspect of the trip here involves my proximity to HIV and TB patients.  We visited an AIDS patient who weighed about 26 kg, or about 70-80 pounds.  As I helped to lift her from the wheelchair into the van to see the Sister at another clinic, I felt every bone in her chest and the shaking of her breath with the pain and discomfort.  At only 39 years old, she lived off ARV treatment and looked as if she were in the final stages of the disease.  Incredibly weak, swelling in her chest, legs and arms as skinny as twigs, she looked at least twice her age.  I learned that they discovered the disease late, and that her CD4 count was already low when she began ARV treatment.  The second time we saw her she looked worse.  Her stomach swelled with a fluid, and as we took her to the clinic to drain off the more than 2L of fluid, she started to fade.  At first I thought she felt tired, but the Sister and nurses called the ambulance to bring her to the hospital.  Another lady in the room could barely speak from a stroke, and threw up right next to me.  In the next bed, a young couple sat next to their young son with epilepsy.  A few days later I found out from my caregiver that the AIDS patient had passed away in the hospital.  I didn’t cry, I didn’t feel sad or depressed, just a bit shocked.  I didn’t know her that well, and couldn’t talk to her, only lift her into the van and accompany her in the hospital.  HIV/AIDS is the leading cause of death in South Africa.  Because her cause of death was HIV and TB, she must wait longer and pay more for her funeral policy.  Normal deaths involve a waiting period of six months while a TB or HIV related death involves a 1-2 year waiting period.  Openness and testing are highly encouraged, yet phrases like “do you eat sweets with the paper on?” referring to condom use perpetuate detrimental decisions.

            My reaction to her passing scared me a bit because I did not feel shocked.  Looking forward on these experiences I thought that I would be hit very hard, crying after work or feeling depressed.  Each day brought mental exhaustion and emotional drain, but I did not cry over the patient’s death.  Many of the township stories and experiences I heard sounded and looked so abstract to me, so foreign, that I struggled to grasp their reality.  I felt worse that I did not cry over her death, that I did not feel particularly sad, and after I brought that up in one of our group processing meetings I saw that others felt very moved by certain experiences.  It felt wrong, my seemingly indifferent outlook, but now I see that everyone processes these experiences differently.  With such an abstract and surreal experience, there’s no right way to feel or react, even if I think there is.    
            The public health system here involves aspects incredibly helpful and affordable to the people.  Home-based care is provided free to the people, along with visits to the clinic and medication such as antibiotics or ARVs.  Despite effective parts, there also exist complexities and weak points.  One of the controversial ways to support the patients is a disability grant, money given for healthy living and supporting oneself and their family if needed.  Yet underlying addictions in townships such as alcohol and cigarettes lead some to abuse the disability grant to buy alcohol, leading some to intentionally grow sicker in order to receive the grant.  When one becomes well they need to find a job to support themselves, but the scarcity makes finding a job difficult.  And the cycle continues.  My media project involves the reasons and factors behind one’s making detrimental decisions to his health.  Unlike my assumptions on arrival, laziness and ignorance play almost no role.

            Though the main part of town remains relatively safe during the day, a recent event in one of the townships changed many of our perceptions of their actual safety.  One night a man raped a seven year old girl, murdered her, and proceeded to show a neighbor the grave.  The town responded in a mob, beating the man and burning him to death instead of leaving him to the faults of the justice system.  One of the patients mentioned that the man had offended two previous times, the first for five years prison time and the second for fifteen years prison time.  The patient believed that the man deserved his death, and that killing him was just, elaborating that murderers should be killed, rapists should have their genitals cut off, and thieves should have their hands cut off.  They also continued that walking around at night one could encounter drug addicts on the street looking for a fix or get robbed.  He blamed these criminals for racial distrust, and that the racial distrust makes it even more difficult to find jobs. 

            December 1st was world AIDS Day, so as part of our project to raise awareness during the two-week party called Plett Rage, we pitched a tent on the beach to attract people to our activity.  Due to rain we conducted the activity the next day, including a bit of education on condom use through a race to put condoms on cucumbers.  Though a humorous activity, we tried to remind many of the intoxicated partiers who do not know much about the danger of HIV/AIDS in South Africa to use condoms as an easy way to prevent infection.  Changing mindset and consciousness is incredibly difficult in such a short exercise, but I hope we at least made some people think about the issue for at least the day.  Many of the beachgoers, to our astonishment, did not know much about the HIV epidemic raging right in their backyard.  I struggled with not feeling patronizing informing them of an issue in their own country, especially as a foreigner.  Before this trip, I didn’t even know there was a difference between HIV and AIDS. But it affects everyone from children to parents, and if no one knows about it or talks about it, then no one will be open about their contracting it.  As part of the patients’ rights, a patient with HIV has the right to keep secret their status.  In the US, I feel that the use of condoms is advertised as a way to prevent pregnancy primarily, but many leave out that condoms also prevent HIV infection.  Being able to talk about HIV at the dinner table eliminates the stigma and tension around the disease.  If no one knows, no one can help.

            Despite continuing hardships that some South Africans face everyday, the joy and happiness I saw every day amazed me.  Kids playing in the dirt with little food and broken down houses still smiled and laughed like any other child, and as I entered the houses the families would smile and greet me warmly.  Talking with one of the Sisters at the clinic, she told us that whenever she leaves she always yearns to come back, and that despite the medical difficulties, she loves the character of the people.  She felt that most of the people she saw living in the townships appeared much happier than those living in the more developed city area of Plett.  I felt that especially the African women, the mothers, had such pride and responsibility in the household, many of them taking care of the entire family and siblings on their own.  I admire their strength.   

