Wednesday, February 25, 2009

Respite Patients!

Here are a few of my patients...some of whom I've mentioned in previous blogs:
1. Veronica
2. Me and Fatima
3. Bheki (left) and Dumisini

Computer class pics!

Here are some pictures from computer class at St. Leo's...

Tuesday, February 24, 2009

South AFrican Internet...

Stinks. We've been without it for 10 days now. Luckily, the priests next door let us use their computer. I'll be back in touch once our computer is up and running. Love, Jenn :)

My little buddy...

Mondays are always interesting at the Respite Unit. I always have a knot in my stomach as we drive to work on Mondays because a lot can happen over the weekend and I never know quite what to expect when I enter the ward. This Monday was no different. I walked in and saw a crib out which obviously meant we had a baby or child admitted over the weekend. I walked over to the crib and saw a young boy who looked about 8 or 9 years old. His Mom was hovering over him along with a few of the care-workers chattering in Zulu. I said hello and walked away. Once things with the admission process calmed down I went back over to him and introduced myself to him. He could barely speak and after a few strained times telling me I caught that his name was Mpumelelo and he was 14. I honestly could not believe that this little boy was 14 and fit into a large crib.

He slept for an hour or so and I kept checking in on him. Once he was awake, I asked him if he’d like to get out of the crib. He and I sat and attempted 3 different puzzles none of which had all the pieces (SO FRUSTRATING!). I read him a few stories and tried to get to know him a little bit better. His English is very good, but he is so sick that he has trouble speaking because he has sores in his mouth and his throat. I had to listen very carefully when he spoke to catch the words that quietly came out. Breakfast was being passed out and I figured he must be hungry. He turned it down and I asked why? He stuck out his tongue which revealed a sore in the form of a deep “hole” in his tongue which caused severe pain when he attempted eating anything. The care-workers then gave him some pain medication and some other various tablets. Still sitting at the puzzle, he threw up everything they had tried to give him. The poor kid!

I spent the next two days with him and grew very fond of him. He still had not eaten anything or kept any medicine down. Therefore, he was in great pain the entire time. We still had some fun doing a new puzzle I purchased the night before. Tuesday afternoon rolled around and it was time to bring Mpumelelo and some of the other patients to the Botha’s Hill Clinic to collect and register for TB medications. Richard, a fellow volunteer and I drove the crew up to the Clinic. This is one of the MANY, MANY moments I say over and over in my head “wow, I’m definitely in Africa.” Richard drove, I sat in the passengers’ seat with a one-month old baby on my lap and we piled 4 adults and my 14 year old buddy in the back seat. Cozy huh?

Clinics here are an absolute nightmare. People travel long distances to wait in lines which wrap around the entire building. Many of these people have no advocate (unlike our patients) and may wait all day, just to be told to come back the next day. I have seen some things that I simply cannot convey to you and will probably never understand at these clinics. Luckily, we were first in line at the TB office. Two of my patients needed to simply pick up their TB meds and two of the new patients had to register to begin TB treatment. It took over 4 hours…unbelievable. My supervisor, MaryAnn and I spoke about it later and she said it seems as if the staff is almost deliberately slow and unorganized. Either way, my heart goes out to my patients every time they have to sit for so long as sick, in pain and uncomfortable as they are.

The only good thing that comes out of the time spent sitting and waiting at the clinics is that it is a great time to get to know the patients a little bit better. This trip to Botha’s Hill was certainly that chance for me and my new favorite patient Bheki. I’ll talk more about him in the following blog entry. We all made it back to the respite and I think the patients probably took nice, long naps upon our return! Mission accomplished.

Stop Clicking...

Every Wednesday I go to St. Leo’s Primary School with the girls to help out. I’ve found a role there which has been a blast for me. I spend the day helping out (sometimes teaching the whole lesson, hahaha) in the Computer Room. The 4th graders that I have for the day are so much fun. They are completely enthralled with the computers. Each group is with us (Ayanda, the “jack of all trades” of Leo’s and me) for one hour. This hour is just enough time to make sure that all the kids have turned on the computers correctly, opened Microsoft Word, find the keys on the keyboard and properly turn the computers off.

They are so excited to learn even the simplest of new tasks on the computers. This week I had them review last week’s lesson which included: shift, enter, backspace, and spacebar. Our review took up much of the time. Ayanda and I then explained how to make font BIGGER and how to change the font COLOR. Once the kids clicked to see what they had just commanded the machine to do, you would have thought they had just won the lottery…the excitement on their faces was so priceless. There were many “oooohhhhs” and “ahhhhhhhs” as font became size 24 or a turquoise blue color.

