Thursday, 16 August 2012

Two Foster Mothers I Met

This blog entry is about two foster mothers Matt and I interviewed during our time working with Ikamva Labantu.  I hope to share their stories with you not only to give you more specific cases we deal with in our work, but also raise the question of "how should we better help these foster mothers".  The later inspires me to write my final report on the shortage of social workers worldwide.

Children playing in the yard
When we parked the car at the door of Mapapu's home, I had this feeling of visiting another one of the crèches we were visiting those days.  Six or seven boys around the same age were playing in the front yard and they could just have been students in a small-sized crèche; as we walked in her home, we saw more children.  This time they were of different ages.  One of the little ones was in the arm of a teenage girl and the other one was in the arm of a lady of my grandma's age.  She is Mapapu, our interviewee today, a foster mother in the Guguletu township in Cape Town, South Africa.
We were weighting the children and measuring their heights to learn about their growth status.  The lady in orange dress is Mapapu.
Although she is the head of the household, which was packed with more than twenty children, Mapapu was not running an educare center.  All these children, from the months old to grown-ups, were her foster children.  In another way of putting it, she was having twenty children except many of them were not her blood relatives.  It might be a blessing for the well-off people who love kids to have twenty of them around.  But for Mapapu who doesn't have a steady income or a lot of savings, having twenty children under the roof of her two-bedroom house means a lot of financial difficulties.  To be more specific about this, just note that in South Africa, the government gives 700 Rand to the foster mother for taking care of each foster child.  However, due to the complexities of getting this grant, Mapapu was raising more than twenty children with a grant of 2800 Rand every month.  "Social workers came and drop the babies at my door.  All I could do was pick it up and raise it as my own.  Nobody ever came back and took the child away.  So I just have more and more children."  When we asked about the legal custody of those children, Mapapu took out some legal documents that state the expiration date of her custody.  Even though some of those dates already passed, no social worker came and helped her to update these documents.  No legal custody means no grant, while the social workers were all busy delivering new babies to her home.  Mapapu had no choice but to spare the little food they've got for additional children in her house.
Two little ones wearing T-shirt in the winter.  I myself was wearing a puffy jacket.
Limited money at home might just suffice for food because the children were clearly out of winter clothes.  In the middle of the winter in South Africa, some of the children were wearing T-shirts, shorts and flip-flops. At some point during our visit, the pipe in the front yard broke and the boys tried to save the leaking water using basins, buckets and bottles.  After the pipe was fixed, their thin T-shirts were wet but no one went to change, probably because those were the only ones they had.
Pipe broke and the children were saving the water.
Monetary issues were not the only problem Mapapu was facing.  She started tearing when we started to talk about the future of these children.  She showed us a poster she made in 2011 that tries to solicit donations from the society.  In the poster, she cried for old clothes, shoes, food and adoptions.  "Nothing came back", her anxiety was all in her crying voices. 
The poster Mapapu made
Another foster mother, Vivian Joba, who was taking care of eight children, worried about the same thing: what the future of these children is like.  She was worrying about one of them especially.  This girl, who had been living with Joba since three months old, had a car accident six months ago and broke her neck.  She was disabled and no one, not even Joba, knew her future.  When I think about this tragedy further, I realize that this is a tangled matter rather than mere misfortune.  The accident happened when the girl was playing on the street unattended.  Because Joba was taking care of more children beyond her physical ability, the girl was not attended and thus gave chance for the accident to happen.  The accident also increased Joba's dependency on grant.  However, six months passed by and no social worker showed up to help her with the medical bill and special care grant.
Joba's disabled little girl
Ikamva Labantu is still recruiting social workers but the shortage of social workers countrywide has made it especially hard to recruit for NGOs who couldn't afford high pays due to limited funding.  I believe that I saw problems in the foster care system from talking to Mapapu and Joba.  But meanwhile, I am glad that I am for sure not the only one who saw those problems.  I talked to my supervisor at Ikamva and she told me that Ikamva was thinking of training community workers to do some of social workers' job.  I sincerely wish that by the time next year's group arrive at Ikamva Labantu, Mapapu and Joba will be no longer suffering from their problems.

Some Ideas on Poverty in South Africa

I realized it's more than a month after I originally wrote this blog about my personal experience in this public health program in Cape Town.  So what happened in the last month?  First of all, I had a fever right after finishing my final exam at UCT.  More precisely, the time was that Thursday afternoon when everyone was done with the class and went to the top of table mountain.  Most of the time there, I was having heat in the forehead and coldness in my arms and legs alternating torturing me.  But still, at the times when I could function a little bit, I walked slowly and tried to pose for nice pictures. :)
And then it was almost time for us to say goodbye to each other.  It was just too sad that I got fever again on the trip back.  Transferring at Doha when local temperature was over a hundred degrees at midnight while having a fever was no fun.  I was by myself to go back to China to stay with my families for the rest of the summer.  
So I got back home.  And the flu did not get better after two weeks.  I was shocked by the length myself and the explanation I came up with was that the air pollution was too bad that my immune system was weak due to the pollution.
But thank lord I'm okay now.  I'm in a chain cafe in Hong Kong right now.  I travelled with my laptop from home to use the unblocked Internet here.  Sorry to everyone who's been waiting for me to share my experience.  I hope it's not too late to share my memories and feelings this summer in South Africa.