Being in South Africa for the holiday season, we have experienced two major American holidays here, Thanksgiving and Christmas.  We spent Thanksgiving at Rocky Road, the hostel we sojourned at intermittently during the trip.  Our homestay mother Steph also prepared a great meal, but the willingness to accommodate a holiday they don’t celebrate astounded me, and the meal at Rocky Road was one of my best Thanksgiving dinners.  Soft atmosphere, a nice fire, such a personal and relaxing atmosphere.  Due to the feeling of family here in the group and with the people we’ve met, I’ve hardly felt homesick the entire trip.  The food has been excellent, with the highlight being the number of braais we have had.  The braai is basically a barbecue, and the family we stayed with loved it, so many times we would have a braai with our host brothers and host mom.  I felt amazed that she handed us the house so happily, and she treated us more as friends than guests in her house.  The amount of people that she knew in town, the kids that felt so comfortable talking with her and staying over for the night, astounded me.  She really is Plett’s mom.

Our Christmas week we spent doing safari activities with an organization called CrissCross Adventures in Addo.  A young couple led us on amazing activities that week including visits to a raptor and reptile center, cheetah center, Addo Elephant National Park, and a river safari.  I let some snakes wrap around my neck, and hold them, as I learned that snakes are very misunderstood, and many are not aggressive.  Good to learn as I let one slither around my windpipe.  We saw a crocodile, very aggressive animal, an ostrich, even a goat ramming its head repeatedly against the fence.  We got to pet lion cubs and even a cheetah, along with seeing some sirvals, which reminded me of Egypt a lot and the jackals alongside mummies.  The cats were so majestic, and I can see now why Egyptians saw them as royalty.  Yesterday we went out on the river in canoes for a little river safari, learning about different plants and how ancient the land is.  Our tour guide Chris found a huge elephant tusk up on the bank of the river, and he told us that most likely it aged back to the days of ivory hunters.  Our funny guide Moses told us about his life growing up as a kid in the Xhosa culture, stealing honey from bees nests by burning a plant, sticking a plant in a termite hole to get them stuck to fry and eat as protein, even run 6 km to school then grab a branch with which to brush his teeth.  We tried the aloe vera plant, which tasted horrible, and even smelled a potent mint leaf.  The spearfishing and other hunting stories of the Xhosa bushmen amazed me, that everything they needed they could find in the bush.  My favorite day with CrissCross was our safari day in the National Park.  We drove through in a fish tank or pope mobile, as Moses called it, where we could see the animals out the huge windows.  We saw a rhino, ostriches, bunches of elephants, warthogs, jackals, kuddu, elands, and even a lion at the very end of our tour.  At one watering hole, we saw maybe thirty or more elephants sliding into the water to bathe and drink, some even coming close to the van.  Little warthog babies ran next to their mother, and we saw the most interesting ostrich mating ceremony.  The male sat on the ground, swaying its feathers back and forth in order to impress the female, and once they started mating it looked like a dance.  A strange site to see, but very intriguing to watch.

For IST, the whole group went to Cape Town.  The city was huge and bustling, and one night some went out to the clubs on the main street, even after we had already gone out multiple times during Plett Rage.  The amount of activities Cape Town offered was immense, so we had to pick and choose.  Hope and I couldn’t get tickets to Robben Island, where Nelson Mandela was held, but we still climbed Table Mountain, visited the Cape of Good Hope, Cape Point, Boulders’ penguin colony, Chapman’s Peak, and a seal colony off Hout Bay.  Table Mountain was one of my favorite activities, which involved a mere hour and a half to summit but offered great views of the city, ocean, and another hike called Devil’s Peak.  Recently named one of the seven Natural Wonders of the World, Table Mountain is available to everyone to climb by cable car, and because of time we took it down.  I felt mixed about the cable car; I feel that a Wonder of the World should be harder to see, to make it more fulfilling to reach that summit, but doing so would leave many without the opportunity to see it.  Our bus day tour hit many of the big attractions near Cape Town, and we hiked and biked through the Cape of Good Hope to Cape Point, the southern most tip of Africa.  Practically surrounded by water, I liked the endless blue save the numerous tourists seeing it with me.  With so many people it felt pretty crowded.  Seeing the penguins on the beach was cool too, especially because I wouldn’t think to see penguins on a beach at all.  Hope and I both enjoyed the market type shops too, being able to bargain and look at all the crafts people offered.  Thankfully the atmosphere was not as overwhelming as the Otavalo adventure.                                     

As far as other fun activities, earlier in the trip some of us went skydiving and bungee jumping.  I did both, and the surreal nature of the jumps was awesome.  With coastline and beach hikes scattered throughout our work project, we have experienced many sides of South Africa.  Whether a seal colony basking in the sun, bright flowers spotted on a hillside, or dogs sitting in dirt with ticks invading their faces, little children playing soccer on a dirt field, and garbage fires.  Yet throughout all the hardship, the people remain energetic, loud and lively, with the woman especially exuding an air of supreme confidence and pride, which I envy.  Through the work of PlettAid and caregivers, change is happening here in South Africa.   

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