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18.7.08

South Africa: a revolution

posted by Brett - he traveled to South Africa during July and August of 2008 for hands-on experience in public health, one of his concentrations at NYU's Gallatin School of Individualized Study

There is a bit of an uprising. Some of the class are voicing their opinions on actions taken at a dinner a few nites ago. Honestly, I think most of this is ridiculous. But it's not really important.

Anyways...
I saw a play a few nites ago. Cissie, about Cissie Gool, an activist during the Apartheid, specifically held situated in District Six. It was good, but I forgot how I don’t really like plays. Musicals maybe, plays, not so much. Unless they are skillfully executed and done in a unique manner, like The Laramie Project, or Waiting for Godot. Or Vagina Monologues.


I have finished my shadowing for the week. Again, I was with ARK, Absolute Return for Kidz, and I shadowed Dr Peter Bock and Thuthu. I didn’t get Thuthu’s last names, but with Thuthu being the condensed version of her name, I wasn’t going to butcher the whole thing.

Each day I went to a different township; Nyanga, Phillipi, and I think Gugulethu again. Jaughna and I went to maybe five clinics and three NGO’s. ARK provides personnel, financial, and all sorts of other resources to clinics via other NGO’s. ARK works with Ma Afrika Tikkun and S.A.C.L.A. to provide training for Patient Advocates who work in the townships, directly with HIV/AIDS, TB, diabetes, and other patients. ARK trains, though, specifically for HIV/AIDS PA’s. The PA’s go to the homes to check in on the patients/clients and makes sure that they are adhering to the ARV and DOTS plans. The ARV’s should be taken according to their regimen, because failure to do so can result in the development of a drug-resistant strain of HIV. Africa is privy only to two lines of drugs that help the body decrease the viral load. The US has plenty more.

I was especially happy to see that there are a few gardens that have been started at Ma Afrika Tikkun and SACLA. The gardens are teaching tools for those that work in them, and they also supply the kitchens with loads of different vegetables. The gardens are not very small, either. The kitchens, in turn, are forums for some of the people in the township to come together to cook or learn cooking, as you’d assume. But the kitchens also turn to the community to provide food about four nites a week.




ARK is doing a particularly good job at working within the boundaries of the government, as they are setting up these clinics and other facilities for the government to takeover after 1-3 years of ARK’s system implementation. But ARK moves beyond much of the government’s abilities. They have been instrumental in working out ways to pull apart the vertical health system and rebuild new ways of combining health services. In SA patients can’t go to one clinic to get multiple things fixed up or checked out. Everything is divided and they have to have referrals from one location to the other. With people living in shacks and unemployment around something like 40-60% in some of the townships, health and referrals and treatment start to move to the backburner. It’s unfortunate that this is the situation, and I really cannot express the kind of dire circumstances that people are put into as just a result of the system’s setup. It’s not that the services aren’t available, but they aren’t accessible. Accessibility issues are killing me. But they are really killing other people.

The stigma of HIV/AIDS here is ridiculous, too. People avoid testing, avoid disclosing, are beaten, are killed, are all sorts of things because they are HIV+. There are a number of other NGO’s working on destigmatizing and trying to get at the roots of gender-based violence (GBV).

There is just a lot to take in. And no way to get across the kind of things that need to change. The people living in the townships aren’t looking for handouts, but they are looking for a way to move out of tin shacks and just everything.

Anyways, let’s figure something out.

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