In this blog entry, I am going to share with you some of my thoughts on poverty at the end of this program.  The ideas might not be deep and might sound cliche, but they all came from my own experience and every word I say comes from my sincere mind.  I really appreciate the chance to form my own ideas after experiencing South Africa for seven weeks.  Meanwhile, I hope these words are throwing stones into lakes.  May the waves they excite inspire you to one day learn more about South Africa and check all the happy, sad stories out.

I still remembered sitting at freshmen convocation dinner ten months ago, and our dean Katherine S. Newman said something that has the meaning of "You might not realize, but your time here at Hopkins will help you gradually understand how truly privileged you are, and you will share your privilege with people who are far less fortunate."  I had never better understood her until I came to South Africa, and this experience redefined my conception of poverty.With amazing shores, mountains, wild winters, bustling Long St., fashionable markets and prosperous business, Cape Town is a paradise for many.  Yet, if one digs deeper, he sees townships, jobless people wandering, children playing on the street unattended, shacks, and clothes hanging outside of homes, all of which only contradicts the paradisiacal picture of Cape Town.  Poverty, a word I use to summarize the later picture, turned out to mean a lot more than its literal meaning, as our program here comes to an end.Poverty means Ubuntu.  As a contrast to how people live in luxurious apartments and seldom talk to each other in China, people in townships are close.  People walk in and out of other's house; a whole community gathers to attend someone's funeral; people show up at dinnertime and join other families for dinner.  Not necessarily I would want to be part of this culture, but it's still nice to see how people here interacts.  (As a matter of fact, I feel more comfortable with my neighbors at a distant.)  What's more interesting is, in spite of the closeness, people seem to keep things to themselves at the same time.  For example, people seem to be reluctant to being spotted seeking help for HIV/AIDs. Poverty means boredom.  I thought I had bored times in my life until I spent some time in townships.  People do nothing and that is what they do everyday.  And I could honestly not imagine any one in the organized, always busy world I come from, to live a life like that.  As a respect for the culture, I should not say it is a bad thing.  But somehow I still feel some people here could have worked harder and they just laid back and waited for aid.  Isn't that boring?Poverty means wasting electricity every second.  The lights in townships are always on days and nights in Soweto, in Langa, in Guguletu, in Khayelitsha.  And nobody seems to care about this.Poverty means sad childhood.  Young parents abandon new-borns, siblings take care of each other, no storybooks and toys for them and nobody seems to care if they have fun.  It's heartbreaking to think about how different lives the children in different countries are having and think of my little brother who has a room of toys, robots, dinosaurs and Legos.  My parents' generation fought hard for the wellbeing of their children but what did parents here do?  Poverty didn't even give them the chance to have the courage of pursuing a brighter future.However, generalization is far from enough to tell the story of South Africa.  I see endless kind people doing great work at Ikamva Labantu.  I hear about people in other NGOs putting their efforts to change the situation.  Moreover, I engage in work that seeks to improve people's lives here.  I can spend a whole day talking about anecdotes and personal highlights, about what our research is and what we found out.  More importantly, I began to acknowledge how extraordinarily lucky I am, to have everything I've had in my life.  I appreciate every little things in my life and I feel so ready to share my privilege with the less fortunate in the future—I might not know yet how, but it is a must.

Wednesday, 25 July 2012


I think we’ve been back for 36 hours. Maybe. And we left Cape Town a little more than three days ago. I’m not really sure. All I know is that I woke up at 7:30 this morning after 5 hours of sleep. So much for the recovery period I was planning. No hibernating here in 90-degree heat. Suddenly I’m kicking myself for counting down the days until the Baltimore heat. I’ve unpacked a little. There’s a pile of dirty clothes on the floor in my apartment’s entryway. It’s times like these I don’t really like being a grown up in my own apartment. This whole unpacking process would be expedited if I could roll my suitcase into my laundry room at home.  Within a few hours my “Africa” clothes would be folded neatly on top of the washer machine, awaiting their departure to the third floor. Thanks, mom.

The 24 hour (!) travel period wasn’t nearly enough time to digest everything that happened in Africa. We’re all definitely still wrestling with the time difference and heat wave (I’m praying those bumps on my arm are a heat rash and not bed bug bites). I know I am still trying to get acclimated to Baltimore and life without my ten new friends. I would totally suffer through another Graca Machel breakfast (and instant coffee) if it meant I could hear Ling complain about the lunch ladies and watch Ndu shovel egg sandwiches in his mouth. And as much as I’ve missed Blue Bell (my blue Honda Civic), I miss Wayne’s gold speckled smile that he cracked even when we were running a little late for our departure to work. I miss his spacious van that was always mistaken for a mini bus taxi. I miss “Monday Mornings with Matt” on the rides to work and how much everyone bonded in the car ride back and forth from their internships. I miss the “judgment free zones” that seemed to pop up everywhere with the ten of us. Somehow the rules of the Monday night reflection circle were applied to Wayne’s van, Liv (our rental car), the Oatlands, and even the couches of Cubana. So much was said and understood among all of us that we were “all reflected out” on Friday night during our final reflection session with Lisa and Angela. In the beginning of our trip (i.e. the awkward van ride from Hopkins to Dulles), the silence may have been awkward, but by our seventh and final Friday in Cape Town, the silence was comfortable. It was so evident that we all had uniquely “heavy” experiences. We didn’t need to talk about it.

With our driver, Wayne. Van not pictured. 

Now that I’m back in Baltimore, I’ve sunken to the bottom of the “emotional curve” Angela handed out in the beginning of our trip. I thought surely my “rock bottom” would have been when I opened up my lunch to discover a quiche. Or that day when it was really cold, and rainy, and I didn’t know how I’d be able to make it seven weeks with the same ten people (sorry, guys). Currently I’m sweating in my apartment, wishing for the rain to break this heat wave. And, honestly, I could go for a quiche.

