As much as I hate to say it, my time in South Africa has now come and gone. Calandra Miller and I safely arrived back on American soil at 7:30 AM on August 6, 2009. At the time, I could not say the same for our luggage, which remained (safely) in Johannesburg, South Africa.
The last couple of weeks spent in South Africa were bittersweet, to say the least. I was looking forward to coming home and seeing my family and friends once again, but at the same time I was having to say goodbye to many good friends and, what I consider to be, family back in South Africa. The volunteer girls, Betty, Eva, and Engelinah treated us to some milkshakes as a going away present. This was a distinct honor to me, because what we might take for granted in the United States, they had to budget for weeks in advance. We also spent some time celebrating with Stefan and his family, the Wiids (the family who hosted me in their cottage during my stay in SA), and Pastor Dave Garton and his wife Gail (who run the rehab program that Project HOPE is partnering with). In the midst of our imminent departure, I took some time to reflect on what I was doing and had done since arriving in South Africa.
My purpose for being in South Africa was to assist in the fledgling steps of a promising program targeted towards orphans and other vulnerable children. Calandra and I had the distinct privilege to contribute our work to laying the foundation on which this program could get started. Much of this consisted of doing what many would consider mundane: data collection. Day in and day out we went door to door asking the same questions for our rapid needs assessment. After all was said and done, we had a grand total of 185 caregiver surveys and 266 parenting maps for children. This data has since been used by Project HOPE for grant proposal writing and other fund raising endeavors. All of our labors brings to mind a famous quote from Dr. Irving J. Selikoff, "Statistics are human beings with the tears wiped away." I can now whole-heartedly attest first hand to this, and with nearly every interview was reminded of why I was there.
My translator and I entered into a dimly lit home constructed entirely of sheet metal where we found a frail middle-aged woman crouched down washing the red clay dust off some furniture in her small room. She was obviously ill, and barely had the strength to stand and greet us with the customary handshake. Yet, when asked to take part in our survey she eagerly agreed and carefully sat down on the edge of her bed. Throughout the entire interview the woman provided responses through restrained whimpers and sobs. The questions I asked were simple, non-intrusive, and were not targeted toward specific health conditions. I could only assume it was due to her being overwhelmed with her health and living conditions. At the conclusion of our interview, she pleaded for any help we could give her, but all I could do was offer her a hug and a promise of my prayers, which she gratefully accepted. For many, the only hope they have is their faith in God to deliver them from their squalid conditions.
While walking through the dusty, debris ridden streets of the Zenzele settlement with Betty as my translator, I saw three men sitting on buckets in front of their home singing a song. I didn't think much of it, and continued on to the next person's home to conduct another survey. About 20-30 minutes later, we emerged to these same three men singing the same song. I asked Betty what they were singing out of curiosity. "God have mercy on us," she said.
Unfortunately, many of these people will not find much refuge from the currently overwhelmed healthcare system in South Africa. Residents of these settlements have told us that healthcare providers will often mistreat or even completely overlook them when it is discovered that they are not native South Africans. This is only exacerbated by the physician strikes taking place all around the country due to poor salaries and working conditions.
This is not by any means encouraging for a woman who volunteered for a field test of the Munsieville Survey Calandra and I had designed for Project HOPE. She was 23 years old, and spoke English well enough for me to conduct most of the survey without Betty's help. Within this survey were much more detail oriented and intrusive questions, including those that asked about sexual behavior. After completing the field test, Betty and I struck up a conversation with this woman to discuss the strengths and weaknesses of the survey. When I least expected it, she volunteered to us some extremely sensitive information that she would only entrust to her closest friends and family. She had AIDS. On top of this, she also told us that she had recently been diagnosed with breast cancer in her left breast (which she reported only having pain medications for). Her live-in boyfriend and sole bread winner for the family (making about R800 per month, or around $100 U.S.) also had AIDS. While he was at work, she was responsible for raising their young 2 year old child in the small shack they called home. I was deeply honored by her telling this to us. It was as though she trusted us, as representatives of East Tennessee State University, Project HOPE, and Hope Through Healing Hands, like we were family. She understood that we were there to help and wanted to change the conditions that they lived in for the better.
Even though she was just one year younger than myself, I couldn't help but think about her as a child no more than 10 years ago. There was no one around to teach her safe sexual practices, or to help her get a proper South African identification card. There were no concerted efforts to give her the proper education she needed to become an empowered woman and begin the climb out of poverty's grasp. Then it struck me. This is why Calandra and I are here. This is the spirit of public health, to prevent terrible outcomes like this regardless of where they come from or what gender they are. Though her story was transformed into categorical and continuous variables in a database, her story, in conjunction with many others, will be used in research by Project HOPE and its partnering organizations to help prevent suffering like this for future generations.
I feel honored to have taken part in Project HOPE's endeavors in South Africa. Without Hope Through Healing Hands and the Frist Global Health Leaders Program, it would not have been possible for me to contribute to this great cause. Through this experience, I have gained tremendous into what it is like to operate a health campaign in a foreign country, something that I plan to pursue professionally when I am finished with my formal education. I am forever grateful for having this opportunity, and will carry what I have learned from this experience for the rest of my life.