Wamu Village: The first part of the week was spent in Wamu, a rural village about an hour northeast of Durban. We did home-stays and lived with community health workers (CHW’s), who are individuals chosen by community members to provide basic health and medical care to their community. They are trained by the government and health clinics and have a marked route of patients within their community that they are responsible to stop in each day to check up on and assure they are taking their medication properly. They’re also responsible for implementing DOTS, (Directly Observed Therapy), which is the WHO-recommended strategy for controlling TB. Basically, community health workers directly observe the TB patients taking their medications and must sign off on it to assure adherence so that drug resistance doesn’t develop into MDRTB (multi-drug resistant TB) or XDRTB (Extremely-drug resistant TB).
I got to go around with my CHW Mama on her rounds from house to house, which was an awesome experience for me. We visited patients suffering from TB, HIV, severe arthritis, hypertension, and diabetes (the diabetic woman had necrosis from diabetes and lost a leg and had a gaping hole on the bottom of her other foot). It was really cool to see healthcare on the community level like that.
As far as the home-stay itself, it was definitely an experience. There were +/- 7 kids living in the house with our mama, only two of which were actually hers. Her sister and brother-in-law both passed away so she inherited their kids and some others too. All I know is, there were 9 people sleeping in a very small room at night (in beds and on the floor). My partner and I shared a bed in the room and also had a small child sleeping between us (who liked to punch in her sleep). The long drop toilet was also the worst I’ve come across in SA so far. It was pretty rough. It was hard living, but definitely an awesome experience.
Mtwalume Village: Mtwalume is only about 45 minutes south of Durban and is a little coastal village near the beach. We visited the Bangibizo Primary School, which alone impressed me more than any other school, NGO or hospital I’ve visited so far. The difference was that the teachers legitimately cared about their students (and weren’t just trying to get them to pass their matriculate exams). They admitted that 50% of the students are orphans (mostly due to HIV) and a lot of times the teachers must take money out of their own pockets to assure they all have food and clean, mended uniforms. They grow vegetables in a huge garden outside and stress the importance of good nutrition for the students. They give many of them to the orphans to take home and give them seeds so they can grow their own veggies too. They also are very involved in recycling and each year they clean the beach and make things out of the trash the collect. The school receives almost no funding from the government, yet they are a success and have the majority of their students passing their matriculate exams each year. I think a lot can be learned from them.
I really fell in love with Mtwalume. The people were warmer, I loved my home-stay family, the school, and the whole area (it’s also a plus to be near the beach). I’m trying to re-work my Independent Study so that I can live with my family I had there (my mama was begging me to come back and live with them) and so that I can help out certain days by teaching English at the Bangibizo School while also focusing on an aspect of HIV and healthcare while there too. I’m still working out the logistics, so hopefully I can make this happen. At the end of the trip we visited a beading workshop where we worked with HIV positive women and learned the art of African beading. We made HIV ribbon pins out of beads, and mine turned out pretty good if I do say so myself :)
After leaving Mtwalume, we went to a rural TB hospital. We all had to wear facemasks since TB is highly contagious and airborne, but we were able to talk to the hospital administration and ask questions, get a tour of the hospital, and also go in and talk to some of the patients. Most patients have to stay at the hospital for 6 months before they can be released, and it’s very hard to get to the hospital so most patients don’t see their families for a very long time. TB has kind of been overshadowed by HIV as a public health issue in South Africa, but remains a HUGE problem here (and is most of the time complicated by HIV). HIV positive patients are more likely to contract TB since their immune systems are suppressed.
Then the weekend came. We went hiking and camping in the Drakensburg Mountains and it was absolutely beautiful. I wasn’t really anticipating how difficult of a hike it would be, and when I say I went hiking, I mean I literally climbed a mountain. It was hard but it was definitely worth it to get to the top. All together it was about an 8 hour “hike.” We saw lots of baboons, impala, jackals, and interesting bugs along the way too.
We came back to Durban on Sunday and I ended my 9-day streak of not showering ☺. At least I jumped in a river on the hike… that counts as a shower! I’ll be living in Durban for the next 2 and a half weeks before I start my Independent Study project (hopefully in Mtwalume)! I’ll keep you all posted.
By the way, the title of this post is a quote that comes from Tracy Kidder’s “Mountains Beyond Mountains,” which is about Dr. Paul Farmer and his work to provide healthcare to rural areas in South America and Haiti. It stands as a metaphor: “beyond mountains there are more mountains.” Dr. Farmer discovered that beyond one issue lays another, larger issue and that every step forward he’d take, he’d have to take two backwards. I thought it fit this post well, being that I was able to see this observation first hand in the rural areas, and also because I spent the weekend in the mountains.
No comments:
Post a Comment