Our rental cars with their respective drivers. Liv is the slightly cuter one on the right with Tyler. 

Liv expertly navigating the rough roads.

Through this blog you’ve seen that we have had our share of experiences and adventures in South Africa. We’ve experienced townships in both Soweto and Langa, we’ve swam with sharks, we’ve jumped off bridges, we’ve climbed up mountains, and explored every tourist attraction of Cape Town. We learned as much about HIV/ AIDS that could be taught in six weeks and worked part time at local NGO’s.  However, our individual journeys were more than what was written in this blog and more than the pictures you see on Facebook. Words and pictures don’t seem to do justice to the emotions we felt, the lessons we learned, and the ways we have all grown as scholars and as world citizens.

One of our Monday reflection sessions.

Thank you to the Public Health and Study Abroad Offices for organizing the trip, the President’s Office for sponsoring our trip, and parents as well as fellow students for reading our blog. A special thanks to my family who supported my decision to skip town for the summer and then respecting my privacy when I was on the other side of the world.  

Time to finally do my laundry and finish unpacking. 

Tuesday, 24 July 2012

Siyayinqoba BEAT IT!

Ah. Community Media Trust. Where do I start?

Mmmm. Coffee
Let’s start with the walk to work that Audrey and I enjoy every day. Our daily trudge at breakneck speeds, in rain or snow, past Kauai (smoothies!) and Pick and Pay (our life support), and over the great concrete bridge of quad-workouts has become something of a ritual. We arrive at precisely 9 every day thanks to Audrey, and settle down immediately to work after the crucial tasks of getting coffee and checking email.

Our work is varied and free form. We started off with writing summaries for the Siyayinqoba Beat It! DVD series, and then slowly graduated to consultant-level tasks like interviewing the director, staff and beneficiaries, as well as compiling probably the longest report I’ve ever written as documentation for our JHHESA funders. In the process, we’ve learned a ton about public health in South Africa through the lens of an NGO, as well as how an NGO works from the inside out.

A little introduction to Community Media Trust is necessary before I proceed. The media production organization was started by Jack Lewis in 1998 in the era of emerging AIDS denialism and severe lack of health literacy in the country. Originally started to support the Siyayinqoba TV show, which airs on SABC every Thursday, addressing the national audience, the company has since then expanded into a multi-purpose organization providing crucial training to community health workers and health communication channels via social mobilization projects at the local and regional levels. All of which designed to spread and promote scientific health literacy in the country to promote service uptake and HIV testing. 

One of Siyayinqoba's skillfully done adverts for their national television programme. 
What we did, essentially, was find all of this out. We first talked to Debbie, our supervisor, who gave us the most detailed and brutally complete run-down of how their Monitoring and Evaluation system works. Running an NGO is an inherently complicated business, and when funders ask you for statistics measuring your impact, it gets even harder. I’ve grown a healthy appreciation for accurate and organized record keeping, because of it’s role in wowing funders and ensuring a steady supply of finances—which, as any NGO will tell you in this era of funding cuts and budget downsizes—is life and death.

We talked to Jack Lewis, the founder, who’s quite possibly one of the most amazing and inspirational people we’ve met. He’s the visionary of the company, and his main role in the office is to sit on his sofa while everyone else runs the company and talk to people—and he’s incredibly good at it. He has the wisdom of a man who’s fought in the HIV war long enough to know every nook and cranny of it, the charisma of a master raconteur, and the connections of….I don’t know. He has a lot of connections. He knows everyone. 

Needless to say, we gained an incredible amount of information about not only the general situation of HIV in South Africa but the NGOs that are working hard against it, including the obstacles and problems that most face. Some of the political insight he imparted to us has, admittedly, given us quite an unfair lead for our reflection papers for Anna.

We also interviewed some of the beneficiary organizations and stakeholders, telephonically, from around South Africa. Most of the beneficiaries gave the most glowing reviews of CMT, which made us all the more proud, if not a little smug, about the wonderful organization we worked for.

Then we spent about a week pounding out the actual report, which I’ve linked to here. Just in case you’re up for some light bedside reading—it’s twenty some pages and contains just about earthly thing you’d want to know about CMT.

Twenty some pages of this. High level stuff.
Interspersed between our massive documentation project, we got to do a little journalistic work, too. Community Media Trust has recently begun a GroundUp newspaper project, which aims to include “ground-level” articles on health, poverty and other social issues within local communities. The operation is headed by Nathan Geffen, who, coincidentally, is also the author of our textbook for Anna Grimsrud.

Our textbook, written by the one and only Nathan Geffen.
We managed to write two articles on our journalistic excursions—the first to investigate public transportation in the city from a tourist’s perspective, and the second to investigate homeless conditions in the shelter. For the first, we got up at 5 on a rainy morning to go ride the MyCiti Bus to Tableview. We saw quite a bit—how many of the buses were severely underused, specifically. Our excursions to the homeless shelters gave us quite a view on the winter conditions that the homeless have to suffer through, and we got to understand a little more about the nature of homelessness in Cape Town--many are skilled laborers that simply cannot find jobs. If you want to read the articles (of course you want to read them), check out the GroundUp website. It's up and coming, so it really needs a lot of views:

It’s hard to summarize six week’s worth of work in this, but I think that’s really about it. In conclusion, Community Media Trust was a blast. We are now officially qualified experts on HIV, as well as genuinely knowledgeable people to talk to about NGOs, politics and HIV life. We've honed our documentation writing and interview skills. Most importantly, though, we've seen firsthand what working in an NGO looks like, including the romantic parts and the more dull parts. It's been real!