Classroom management is a whole different ballgame. I can’t even tell you how many times a class I say “stop clicking.” There are not enough computers and the kids are all at completely different levels. Also, my Zulu is non-existent, so it’s an interesting challenge to say the least. I have to say I thoroughly enjoy my time with the kids at St. Leo’s each week.

UNO hits South AFrica!

The patients at the Respite Unit and the boys at St. Therese’s Home have recently fallen in love with UNO. You know, the card game of color/number/skip/reverse, etc. I bought the cards while I was out last week and it’s been quite a hit here. We’re still working out the kinks…for example, not putting a red skip on a blue five…but we’re getting there and having fun just the same! At the Respite, I played for a couple of hours straight with 3 of the male patients who just loved it!

At St. Therese’s, before we played I was explaining the basic idea of the game. The kids have a pretty good grasp on English and I thought I was making sense. I told them that when you have one card left that you yell “UNO.” I also explained that UNO means one is Spanish. They were hanging on my every word and one kid blurted out “How do you say one in English?” Never underestimate the power of simple games to bring true joy to others.

My new friend Bheki...

As I mentioned earlier, I met a wonderful man last week…his name is Bheki (short version of a HUGE name). He was admitted to the Respite Unit last Monday with severe weight loss, night sweats, dizziness and chest pain from TB. Bheki is 28 and is HIV+. When I took him to the clinic last week, he was in pain and dizzy and I knew he felt like absolute crap. There is something about him that I was drawn to the instant he smiled. We began chatting about how he ended up at the Respite Unit. He told me his boss brought him in because he was so sick and he didn’t have anyone else to take care of him. Bheki has worked as a gardener at a private home for the past few years. He told me how grateful he was to his boss for helping him.

Over the past week, we have talked much more. He is such a beacon of joy. He smiles and you just can’t help but feel better. Now, he’s on treatment for TB and is feeling a little bit better. He’s now working on gaining weight and then hopefully, he’ll be able to begin ARV therapy for HIV. We’ve talked about everything including sports, family, his health, America, his job, my volunteer year, and whatever happens to be on TV. He has also been teaching me some South African card games (by the way, they do not use Jack, Queen, or King here at all…weird huh?) and helps me practice my poor Zulu.

One our conversations was particularly touching when we spoke of his family. He told me that he is one of 6 children. He has 5 older Sisters (one has since died of AIDS). I came in and he was so excited to tell me that one of his Sisters had visited the night before. He was pleased beyond belief because she brought him a bottle of juice and a bag of chips. Then, he was quiet and I saw tears well up in his eyes. He told me that he thought his family had “thrown him away because he was sick.” His sisters visit was much more than a simple visit, for Bheki, it was a re-assurance that he is not forgotten like so many patients sadly are. He told me that he had been so sad, but after her visit “his heart is happy again.” He always thanks me for talking to him. In reality, I should be thanking him. Bheki has no idea what an impact his kindness and courage have had on me.


A bit of an update on the 14 year old boy I spoke of…Mpumelelo.

After 3 days of him being in the Respite Unit without eating or keeping meds down at all, he was admitted to the Don McKenzie TB hospital. He was very dehydrated and was in need of an IV, etc. I was of course sad that he left and even more upset that I didn’t get to say goodbye or good luck to him. Anyone who knows me knows that goodbyes are not speciality!

I have been asking MaryAnn if she had heard anything about his condition. She told me that they finally got him to eat, but that he was very scared and miserable there. He told the staff there that he wanted to come back to the Respite Unit. This news did not make me feel any better.

Today (2/23) I went to the TB Hospital to drop off and pick up some of our patients and decieded to look around for my little buddy. It just so happened that he was exactly where I was today. I called out his name (in a sea of hundreds of TB/AIDS patients in the male ward) and he saw me. His face lit up and so did mine! We talked briefly and I told him that I missed him a lot. He said, in perfect English I might add, “I miss you too Jenn.” I told him I’d drop in again soon and he smiled ear to ear. It was one of the best moments of my time here so far for sure!!!!!!

"I almost died..."

