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!!
-Rachel
-Rachel
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