Here’s an artistic picture. Just for fun. Photo credit: Audrey.

Sunday, 22 July 2012

Cape Town Things

Travelling to a new country, all of us were forced to change some of our “American” habits and adapt to a new city and culture. Below are some random musings, lessons learned, and uniquely Cape Town or African “things’

1.    6/28/2012 isn’t a real date. 28/06/2012 is the 28th of June.
a.     When I went to the doctor’s office in early June, I wrote my date of birth down as 04/03/1992 and when the nurse confirmed my birth date, she said “March 4th 1992.” I laughed at my mistake and if she hadn’t known before, I’m sure she knew then that I was American.
2.     Look left before right when crossing the road
a.     In South Africa, as most other countries, vehicles drive on the left (a traffic pattern that doesn’t necessarily apply to pedestrians as well). So when you cross the road instead of looking right, then left, as you would in America, it is in your best interest to look left first. We all made this mistake a few times but luckily no one got hit by any moving vehicles.
3.     Get into a van on the left side
a.     Just as the driving pattern is reversed here, so is the drivers seat in the front of the car. Rather than sitting on the left side of the car, the driver sits on the right side of the car. So for the buses that we took on tours and to work, the door for the passengers is on the left side of the vehicle. Therefore, if, by chance, you’re sprinting to the van on a Friday afternoon leaving work in the pouring rain, go to the left side of the van. If not, prepared to get teased by your driver. (Shout out to Wayne who only giggled under his breath after witnessing this mix up more than a few times)
4.     Divide all prices by eight.
a.     The exchange rate right now is about 8.3 Rand to 1 USD. So that 63 Rand Large Bacon Supreme pizza from St. Elmo’s Pizzeria comes in at less than 8 dollars. Nice. 
5.     Order more food than what would be acceptable in America.
a.     Sure, you’re a public health major, and ordering more than one pizza might warrant some stares from strangers and could even shave a few days off your life, but that “large” pizza from St. Elmo’s is only 30 centimeters in diameter. Plus, the whole “Chicago deep dish” concept is nonexistent here. So do your stomach a favor and just buy two pizzas. I guarantee the transfat content is those two pizzas is less than a steak egg and cheese with a hash brown from UniMini.
6.      Remember to weigh produce at Pick N Pay
a.     At Pick N Pay, the local supermarket, there are employees whose sole responsibility is to bag your produce in those clear bags, weigh the produce, and tag the bag with a sticker denoting the price. Waiting in line to weigh your produce is a little annoying, but kudos to Pick N Pay for creating jobs in a country with a 25% unemployment rate. (And just an FYI to all the Jersey drivers- they have gas station attendants to pump your gas too)
7.     Get used to the metric system
a.     As an avid American, I too resist the metric system. I’m used to inches, feet, and pounds. But I’ve learned that even though the entire world speaks English (exaggeration), they don’t use the United States customary units and instead use the more straightforward metric system. I’m not really sure what 250 grams of fish and chips looks like (instead of a small, medium, large, restaurants label sizes in grams of food), but I do know that 13 degrees Celsius is jacket weather and 20 degrees Celsius means I can run outside in a t shirt and shorts.
8.     You can survive off instant coffee
a.     In a country with a Starbucks at every corner, Americans have been spoiled with easily accessible filter coffee. (Filter coffee= typical coffee from a coffee machine made with coffee beans. Confession: I didn’t know that either). Filter coffee in Africa is not as available as it is in America. For instance, at the dorm cafeteria, there was only instant coffee. This applied to my internship as well. Somehow, I was able to fully function throughout the school or work day on instant coffee. It may not be the tastiest coffee, but it still does the trick.
9.     Don’t worry if you’re running late
a.     “South African time” = 15 minutes later than the actual time given. Even though this doesn’t apply to every circumstance, such as class with our Canadian professor, it is somewhat acceptable to arrive “fashionably late.” Several students in our group had no problem adapting to the new time schedule.
10.  When spoken by a South African, “Is it?” isn’t a question
a.     So instead of continuing to talk about whatever warranted the question/ statement, just smile and nod.  I’m not really sure what “is it?” means, but the smile and nod reaction seemed to work for me. From what I have experienced, “is it?” is similar to “oh, really?” Again, I’m not sure, but just know when someone is saying “is it?” they aren’t asking you to justify a statement or go in depth with an answer. This whole comment/ question phrase caught me off guard, but may not have been the case for the other Americans. 

Cape Town Food Report

Food has always been a big deal to me. My father claims that I am “The Perfect Eating Machine” because I have a habit of consuming quantities of food that some may say is socially unacceptable. One of the main reasons why I love to travel is it gives me an excuse to unleash my inner monster and try lots of new foods. My dining experience in Cape Town has not let me down, as I have tried several succulent dishes over the past seven weeks. The purpose of this entry is to highlight a few of my favorite places and meals, so I hope you enjoy reading this as much as I have enjoyed savoring all of the wonderful cuisine that Cape Town has to offer its residents and visitors.
Me in my natural habitat.
The ten of us discovered the Eastern Food Bazaar after a trip to Parliament at the beginning of our trip. When I first walked into the block long Middle Eastern and Asian food court, two things came to mind. One, all of the food was extremely cheap (and even for South Africa, where food is very inexpensive compared to the United States). And two, I was dubious about the quality of the food because it seemed like any other old food court. Boy, was I wrong. The chicken tikka masala and garlic naan I ordered was easily the best I have ever tasted (and yes, better than Tamber's, The Ambassador, and Akbar, for you skeptical Baltimoreans). In addition to the incredible food, I still couldn't get over the fact that I only spent 39 rand (just under five dollars) for such an enormous portion of food. Besides a couple others and me, our group had lots of take-a-way boxes for another meal later on that evening. Christina and I agree that after our experience at the Bazaar, we are now able to die happy.