“I almost died…”

Last week, a patient was admitted after I had already left for the day. I greeted her and introduced myself the following morning when I saw her. She was quite obviously young and very sick. She told me her name was Fatima and she is 22 years old. I realized quickly that her English was very good so we’d be able to communicate easily. As I’ve gotten to know her a little bit better, I’ve realized what an amazing young woman she is.

She began to tell me her story. She is an AIDS orphan and has lived with her Grannie and her 2 Uncles for the past few years. Once she became ill with HIV and TB, her Grannie became very angry and ashamed. She told that her Uncles were always at work or drunk. Her Grannie ignored her even though she can no longer walk or take care of herself. Over the past few months, her Grannie began beating her severely. She rolled up her sleeves to show me the bruises which were horrible. She was talking through her tears.

I reassured her that she was safe at the Respite Unit and that no one could hurt her any longer. I also told her that she’d be very well taken care of. It was a very touching situation to talk to someone who had been through so much at such a young age. I felt a very strong connection to her as she opened up her heart to me. She said that the night before she was “rescued” her family was denying her water. Fatima told me bluntly, “ I almost died…”

This young girl looked death straight in the face and fought on. I am in awe of her. Later that day, she told me that she used to be a chef before she got so sick. Her passion for cooking and serving food was obvious. I told her about the few (and I mean like 2) meals I know how to cook. I’m hoping to write down some of her recipes as time goes on. She is truly an inspiration and I look forward to getting to know her better.

Baby Sanele!!!

Baby Sanele!

Last Friday (2/20) I was left “in charge” at the Respite Unit. What does that really mean? Really nothing, but it sounds good doesn’t it?! Anyway, the supervisors and some of the care-workers were off site for a Compassion Fatigue Workshop. It was a very quiet day around the unit and I took full advantage. I had a play date or should I say “day” with Baby Sanele, my 18 month old buddy. He has grown up a lot since we first met.

As you probably read in previous blogs, he was terrified of everything, including me when I first met him. Now, he plays ball, babbles, laughs, snuggles and reads with me everyday. He is still timid when “strangers” (mostly white males) come around, but he’s growing up a little more everyday. On Friday, he practiced walking with me AGAIN, jumped on the couch, scared the fish in the tank, read lots of books and took some long naps cuddled up on me too! I even got him to say “ball” a few times very clearly. He had my full attention for really the whole day. I took a picture of him so you can all see how precious this little guy is. His Mom (Deborah), also HIV+, has been quite under the weather, so I’ve stepped in so she can get some rest.

Today (2/23) I overheard MaryAnn (my boss) tell Deborah that they could probably go home before the end of this week. I am already pretty sad to have to say my goodbyes. Of course, on the other hand, it’s a good thing because they are healthier and can be comfortable once again at home.

-The first picture is of Sanele enjoying a nice day out on the lawn
-The second picture is Sanele and his Mom Deborah...

The Ladies of the Respite Unit...part 1.

Today was a camera frenzy at the Respite Unit! These are some of the ABSOLUTELY AMAZING CARE-WORKERS!!! I am proud to work with them everyday. They are unbelievable!

The boys of St. Therese's Home...

Here are a couple of shots of the boys from my cottage at St. Therese's Home! I just took them today (2/24).



We had a great weekend! On Friday night, we were all exhausted. Katie and I watched “She’s The Man” which I had never seen and thoroughly enjoyed. I ended up making it about half way through the movie before calling it a night at approximately 9:30pm. Awesome.

We had pre-arranged to join Baba Benji for our weekly trip to deliver food parcels in the valley. It has quickly become one of the highlights of my weeks here. The families are the same each week and now they know me (and the others of course). It was a gorgeous, HOT morning and we had a nice time seeing all the adorable kids on the route, giving them candy, and taking some cute pictures! One of the families makes sure their children say “thank you” to me in English which is pretty amusing…coming from 2 and 3 year old babies! At least now the little Zulu children have stopped running in terror when I arrive because they now recognize my white face.

