Sunday, May 22, 2016

First week complete

It has been such an incredible trip in South Africa so far. It is week one and there is just so much to process. We started out more on the tourist side of things. Going to the local pubs, eating decadent meals, cabled up the beautiful table mountain and enjoyed the beach. This place is absolutely beautiful I am infatuated with the scenery. I spent part of the day at the old Cape Town hospital and museum where Christiaan Barnard preformed the first heart transplant. “The primary purpose of medicine is to restore joy and allow patients to live the life they wanted to prior to illness. When it no longer fulfills this purpose, it is meant to aid in comforting the patient from life to death.”  This is what medicine should be, but often times I find that modern medicine is caught up in the politics of big pharma, money and liability. It is my aim to be the health provider that remembers this quote and keeps the patients goals as a first priority and work to guide them to reach it. The U.S consulate gave us a briefing of the safety of the town and they said there aren’t a lot of safety issues in the western cape, just the same as it would be in the United States in a major city. Travel in groups, watch your drink, and ride a taxi when possible.
 Things got very eye opening when we hit into real time Africa and got to go to visit an HIV/AIDS health clinic. Hundreds of children and families waited to go to the HIV/AIDS clinic. Some were poor and weren’t taking their ARV’s (antiretroviral treatment). This caused their virus to become activated and caused several types of infections. The most concerning is TB because it doesn’t work well with the ARV’s and they have to stop treatment. When you don’t religiously take the medication resistance can occur and thus needing a more complex treatment plan.  There is such a heavy stigma associated with HIV/AIDS so much that this boy stopped taking his medication because he didn’t want his soccer friends to find out, but then ended up with TB and cannot play for 6 months. There is a lack of education that causes patients to not really understand what HIV/AIDS is as well as a strong belief in natural remedies. I’ve talked to several people that believe snails cure ring worm and other herbs and vegetables to inactivate HIV/AIDs. Education is definitely lacking, but there are programs that are working to increase the understanding of sexual health and the disease associated. Even my understanding of HIV/AIDS has changed since I’ve been here. I thought you couldn’t live a normal life, that there wasn’t a lot of hope especially amongst poor populations. However, there are so many incredible resources and organizations that help fund situations like this. There were several patients at the clinic that took their treatment and appeared completely normal. Those patients had a good support system and chose to be positive and accept the disease for what it is. The organization KIDS Positive that works to fund children with HIV/AIDS, offering more resources in the clinic, aid in treatment, not just medication but also therapy and support groups. The beadwork project (Kids positive) works so families or people infected with HIV/AIDS can make jewelry cheaply to help fund their treatment. 80% of the cost goes directly to those infected. They also have a box that you purchase to help with strengthening and hand eye coordination that can be lost with the disease. Each time you visit and get treated you get a new toy in your box. The problem is that a stigma then developed when they saw people leave the clinic with a box and then people identify it to HIV/AIDS. There is so much hope for change of this stigma, which will drastically help control the disease from spreading further and keep fatality rates down.
We went to Cape Town University and learned about the HAICU program (HIV/AIDS inclusivity and change unit). They are making efforts to change stigma associated with HIV/AIDS, provide sexual health education and offer support for those infected. Students in the organization go through an intensive training process that interconnects all aspects of human sexuality. This includes sexual and reproductive health, gender identity, sexual identity, sexualization, intimacy and body awareness. Since tradition plays a big role in the culture of South Africa there are efforts that are being made to modify this to use modern resources to help with disease prevention and health promotion. We also heard from one of the founders of “Openly positive”, Derrick Fine. The organization is of people with HIV/AIDS who are opening up about being HIV positive. People from all different walks of life share their positive outlook on life despite their disease.  They work to fight against the stigma and fight for support. “Whisper not”. Don’t be afraid to share your story, there are people from all walks of life who are HIV positive. Whisper not isn’t merely just for those HIV positive, anyone who is affected by the disease, a caregiver, a health care provider. I think that opening up about your story and health is an important direction in getting rid of negative stigma. What is “normal,” is just relative. We cannot let people feel like they are alone, they need to see that there are others just like them and there is a support network to reach out to.