A glimpse of the Eastern Food Bazaar in downtown Cape Town.
On the Fourth of July, Lisa surprised our group by taking us out for an all-American meal in Cape Town's City Bowl. We went to the Royale Eatery, a quirky restaurant that boldly claims to serve burgers that “make your soul tingle and your dreams come true”. In addition to the uplifting burgers, Royale has an interesting selection of drinks and milkshakes. I ordered an “Ungrateful Basted” burger with sweet potato chips (fries) to eat and a peanut butter and Jack Daniel’s milkshake to drink. The burger lived up to its high expectations, as I was on cloud nine while wolfing it down. This heavenly sandwich consisted of a 250g beef patty basted in their smoky sauce, lettuce, tomato, caramelized onion, gherkins (pickles), cheddar cheese, and bacon. The sweet potato chips were quite tasty as well, but they were different than the ones from back home because they were white instead of burnt orange. The PB and JD milkshake was out of this world. It was extremely thick, so I needed a spoon to eat all of it. This delicious combination of a giant burger, sweet and salty chips, and alcoholic milkshake made this Fourth of July one for the ages, so many thanks to Anna, our Public Health in South Africa course professor, for recommending Royale to Lisa!

Ndu's in pure bliss!
According to many locals, no trip to Cape Town is complete without spending an afternoon at Mzoli's. This popular venue located in Guguletu, a local township, attracts people from all over because of the unique experience that it gives its visitors. When I first walked into Mzoli's, I found myself in a nondescript butcher shop with boring white walls and lots of raw meat. My group and I were instructed to order our meat at the counter and then go next door to a giant red tent to wait until our food was grilled to perfection. We did as we were told and ordered approximately an entire farm's worth of meat. The tent next door was not very sophisticated, but boy was it alive with energy. Inside, a DJ plays a mixture of electronic and hip hop music while people party and chow down on the best grilled meat in all of Africa. My personal favorite part of the afternoon was the combination of the taste of seasoned pork chops and the sound of A Tribe Called Quest playing in the background. Now whenever I hear their music, my mouth will automatically salivate because of the delicious food that I inhaled at Mzoli's.
A pile of goodness at Mzoli's.

Life Lessons at St. Joseph's

During my time here in South Africa Christina and I were assigned to St. Joseph’s Home for Chronically Ill Children. St Joseph’s home provides free medical and rehabilitative care for children who suffer from chronic and debilitating illnesses They form part of the Community Based Care Program of the Department of Health and as such provide Intermediate Care, acting as a bridge between hospital and home. Their facilities have four medical wards and one HIV ward, a nursing school, special needs school and also provides physiotherapy, occupational therapy and even have their own social workers. The age of patients range from infant to 18 years old, leaving the home with their hands full. Though the residents and the home are sick it is actually a very happy place. I didn’t believe it at first but after visiting the beautiful campus and having a tour of all the wards she couldn’t have been more right. My favorites are the sunflower, daisy, and sweet basil ward because they have the smaller children and everyone loves the kids. The teenage wards, Protea and Freesia, had a slightly gloomier mood. The home’s director, Thia, explained it is because the older ones have more of knowledge of their disease which made sense but still was a big contrast between the smaller wards with kids running around or splashing around in the rehabilitation pool. The home gets a bunch of volunteers who assist in the wards which was pretty desirable to me but our job was far more formal. Our job was to conduct a time motion study on the nurses. We were to observe and report all the actions of the nurses and put together a report on the things they did and the amount of time spent on each task. They are a private home but are mostly state funded and hopefully, based on our data, they could make certain decisions about the skill level of the labor. It seemed to me a little cold in a place where I could seemingly do something so much more helpful. I was forced to look at things from a wider lens, resolving to the notion that my involvement will help keep the home open longer, though I may never see the fruits of my actions. Though the nurses had been told that what was going on and to go about their business normally, they were very apprehensive and created some very awkward situations. The lubricant to the strained situations was always the children. It only takes one to start talking to us and then they begin to swarm. The children always enjoyed the chance to write or draw with our pens, making karate sound effects or asking questions about China to Christina (She’s Asian), and apparently I am a fantastic jungle gym. They were always a treat, even though I once received a hardy bite on the finger as a parting gift from one of the children after a shift. Even though we were not as close with the nurses on our last day on duty something unexpected happened. It almost seemed like a perfect storm of situations, many of the other nurses we would have been observing had gone on lunch break, and the children were having their afternoon nap which made the ward calm and quiet. A child starts crying and one of the nurses, Elizabeth, goes to soothe it at brings it back with her and she begins to talk to us. I will admit that I was only coming in and out of her talk for the first few minutes. But as I heard more I had to move closer. She told us a story of a husband who she loved but who also was a drinker and who loved other women. Though they had problems her husband and her two boys was the family she came to love. One day about one block from their home, her husband had an automobile accident which put him into a coma for 7 months before he finally died. Without the strict male influence in their life, she continued, her sons began to go wayward. Both became drinkers and are both currently on drugs. The younger of the two boys has 5 children with two/three different women and was sent to jail because he would invite people over to her home to do drugs while she is at work. To add even more to her plate in her old age she suffers from diabetes, hypertension, and has had a stroke. She is also in and out of court because South African law states that the children must be supported, if not by the parent, then the family of the parent. Her story incorporated everything we had learned about South African issues from automobile accidents to drug issues, and even gender roles. She seemed hopeful for change with religion playing a strong role in her story. This woman was worn but she was the epitome of strength in my eyes. Our time at St. Joseph’s seemed very cut and dry at face value but proved to give us lasting experiences, and shining examples of happiness and strength through the most difficult circumstances.        