Saturday was sweltering here…probably around 85 or 90 degrees. We decided to attend the Durban Sharks rugby game. Rugby is HUGE here. I’m going through sports withdrawl due to not being at Saints () and not having sports on TV here, so this was a lot of fun for me! I had never seen a live rugby game and I loved every minute of it. Wow, what a rough sport! The Sharks won which was an added bonus. There are many things here in South Africa that I don’t understand. One of the weirdest things I’ve seen during my time here had to have been the “Sharkettes.” They are not cheerleaders and they are not the dance troupe. No, weirder still, they are girls who wear bikinis covered with a black silk bathrobe and run around before the game “faux-flashing” the crowd. Nothing more, just simply “faux-flashing.” I can’t say anything more…

We woke up on Sunday, got ready and headed out to a place called Montebello (about an hour and a half from us). My roommate Katie was an Augustinian Volunteer last year in the Bronx and worked at a shelter called Siena House. The shelter is run by the Dominican Sisters and one of the case workers there is Sr. Pat. Sr. Pat has been in South Africa as a visitor at a compound run by the Dominican Sisters here. She graciously invited us to visit and have lunch with her. It was a blast. She (and the other Sisters) were very hospitable and welcoming. It was fun to see/talk to another American! The compound that the Sisters run at Montebello is quite impressive. They run an children’s home (similar to an orphanage…see pics below), a chronic sick home (mentally and physically challenged adults and children), a boarding high school with 400 students, a crèche (daycare), an elementary school and a training novitiate for young women interested in entering religious life. Sr. Pat took us down a very muddy road to visit the children’s home where she had been spending most of her 6 weeks. The kids literally went nuts when we arrived. They were so sweet and very excited to meet more Americans!

It was a long day, but it was well worth the trip. Just a side note…as we drove to our destination, we passed a sign on the highway for “New England Road,” how funny is that??????

Here are a few pictures from Montebello:

-The group shot (roommates plus Matt-Alex's Boyfriend)
-the girls from the high school
-Me with a cute little guy from the home
-Sr. Pat with the kids from the home

Saturday, February 14, 2009

I fell in love this week...

I took Monday off because I woke up with a really bad headache. When I arrived at the respite unit on Tuesday morning it was pure chaos (not too unlike every other day there). Hanneke pointed to a crib and told me that I should take a look at the new little child that we were in the process of admitting. I walked over and peeked inside and simultaneously fell in love and was heartbroken at the same time. The little 7 year old boy was named Zanele and weighed less than 20 pounds. He was brought in by his sister who looked to be about 14-16 years old. They were both AIDS orphans. The sister left once the care-workers finished the admissions process.

I sat with him the whole day. He has AIDS and TB and could barely move at all. His skin was covered with marks and so sores. He was laying there almost lifeless and I could barely stand it. I just kept talking to him and singing him songs and though he didn't move, his eyes were glued to mine. I fed him breakfast and lunch and just held his hand over the crib's edge.

He slept for a while. When he woke up, I brought a book to him. It was in English, but I figured it was something to keep him interested. I read all about Winnie the Pooh. I had one of the care-workers ask him if he wanted to hear more stories and he said yes, so I kept on going. I left that day, got in the car and burst into tears. 7 years old...alone...sick...motionless...scared.

This little boy did not ask to be sick or orphaned or alone. He deserves a childhood just as all children do. Instead, he's fighting for his life. I can't imagine what fear this little boy must be feeling not only about his body and how he physically feels but also about where he is, who these strange people are, why they're hovering around him, etc. I could not wait to get to work the next day. I went straight over to him and starting reading. He still looked so sad and scared. The care-worker told me they were admitting him to the TB hospital so he was leaving. I drove with him in the car to the hospital. Again, how scary? I gave him a hug and told him he was going to be ok. Please say a prayer for him. If I can get any details, I'll pass them along.

St. Theresa's Home for Boys...

We've now started at our new placement on Tuesday and Thursday afternoons. Alex, Katie and I are working at St. Theresa's Home for Boys closer to Durban. This is an "orphanage" for boys which was started by the Augustinian Sisters in 1925. They house a good number of boys who have either been orphaned, abandoned, removed from homes or that are unable to live with their families for one reason or another. The boys are divided up into cottages (by age) and have 2 full-time "Aunties" that live with them and alternate weeks. I was placed in cottage 3 and I absolutely LOVE IT. The boys are so sweet and already I have formed bonds with them. Unfortunately, I don't remember these long, complicated Zulu names I'll do as I did at Saints, call all the boys "buddy or dude or sir or superman." It's worked well so far.