A lot of the topics we’ve gone through are pretty heavy but we do have some downtime to relax and explore the town. We had a braii (barbecue) on Wednesday where they grill ostrich and beef primarily, lots of rice and stew. $1-2 a beer at a pub is the average price, so you can imagine we are enjoying that side of the currency exchange. There some really unique pubs here, we went to the “Dogs bullocks” the other night and it was a quirky little place, as you can imagine. They don’t serve you, but you select the “bitch” of the table to get up and serve when your drinks or food comes in. They just yell for the “bitches” when it’s ready haha. We also went to Long st. which is the South African Bourbon street. There is lots of dancing, lots of drinking, good cuisine and good music. Some highlights of the bars were “The village idiot”, “beer house” and “sgt. Pepper”. Another afternoon we went to camps bay to watch the sunset over the water and I just couldn’t decide which direction to look in. The beach or the mountains behind me, everywhere I look I’m captured by the scenery. Day by day we are crossing off items off the Cape Town bucket list. Went cage diving in shark alley, and got some great footage of a couple of sharks. It was incredible, you dive under the water when they tell you want they drag bait to attract them in. One bolted at the cage, while I was on the end and jumped out of the water! I also went to Robben Island where Nelson Mandela was held prisoner for 10 years. Our tour guide was a prisoner for 5 years, he talked about how he was suffocated with wet rags, beaten and whipped, stripped naked and his genital mutilated. Constantly interrogated, all just to fight for their freedom. He said many died, but survival was through laughter and hope. Positivity was how he survived, that one day they would be free and justice would be served. Such a strong and inspirational men that were held there, it was an honor to stand before them.
After a break, we went back into the slums of South Africa in a township called “Smallville”. There are thousands of people 30 bathrooms, only a few water taps and showers. My heart melted for these children. I got out of the van and was greeted by all the children and one ran up to me after I put my thumb out and gave me a “Cosa welcome”. By the end of the day this little girl Musalya stole my heart. We fed them fruit, snacks and juice and was told by the director that, that was all they were going to eat today. John Philmon of YSA (youth solution association) visits every day to help feed them before and after school, but they still don’t get the attention they need. I was overwhelmed by how many children there were completely unsupervised. I watched them stuff the fruit in their pocket to hide to try and get more. I watched older siblings give their meal of the day to their younger sibling. These children just wanted to be loved. The only thing they fought over was attention from us. They just would run up to us with smiles and hugs. They liked playing with our cameras and taking pictures. So enlightening to see children in such poverty and tough mature situations for their age have such a positive and appreciative attitude.  I guess they aren’t used to seeing blonde hair because the boys and girls gave me a bit of a hair makeover, as well as my other classmates. When I left to interact with other kids Musalaya would find herself back to me with a great big smile on her face and hugs. She called me “sissy” because she said I’m always allowed back as her family to come play with her and she hoped I would. It broke my heart to leave them, but knowing that we made their day and were able to help clean them, made it a bit more bearable. We were exhausted, there working all day from 8 in the morning till dinner time. When we got in the van we were thinking about where to go to dinner because we we’re so hungry. But as the words slipped out our mouth and thought of the township we questioned “are we really hungry though?” It was really hard have an appetite after thinking about that sort of level of poverty exists while we our spending our days in such luxury and privilege. While, I feel so blessed to have had the opportunities and lifestyle I have, I am taking with me the importance of a positive attitude. It doesn’t matter what the situation is, or how much money you have, you still have the choice to smile and laugh and be happy regardless. I thank these children for teaching me the lessons of a lifetime.
            We learned more about how interconnected HIV/AIDS is with drugs use. Drug dealers are all a part of gangs that are very serious here in South Africa. The only way to escape them is by death or vanishing. Each gang has a different number associated with them that are a part of 3 larger gangs. You must go to jail first to be a part of a gang. “26” works to steal “27” works to kill and rape and “28” are part of sex trade and make a point to establish “manhood”.  “28” is big on asserting male dominance, as a gangster in the lower ranks, you are called “wifey” you are raped by higher ranked gangsters in prison until you prove your manhood. There is no choice, they may give you HIV/AIDS, you must cooperate or suffer the consequences. It is very scary to think these situations exist, but fortunately they exist in the eastern cape primarily and not in the western cape. Fortunately, where we are staying is really safe, right by the waterfront, lots of tourism and consistent electricity. I don’t see a lot of people wandering the streets, but there are some homeless people the same it would be in any major city in the United States. Since you cannot be charged if you are under the age of 18, which is quite problematic because they get kids to do the dirty work and hook them in with drugs. They are called “Kat” they will be protected and given drugs as long as they do what the gang says. It becomes a family tradition to be in gangs. When these kids don’t have hope in school they assume being a gangster is the only way to a “luxury” life. Fortunately, there are people that are trying to change this flawed system by charging children so they cannot be exploited.  As a bigger picture, schools are working to lean away from traditional methods and try and give a variety of options. So kids who may not excel in traditional school can see the opportunities for trade jobs or even artistic/musical work.