Yabonga: My learning experience

     Fatu and I had the pleasure of working with Yabonga during the Public Health Studies study abroad Cape Town trip. Yabonga is a nongovernmental organization that seeks to support education for children. Yabonga’s vision is to empower men, women and their families affected by HIV/AIDS to become agents of change in their communities. Yabonga originally started out in 1998  with a children’s program because they realized that the educational system was poor and under resourced. It all started with educare centers that expanded and Yabonga soon noticed that people were becoming affected by HIV. Yabonga expanded their efforts to offer HIV/AIDS programs. Today Yabonga has 14 support centers around the Cape Town area. Yabonga manages to reach about 75,000 people. They train people on how to live a positive life despite having HIV. They train men and women to be peer educators, youth counselors and youth leaders who work in the various support centers around Cape Town. We didn't really get to see much of the HIV/AIDS program since we mainly worked with the Youth Program. The Children's Program also has an Orphaned/ Vulnerable Children program. Community mothers open up their homes for children where they can get a nice meal, counseling and other things. The Children's Program has an importance from a public health perspective. It offers psychosocial support, material support, HIV/AIDS support, educational support, and other enrichment programs.

     My experiences with Yabonga have left me speechless in a lot of occasions. I realized that Americans have so many resources related to education that students in the townships do not. I could go into why education plays a key role in health but I feel like I should share more of the things that the students have taught me during my stay here. I remember when I was in high school; I had a counselor who advised me on applying to schools and financial aid. I wouldn’t be studying at Johns Hopkins if I didn’t have any guidance. I think it is important to realize that the youth of today will be the employees of the future but they can only be qualified to fill these jobs with education. Some of the students didn’t know what they wanted to do and that is absolutely understandable. I didn’t know what I wanted to do in life in 9th grade either. What is more important is that I had someone who I could go to to advise me on things and bounce ideas off of. I think the South African education system puts students into situations prematurely. Students have the option to attend a FET school, which stands for Further Education and Training school. Students can either continue at their high school or apply to a FET school at during their 9th grade year to study for 10th grade. It happens so early.
Most of our lessons focused on students thinking about  what they want to do by considering their interests, values, and skills.

Our days weren't limited to lecturing. We did group activities about peer pressure, decision making, and other life skills. 

It was the student's winter break so we had to incorporate fun icebreakers and games so students would be comfortable with us. I had so much fun playing games with them. I really got to see the student's personalities. 
Going to the park and doing relay races. I lost every time/ I'm getting old.
Space availability in the universities is sparse so we had a Representative from a FET college (Further Educational Training) come and speak to the students. False Bay College is one of the FET schools in the Western Cape. We wanted students to consider this option to learn some type of trade so they have a chance at getting a job and try to pursue higher education after.

       I learned just how much apartheid still affects South Africans. Many of the students Fatu and I worked with didn’t really get to experience full blown apartheid but their parents did. It is important to understand that their parents weren't allowed to pursue higher education and were reduced to work jobs just to get money. Therefore the students’ parents can’t really offer advice on college and further education. I noticed that many students want to be doctors and lawyers and that is probably because their parents don’t want them to live like they are currently. I mean I think it is parent nature to want their children to always do better than them. The problem is that students don’t realize how to get to become a doctor or lawyer. I understand that students want to stop the poverty cycle in their family but they can’t do it by themselves. This made my role at Yabonga fulfilling because I knew that I was contributing. Granted I don’t have all the answers but we were able to sit down with students and talk to them about what they wanted to be. We did exercises about setting SMART goals. Every Monday, Wednesday and Friday we were with the students doing interactive activities to get them to think about the future and have them realize their own potential.
     When I first got accepted to go on this trip I had no idea I would be getting attached to these students after 6 weeks. These students will always have a place in my heart. These students have so much potential. I think a lot of the children living in the townships get overlooked. They deserve so much more though.. It was a struggle to get it in my head that I can’t make everything better but they really deserve better. They deserve to get to explore Cape Town and not be confined to the township they were born in. They deserve teachers and faculty who care about their success.  They deserve more guidance. I was so happy that I could be someone for them to talk to. I will keep contact with Yabonga and I'm eager to hear about the students' progress!

 Guest Blogger: Chantel Fletcher

New Perspectives: The Sonke Gender Justice Network

I have had the pleasure of interning with the Sonke Gender Justice Network for the past six weeks.  Sonke is a Non Governmental Organization (NGO) that deals with gender equality, HIV/AIDS, and human rights in the greater region of Sub-Saharan Africa.  The name ‘Sonke’, an Nguni word meaning “all of us” or ‘together’, symbolizes the organization’s commitment to working in partnership with all those committed to our vision of gender equality, human rights and social justice” (Sonke Annual Report 2006/2007).  Bafana Khumalo, Shamillah Wilson, and Dean Peacock founded Sonke in March 2006 in an effort to unify and take action against the scourge of HIV/AIDS and gender inequality.  From these recent beginning they have come to have an office in Cape Town, Johannesburg, and, in the near future, an office in Geneva, Switzerland.  However, their mission and vision tirelessly remains the same:

Vision- “Sonke’s vision is a world in which men, women and children can enjoy equitable, healthy and happy relationships that contribute to the development of just and democratic societies.”