My boys are around 8-11 years old. They are so great and just love it when I arrive. They call me Auntie Jenn which never gets old. They are, for the most part, behind for their age in school and in need of structured help and support. However, with 10-12 boys, it's not that easy to find time, hands, discipline and words enough to help them all. It's been trial and error so far. When I arrive, we usually play and they give me some nice hugs. Then, I ask who has homework and they all shout "NOT MEEEEEEEEE." Once I finally calm them down, they all need homework and lose focus quickly. Many times, they don't have any assignment or they don't know how to read the paragraph they are supposed to answer questions about. Much of the work that needs to be done there would entail going back to kindergarten level and working on sounds and learning how to read. Unfortunately, I only have 2 hours each's a tall order, but the boys have already stolen my heart.

They are very interested in where I'm from and what I like or don't like. They are obsessed with Obama and love when I talk to them about him. They also are enthralled each time I talk about the amount of snow Vermont gets. Their eyes are huge as they imagine how cold and wet that much snow must be.

I am so glad to be working at St. Theresa's with the kids because they are so desperate for love and attention. It's nice to see their smiling faces and remember that there is so much hope in this world. I'm going to take pictures soon...keep checking in!

Happy Valentine's Day!

This Friday I was asked to work at a government hospital instead of being at the respite unit. My supervisor, MaryAnn told me that the Don McKenzie TB Hospital was in desperate need of help and she wondered if I’d be interested. MaryAnn and her husband, Stephen (one of only a few Doctors at the hospital) are two of the most amazing people I’ve ever encountered. I’ve only known them for about a month, but they are together saving, prolonging and improving the lives of thousands of HIV/AIDS and TB patients all around Kwa-Zulu Natal.

I arrived at the Ethembeni Clinic (an ARV roll-out site and a part of the hospital) and was asked to start sorting, filing and “inspecting” the files of some of the thousands of patients registered at the Clinic. This took up quite a chunk of the day. The files are numbered but there is minimal computerized tracking. It’s all hard copy…papers upon papers upon papers. The record keeping in this country is UNREAL or should I say NON-EXISTENT.

Once I was done mulling over CD4 blood count result sheets and clinic cards, I was asked to assist at the hospital pharmacy. As I said before, the clinic is an ARV roll-out site. This means that patients from all over the area (including our patients at the respite unit) come to the hospital to be trained about how to properly take their ARV treatment and to pick up their medicines each month. The two women working in the pharmacy were a delight and were so excited to have my help. They are literally drowning in a sea of medications and they’re lacking the help to dispense it properly. I spent a few hours packaging TB medications for patients in the acute stages. I also put together some of the ARV packets that will be picked up this week by patients. It was an interesting task and I enjoyed being on the practical end of things for the day.

My roommates picked me up and we stopped off at the local post office to pick up a PACKAGE!!!!!!!! I am not going to lie…I love getting mail here…THANKS MOM!!!! Inside was heaven, oh wait, I mean fruit by the foot, skittles, airhead candy, dried fruit mix, crystal light packets, valentines day treats and last but not least a music card that played TIM MCGRAW!!! Good job Nancy!

I got home and was exhausted after a really tiring week. I laid down for a bit and just as I was closing my eyes Baba Benji arrived to pick me up to deliver food parcels. I have now gone 3 times and I have been tired each time, however, it’s one of my favorite times of the week. This week it was just me and Benji. We arrived in the valley and our “helper” was not available. We went to the first house and picked up another young boy from the parish to help us, Emmanuel. Now, we were off.

Each week, we visit and deliver to the same houses, the same families, the same children, but it never gets old. They are the highlight of my week. I’ll tell you about a few of them…

-One little girl that is always naked and is about 2 or 3 years old. She was legitimately terrified of me, but then she saw that I had candy in my hand to give her. She has horrible open sores all over her face…this week they were worse and quite dirty. I am going to bring gloves, warm water and some supplies from the respite next week to see if I can at least clean her up. I’ll keep you posted.

-How about the three little boys that wait at the side of the road together and LOVE when we pull up? They act like they’re directing our car and love high fives. This week one hung onto the window looking and staring at me. They love having their picture taken each week.

-Then there’s my favorite, the boy I’ve spoken about a few times already. This week, he wasn’t waiting for us. We proceeded to “off-road” to get to his house. We couldn’t even get that close because there is no path or road. Baba honked his horn and the little boy came running down the hill followed by three little girls. I had brought some Valentine’s lollipops that my Mom had sent to give him…luckily, I had four. They then posed for a picture, lollipops in hand! Too cute!

-There is also another house with two naked babies always running around. I brought the food around the corner. The family is so nice and grateful. The Go-Go told the baby to say “thank you” and she attempted her best English. It was so sweet.