This is only a clip of the highlights of my first week in Cape Town!! Sorry for scattered notes of my writing, we have a pretty packed schedule as you can tell and it is about 2:30 AM here and I’m trying to record and soak in this experience as much as possible, but I’m trying to keep up with it. Hope all is well, love you lots!!

Tuesday, May 17, 2016

Beginning of Cape Town

An 8 hour trip to London 11 hour layover and 12 hour flight to South Africa in a middle seat, I'm happy to have arrived in Cape Town. We walked to the waterfront in about 20 minutes and there are plenty of little shops and pubs. We found out fairly quickly how great the currency rate is on our end (15 RAND to 1 USD). A Venti coffee at Starbucks was about 2 USD. The following day we had lunch that gave a very scenic view of the iconic Table Mountain, for a preview of our cable up to the top of table mountain. We went at sunset and it was difficult to not take a bunch of pictures, yet they could never capture how beautiful it is. Yesterday was a pretty eye opening day, vacation mode turned into real time South Africa. We went into the slums and went to the clinic. It is exactly what you see in pictures of the poverty. People crowding the streets living in really small shacks or lying around the street homeless. When we got inside it was total chaos, tons of people waiting around kids running and hundred of people waiting for consult, treatment, blood work and results. The children were absolutely adorable. There is a tradition that when you stick your thumb out to welcome children will go touch your thumb and twist on it. I was shadowing a physician in HIV/AIDS and TB side of the clinic. All of us had different age groups but my physician was pediatric focused. It was very heart-wrenching to see the children who are just starting to realize what this disease means, yet the understanding was different with each patient. They passed out booklets to explain what it means in terms for children to understand. To see a little girl 2nd grade stop treatment because she doesn't see the point, she believe HIV/AIDS just means you're going to die. However, when you continually take your antiretroviral treatment it stays in remission and you likely don't have symptoms. Yet, this one girl who didn't take treatment for a year developed TB, skin infections, and very high viral load count and couldn't afford treatment. I cannot imagine what that must be like to be that helpless as a parent to not be able to provide the care for your child survival, especially when the child likely contracted from the mother. It is hard to keep up with blogging and journaling when we are so busy each day, but I will try my best to keep you guys posted!

Friday, May 13, 2016

London 5/13

Dan and I arrived in London at about 10:00 AM (their time). Though we were tired we got some caffeine, took the tube (mind the gap) and headed downtown. We went to Buckingham Palace, Covent Garden, Trafalgar Square, and some local pubs of course!! Adrenaline is running low and we're ready to sleep on our next flight to South Africa. Later London, thanks for an awesome day!!

Wednesday, May 11, 2016

Big shoutout to my friends and family that have helped support me through my studies. Beyond excited to start my journey post graduation traveling the world !! After all the planning and anticipation, the time is here! I cannot believe that tomorrow I leave for South Africa (with a short trip to London)! I'll try and keep everyone posted as much as possible!!