Mission- “Sonke Gender Justice Network works across Africa to strengthen government, civil society and citizen capacity to support men and boys in taking action to promote gender equality, prevent domestic and sexual violence, and reduce the spread and impact of HIV and AIDS.”

Sonke's Cape Town Offices on Longmarket Street.  Sonke shares some
floors with the renowned Treatment Action Campaign (TAC).

Within the Sonke Gender Justice Network there are a variety of units that work conjointly to develop and coordinate programs with other relevant partners.  These units include the Communications and Strategic Information (CSI) unit; the International Programs and Networks (IPN) unit; the Operations and Organizational Development (OD) unit; Policy Advocacy and Research (PAR) unit; and finally the Training, Capacity Building, and Community Mobilization (TCBCM) unit.  I worked within the IPN unit, which is responsible primarily for consolidating and maintaining networks between Sonke and fellow partner organizations and programs.  In addition to coordinating with Sonke’s various UN partners the IPN unit is the co-chair of the MenEngage networks.  MenEngage is a global alliance of NGOs and UN agencies that works towards involving men and boys with gender equality issues.  This being said, Sonke’s mission is very intimate with feminist ideals and notions as it pertains to changing gender norms and roles in order to promote a more gender-mainstreamed society.  This makes Sonke’s perspective unique because it addresses the gender gap that directly correlates with humanitarian issues in sub-Saharan Africa such as poverty, sickness, disease, and violence.  This perspective consequently prioritizes gender equality as a preemptive measure against these issues.

As an IPN intern I had the fortune of working on several projects for Sonke, many of which are funded by UN agencies such as the UN Development Program (UNDP).  I was first involved with a MenEngage Africa Training Initiative (MATI) course that Sonke is offering at the University of Cape Town in August.  The course is a ten-day intensive workshop on building capacity to engage men and boys in their involvement and response to Sexual Reproductive Health Rights (SRHR); fatherhood; HIV/AIDS; sexual and gender based violence (GBV); child exploitation and abuse; and Lesbian Gay Bisexual Transgender Intersex (LGBTI) issues.  My job was to find and research any courses in sub-Saharan Africa that were similar to MATI and compile them into a comprehensive list that could be used to recommend alternative programs to applicants who did not get accepted into the MATI course.

My second project involved finding and researching original government documents concerning SRHR, GBV, HIV/AIDS, and Orphans and Vulnerable Children (OVC) for various countries in sub-Saharan Africa.  Any original documents containing relevant laws, policies, charters, acts, and strategic plans/frameworks would be analyzed on a country-by-country basis and determined whether or not they address current and contemporary needs.  These “policy scans” would help me later in the internship when I started my third and final project, which was an analysis of Zimbabwe’s HIV and AIDS National Strategic Plan II (ZNASP II) 2011-2015.  Since the ZNASP I expired in 2010 it was now necessary to write a new analysis.

The analysis was meant to identify the existence or lack of direct male involvement in the ZNASP II’s relevant HIV/AIDS strategies.  In turn, my analysis looked for strategies that directly engaged men's and/or boys' involvement in areas such as Medical Male Circumcision (MMC), Condom promotion and distribution, Prevention of Mother To Child Transmission (PMTCT), and prevention of GBV.  Unlike the ZNASP I, the new ZNASP II greatly lacks any direct strategies for gender mainstreaming and involving men and boys, and furthermore no longer makes any acknowledgement of gender inequality as a key driver in the HIV/AIDS epidemic.

In the Interns' office- where the magic happens.

Looking back on my time at Sonke I have realized how truly unique my experience was and the new perspective it has given me on humanitarian issues.  It is such a profound, yet simple, idea that in order to tackle socio-economic and health issues on a communal level it is first necessary mainstream gender roles and norms in these communities.  Old patriarchal values that are detrimental to women’s health and well being can only be addressed by engaging the male population and encouraging them to take on a role that empowers their fellow women.  It has taught me that men have the power to give power, and so they should.

My walk to work everyday in the Company Gardens.

I would like to take this opportunity to thank everyone at Sonke for opening their arms to me during my short time in Cape Town, especially Maja Herstad and Tim Shand.  I would also like to thank Lisa Folda, Angela Mias, Anna Grimsrud and my fellow classmates for all of their courteous and thought provoking reflection that helped me realize the inspiring and wonderful things NGOs do here in Cape Town.

Tyler Woods

Taming The Lion

Cape Town is world famous for the Table mountain range which forms a cradle around its metropolitan area, the city bowl. I would be liar if I said hiking up these land masses was anywhere near on my “what to expect” list. As it turns out the group of us who came on the trip are pretty athletic, most of whom had no qualms about waking up early in the morning and squeezing in a workout to our already jam packed schedule and of course your friendly neighborhood climbing enthusiast, Allen. When the idea of hiking was brought up I wasn’t too opposed but I wasn’t as excited as some either. In my younger days I had been on some pretty formidable hikes if I may say so and I felt prepared but they were activities that were part of a program. I never thought, or had much interest in, voluntarily hiking a trail.