Here are some pictures from our delivery:

Sunday, February 8, 2009

One Day Late!

The pictures above are from this past Saturday when my roommates and I accompanied Baba Benji with his delivery of food parcels. It was a gorgeous day and we wanted to be outside (or in a car with the fresh air blowing, shall I say). Baba usually makes his deliveries on Friday afternoons, but was held up at a meeting and had to make them on Saturday morning. We picked up the 8th grade Zulu girl, Mata, that helps and we were off. We did the same route last week so we recognized some of the people and some of the houses. The same boy that was waiting for the parcel along a dirt path was there again, but this time, he really got to me.

We asked Baba how they know when he's coming when he's a day late. He said he called them (or someone that could let them know) that it would be sometime on Saturday. However, by nature of the rural places and scheduling conflicts, he cannot give them an exact time. It's no trouble for those families to whom we pull up and drop off at their door, but that young boy, he is different. He was waiting on the same rock in the same place as last time. Baba said he had probably been waiting in that spot for a few hours. I just still can't get over the responsibility that some of these children have. He cannot be more than 11 or 12 and he is the member of his family who is responsible for picking up the food that may sustain them all for the week. When he came up to the car, I smiled and he smiled "the most amazing smile you've ever seen in your life" back at me. I took another picture as he walked away, food in hand, because it was truly powerful for me to see.

1st Braai!

We were invited to our 1st South African Braai last weekend. A "braai" is just a fun barbeque that is a pretty common weekend occurrence here. We were invited by my friend/co-worker Hanneke and her husband. I figured I'd post the picture since I talk about her in all my posts.

From left to right:

Me, Hanneke, Alex and Katie...

Friday, February 6, 2009

Molweni Home Visits!

I have been lucky enough to go with my friend and co-worker, Hanneke (nursing intern from Holland) as she begins her research project for nursing school. To complete her research project, she (WE) will be going to the Molweni township (where the girls' school is) and interviewing patients who were discharged from the Hillcrest Aids Center Respite Unit, the place we are both working. Hanneke will be interviewing the patients to see if they have begun and/or continued successfully with an ARV therapy. She will ask each patient a series of questions about how they get their medications each month, how their family/friends support them, their knowledge about HIV/AIDS & ARV's and also about their particular motivations for proactively taking the medications in the face of stigma and hardship.

As I have mentioned before, not all patients that come into our Respite Unit die from AIDS. Some of our patients come in, their health improves, they get into an ARV treatment program and they are discharged. The hope of the Center is that the patients who are discharged will be able to fetch and take their medications in a timely, appropriate fashion and that they have a support system of some type - friends or family to help them along. It is important to note that the physical, emotional, spiritual and financial support of family/friends is integral for patients here in the face of such harsh stigma and denial that surround the disease. During our first week of home visits, we have realized the many roadblocks and harsh realities that face those with HIV/AIDS in the Third World.

The three of us, Hanneke, a Zulu care-worker and me, jumped in the car on both days and headed to Molweni. We were "armed" with very little information...really, just names, date of discharge and in some rare cases, a phone number. Luckily, everyone in the township knows everything about our care-workers busily asked cousins, neighbors and random pedestrians about the whereabouts of the patients we needed to track down. The first home we went to was that of a young man of about 30. He seemed to be in good health and told us all about his ARV regimen, his support system and how he wanted to get better and stronger and "fatter." We left and I felt very satisfied with the interview. We drove around more dirt roads (paths really!) to find our next interviewee when we happened to run into a care-worker from the Center. We spoke with her and told her about the patient that we had just interviewed. The only word of the conversation between the two care-workers was "unamanga" or LIAR in English (Attention all Zulu scholars...please excuse the spelling guess). To sum things up, the woman told us that he never started ARV's and that he was lying throughout the whole interview. Needless to say, we were a bit bummed.

We put that interview behind us and went to see Sipho, a man of around 50 or so. A neighbor hopped in the car with us to show us the way. We arrived at his house and he granted us the interview. This time, Hanneke asked to see his clinic card, all medications and treatment information. She counted his pills and he was right on track. He was a very thin man but seemed to be on the up and up. When asked why he continues to take the tedious regimen of ARV's Sipho responded, "I don't want to die. I know that this is the only way I will live." Plain and simple right?! Sipho then told us that he will be losing his Disability Grant in a month and that the grant is the only income he has. The income is used each month to take the taxi to fetch the only thing that will prolong his life. He said he wasn't sure what he'd do when that money was not coming in any longer. We are in the process of trying to help him secure another location to fetch his ARV's. Life here is not easy.

