Saturday, 13 July 2013

LeeBogen Hits the Townships

For this beautiful summer (well in US terms- it’s actually winter over here on the other side of the world!), Ilana and I have been working at St. Joseph's Home (SJH), an intermediate healthcare facility that takes care of children in South Africa who have chronic illnesses or debilitating diseases. 
Here is a peak at some of the kids at SJH! 

As one of our two projects for SJH, Ilana and I had the opportunity to conduct pilot home visits in the townships for two weeks within the Cape Town area. In these visits, Ilana and I used a questionnaire we developed to evaluate the health of patients who were discharged six months ago, and to ensure their health has been maintained since they left SJH. As pre-med, public health majors, we were both ecstatic about being about to go into the homes of the children and talk to them and their families. Ilana and I have been in a township before when we were in Johannesburg (read more about it below in one of my friends' post!) so I didn’t expect the experience to be that different from what I had imagined, but little did I know what I was getting myself into…
One of the townships with houses of metal scraps & wood
This realization dawned on me as we started driving to our first home in Gugulethu, a small township not too far from the city center of Cape Town. Just as we left SJH, the rain started to pick up, the sky was gray, dark and gloomy, and the wind was picked up speed. Sitting in the back seat of a small white car from SJH, everything became much more real. I stared at the squeaky windshield wipers as various numbing sensations ran through my limbs. I couldn’t believe how nervous I was as I soaked it all in: I had no idea what kind of homes I was going to, and did not know what to expect since I had not been inside a home in the townships yet. Was it was going to be one built with cement? Or an informal settlement-type home made out of scraps of metal and wood in a shanty-town? The rain had made the situation scarier for me because I was not sure how safe it would be in an informal settlement with the rain pouring and the winds howling. Yes, I realize I seem like a chicken, but my imagination concocted an image of roof parts falling through while we were inside (I have a very active/crazy imagination- I don’t even let myself watch horror or mystery movies). I also had no idea how truly safe the neighborhoods would be since the crime rates in South Africa are high, and we would be more isolated in a township. Mary*, the social worker we were with, reassured us that she would not take us to dangerous areas, and I trusted her, so I tried to ignore my little worries.
Such a rainy, gloomy weather for our first day
However, Mary later said that people like to do “crazy things” when it rains, which definitely did not help appease my worries! She even told us stories about how people get hijacked in their cars while stopped at red lights in bad areas. We were traveling as a small group of women without always knowing where we were since Mary did not use a map, relying on her memory of the areas, which made me feel more vulnerable. I did not know if anyone would attack us, or try to hijack our car, or anything… and it raised a few goose bumps just thinking about the many possibilities all fabricated in my mind (with inspiration from the safety travel guide warnings I read prior to our trip here).
But even if I knew that the first home was going to be in a shanty-town, it would not have really stopped me from going. I had always looked forward to having the opportunity to truly see with my own eyes where the children live and what conditions they sleep, play and eat in, and to talk with the caregivers and children to hear what they have to say about their circumstances. I think I was just thinking overly cautious thoughts because of the depths of the unknown that lay before me. Besides not knowing the places we would be going, I also had no idea who would actually be at the home or what the whole experience was going to be like. I tried to focus on the idea that we would be able to see how the children were doing, and just took deep breaths (who knew yoga would come in handy?). After all, I knew ‘the unknown’ was always going to be a bit scary anyways so I wanted to push myself to do what I intended to do all along.
We arrived at our first home in Gugulethu as the rain started to pick up. The area consisted of cement homes that the government built. As I started to cross the grainy paths toward the house that was behind another house on the road, both my heart and thoughts picked up speed. Would the families be accepting of the foreigners at their doorstep? Our eclectic bunch at the home visits consisted of a Xhosa social worker, a Belgian social worker intern, and two American students- one German and one Asian (who was especially tiny). So, even before we entered the first home, I was not sure how the people there would respond to us, foreigners who arrived unannounced with clipboards and strange accents, asking them about their household and the child (note: we go unannounced so that we can see the children in ‘normal’, real circumstances and not have them ‘all cleaned up’). If I were them, I think I would be more afraid than angry, but I was not sure if we would be greeted with nervousness, anger, neutrality or something in between. Either way, how receptive they would be to us was completely variable, and I was not sure if I was ready to put myself in a situation that may make the people around me, who I just met, feel extremely uncomfortable. Despite these thoughts, I was already there and stepped into the home.
My first home visit went a lot better than expected- and I definitely had a nice sigh of relief. Sarah*, who was the cousin and caregiver of George*, a 10-year-old boy living with HIV, was not overly enthusiastic about us being there by any means, but she was accepting of us and okay with answering questions. This was a nice surprise because I didn’t feel like Sarah was holding anything back. We were able to find out that George is doing well with taking his ARVs, but he does not get a steady supply of food since Sarah is unemployed and cannot get a child support grant for George since he does not have a birth certificate. Hearing Sarah say it is hard to see a child suffering from starvation was heart breaking. Though Mary said we can drop off some food to help, I wished there was something I could do to help them with the long-term, and struggled to think of something helpful, which ended up being a constant challenge for me throughout the rest of our home visits.
Leebogen with our questionnaire in hand!
Though I was initially very nervous about going into the homes in the townships, I ended up being perfectly safe in the houses (including those of metal pieces) I walked into, and now realize how silly my worries were in retrospect. By the end of my first week, I was much more comfortable. This allowed me to focus more importantly on connecting with the families and figuring out what parts of our questionnaire works, which will hopefully be a useful tool for SJH once Ilana and I (quite sadly) leave. I was also able to get a sampling of the true joys and disappointments that the SJH social workers probably go through as they learn about different children’s circumstances. I loved seeing the children who were maintaining their health at home, but it was difficult to see that some kids do not have access to basic things to maintain their health like treatment or food. I was outraged, zealous and disappointed throughout my experiences, and it was weird to go back and forth from the various extremes of emotions so often. However, I would not have traded my emotional journey for anything. I only hope that Ilana and I have truly helped gauge the successes of SJH’s help of giving the children the tools to better health, and also help ‘catch’ some of the kids who are struggling with maintaining their health after SJH, and get them the care they need. LeeBogen** over & out.

*Names have been changed for confidentiality reasons
**LeeBogen is the nickname for Ilana and I

Written by Jessica Lee

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