Lion's Head Hiking Team

My Saturday morning sleep was interrupted by Matt bursting through the door, “You’re still asleep? Get up we’re about to go hike Lions Head.” Before I could say anything he was out the door again. That exchange truly was the M.O. for the entire trip, everyone always rolling with the punches, but I wouldn’t have it any other way. Lion’s Head is actually supposed to be an easier level trail but after some time on the steep rocky trail I couldn’t help but think that the difficulty level needed to be re-evaluated, but it was probably more me than the trail. Though it was challenging in my book we made it an adventure, taking pictures and a few detours along the way. The scenery on the way up was almost foreboding, giving us a glimpse of what was to come. I can’t forget to mention the appearance of Kerr, Lisa’s husband, running down the mountain greeting us with a “Hey Baltimore! You’re almost done!” and then off again as quick as he came. 

Quick detour overlooking Camps Bay

Quick picture on the way up!

As we got closer to the summit, the trail started to look more and more like the climbing wall at the rec center, still in the back of my head, “This is the easy trail?” Though it got dicey at the end the destination was worth the sacrifice. The top of Lion’s Head offers one of the best views of the city bowl and the harbor. A photo-shoot of epic proportion ensues with everyone wanting a piece of the regal backdrop to take home. But then everything slowed down and faded into silence. Matt laid flat on a rock with his legs dangling above a 2,000 foot drop with a blank look on his face. Everyone seemed too get that look in their eye, when they’re in front of you but not actually there. They've gone inside themselves, thinking, reflecting, on everything. I found there’s a certain existential experience associated with being at great heights. There’s always the wow factor once you reach the summit but when the initial feelings of excitement and accomplishment fade, sooner or later, everyone has a quiet moment to themselves. When everyone came back together there was just love and we were a bunch of college kids screwing around on the top of a mountain. Our Lion’s Head hike most definitely brought us closer together. There’s a certain uniting effect from sharing hardship and conquering as a unit and on the way down every rock has a story about how you climbed over it.


-Ndubisi Okeke

Discourse on Prevention Methods

     Over the course of my time here in South Africa, I have learned that the behaviors responsible for the rapid spread of HIV in South Africa are the product of an intricately woven web of cultural and societal norms, withstanding gender inequalities and economic conditions, environmental factors, and political landscape. As such, I have also become aware that HIV prevention will not be completely successful unless both the high-risk behaviors and the underlying social problems further down in the causal chain are addressed by interventions. For example, although condoms may be available, gender inequalities at a structural level, in the form of male dominance and female economic dependence, stop people from using them.

Condom Education

     Although it is obvious that societal issues first need to be addressed before people will change their behaviors, it is not obvious how to go about actually doing this. I feel the best way to at least start addressing these issues is through hybrid intervention strategies that incorporate prevention methods from behavioral, harm reduction and biomedical models. Examples of this type of intervention include voluntary counseling and testing, which aims to decrease transmission and stigma by making people aware of their status, condom marketing, which aims to change social norms about condoms by increasing access, knowledge, and social acceptance, and social mobilization, which aims to reduce stigma and drive the uptake of HIV prevention and treatment services through educating the community about HIV services and testing. I think these methods are particularly effective at a community level because not only do they make health services widely available, but also they educate people about why these services are necessary and, in doing so, increase exposure to HIV prevention materials and hopefully reduce stigma.

Community Education and Mobilisation

     Cultural norms, and thus the groups of people that are primarily affected by HIV, differ in both South Africa and the United States. In the United States, people generally share the assumption that diseases are germ based. In South Africa, different cultures have different beliefs about what causes diseases. Thus, on a structural level, South African citizens and US citizens will have different attitudes towards western medicine, treatment, and understanding of disease. I believe that here in South Africa, educating the population about the biomedical model HIV and disease is crucial in ensuring that people will access and understand protocols and adhere to medication and prevention programmes. Various factors make it the case that HIV affects South African populations at large, and due to biological and societal factors, especially women. Therefore, it is important to reach whole communities with mass media campaigns and education about the biomedical model of disease.

     There needs to be a change in the way that people view and think about HIV, and I feel that can happen through education about the biomedical model of disease. Prevention of Mother to Child Transmission (PMTCT) is of particular importance, since women do make up the majority of the population living with HIV. PMTCT is a perfect example of integrating behavioral and biomedical interventions, providing educational information on methods of passing HIV to the baby, providing treatment to both the mother and the baby, and ensuring good nutrition and health of the baby after birth. In the United States, the main intervention methods used will be different because of different at risk groups and cultural beliefs. In the US, HIV primarily affects key populations and high-risk groups, such as men who have sex with men (MSM) and people who inject drugs (PWID). I believe that harm reduction prevention methods, such as advocating for and providing condoms and needle exchange programs, are of particular importance to the US. Harm reduction is an important tool for HIV prevention because it addresses factors affecting individual behavior without targeting the behavior itself, which to me seems like something people would actually engage in.

Voluntary Counseling and Testing

     Although I do feel that educating people about the biomedical model is one of the best options for HIV prevention, this statement cannot go unqualified. There is no proof that education will change behavior. Human behavior is not always rational; just because people learn about harms does not mean they are going to take the proper actions to prevent them. There are more complicated social problems that prevent rational behavior from occurring, such as gender inequalities, poverty, and sexual norms. The epidemic tends to gravitate towards circumstances where people’s choice is restricted, whether it be through gender roles or societal norms. Bombarding these people with behavior change messages just won’t work without first addressing the social problems, which is an enormous task with no easy solution.

Audrey Leasure 
Photos courtesy of CMT Norwood Open Day event