Another home visited I tagged along for proved to be my most helpless moment here so far. We arrived at a home and were greeted by a very jovial woman. We entered the one room home that was no bigger than a large SUV. Sitting on a bed, was our patient, a 23 year old woman. She said hello and when asked how she'd been since she left the Center, she burst into tears. She explained that she was sick and sore all the time. She was quite thin and emotionally drained. I was kind of hovering in a corner because there wasn't a ton of space. I watched as the girls' mother began wiping tears as she watched her daughter is obvious pain.

The girl explained that she never started ARV therapy because they could not get to the clinic to finish her testing (CD4 Count). She was not eligible earlier because her CD4 count was not LOW enough. In other words, because of the lack of resources and the huge amount of need, patients here have to be "sick enough" to get the proper treatment. She just had missed the mark. Now, she is unable to make it to the clinic to get an updated test done because she too, lost her Disability Grant which was her sole income source. This young, beautiful girl is too sick to work, cannot receive medical treatment and was obviously terrified for her future.

The issue of Sustainability came up in a big way for me during this encounter. It is the policy of the Respite Unit to be of service in many ways, but not to enable people to become dependent, not search for help and answers on their own. Many times during my short time here, I've wondered how a small amount of food or a ride to the clinic could actually do more harm than good? Is that possible? Isn't that why I'm here, to help people who need it most? I have a feeling that I'll struggle with this the whole year, but boy, do I wish it was simpler! We had to leave that young girl and her mother as hopeless and helpless as we found them. Hanneke gave them some suggestions about testing sites and "next steps," but then we had to get in our car and drive away. I have never felt so helpless in my entire life.

Waiting and Wandering at Welfare...

Things in South Africa are very different. I mean, everything here is DIFFERENT. The culture, the people, the climate, the food, the prices, the relationships, the education system, the poverty, the healthcare, and now, add to the the list the "welfare" system. Welfare to me, is supposed to be a system of assistance for those in our society who need it the most right? Well, that's not quite the case here in South Africa. Welfare, as I found out on Monday is difficult to navigate, full of confusion, disorganized, chaotic and under- (fill in word...staffed, resourced, managed, etc.). When I arrived at work on Monday, I was told that Hanneke (nursing intern) and I were to take 3 of the respite patients to the Pinetown Welfare Office to complete a long process (over a month in total) and that they'd finally receive their Disability Grant cards.

We loaded our three patients in the tiny car before noon and we were off. As soon as we pulled up to the crowded area of town, I knew it was going to prove to be quite an experience. We walked across the street to this small complex that was absolutely mobbed with people. Desperate people...waiting. There is NOTHING easy or efficient about this place. We first asked 10 different staff people who we talk to or where we go and NO ONE KNEW. We were tossed from little room to little room in a sweltering office building trying not to fall over the men, women, and children that were staring at us.

I'm not even sure how we got to the "start" point, but we did. We were given priority because our patients are so ill. They were allowed to sit in the queue (waiting line) that snaked through the entire property, as we maneuvered the process on their behalf. We were then told that the men had to see one person while the woman with us had to see another. Hanneke and I split up and I took the 2 men with me. I took the first patient into the first office with me where he was asked to give a few bits of information which was recorded BY HAND in his file. They also had to give their thumbprints more than I've ever seen in my entire life. I don't think the FBI would require as much as the Pinetown Welfare office. We then went to the next small cubicle and did almost the same thing. This same process occurred at least 6 more times until finally we got to the woman who recorded the same information ON A COMPUTER.

Hundreds of thousands of people sick, destitute and needing assistance and they are subject to this grueling process of tedious bookkeeping. I was so frustrated by the time we got to the computer room (1 computer in a room). We then went to the second to last office where all the people that had been part of the process were just "hanging out." I had to laugh or I was about to cry, so I thanked them and chatted. The one man turned and reached for my hand, then said "you are so nice...will you be my wife?" I laughed and asked him to show us where to go next, as I was sure we WEREN'T done yet!

The last office is still a bit of a mystery to me. This time the patients gave electronic (maybe?) fingerprints and some more information. They then received their Disability Grant card...FINALLY. The patients will have to wait another month to be able to collect their money, but at least it will help them and/or their families. We piled back into the car...tired and sweaty and frustrated. It was now late afternoon.