A New PerspectiveCape Town, Spring 2012
I must first preface this post with the disclaimer that it will be very different from what my blogs are usually like. Normally, they come complete with pictures and descriptions of my study abroad adventures; occasionally there will be a line or two about a funny rookie moment I had. While many of my future blogs will continue to be like this, I felt the following subject matter warranted something more serious. As a part of the IES curriculum, all of us students are required to take a class through the institute that is focused on South Africa’s development. The IES courses that were offered this semester were “Health and Community Development in South Africa” and “Social and Economic Development in South Africa.” I am currently taking the latter. It is very interesting, and the fieldwork component makes it different from my UCT classes. That being said, a couple of weeks ago, as a part of our class, we took a field trip to the Western Cape AIDS Hospice. It is located in Mitchell’s Plain, which is a part of the Cape Flats. If you are interested in South African history and the land distribution inequality issues from the apartheid era, I suggest you research the Cape Flats. There is a fascinating history behind it. In short, it was essentially where thousands of “non-white” South Africans were forced to move under the Group Areas Act of 1950. It is just north of Cape Town and is a barren and wind-blown area. Whites did not want to live in the Cape Flats because of its harsh weather conditions and lack of access to resources in the city. It is often called the “dumping ground of apartheid.” Pardon my digression, as I was saying, the Western Cape AIDS Hospice is located in Mitchell’s Plain in the Cape Flats. It is the only hospice in all of the Western Cape that is devoted completely to treating HIV/AIDS, which is astounding considering the region’s statistics. With around 68 percent of all people living with HIV residing in sub-Saharan Africa, the region as a whole is being severely affected by the epidemic. South Africa is number one in the world for the number of people living with HIV/AIDS. Of the 34 million people who suffer from it worldwide, around 23 million live in this region. The statistics are staggering. What is even more shocking is the way in which the hospice staff is forced to deal with the disease, simply because of the sheer number of people that need to be treated at this one facility. It is very hard to get a bed at this hospice, as it is strictly reserved for the terminally ill; often times, most people are treated as outpatients (which is often problematic in and of itself). With only twenty-three available beds to treat an epidemic that is significantly impacting the Western Cape province of South Africa, you can imagine how long the waiting list is to get into the Mitchell’s Plain hospice. Often times, people pass away before they can even be seen. Those who are admitted are given 14 days to occupy a bed. They receive rigorous treatment and are then sent on their way with the antiretroviral therapies (ARTs) prescribed to them. While at the hospice, we had the opportunity to talk to a nurse as well as some of the patients at the hospice. The nurse explained to us that treating HIV/AIDS in South Africa proves to be a vicious cycle. Because of the huge disparities between the rich and the poor, she explained, there is often little education surrounding HIV/AIDS and the ways to prevent it. Many cannot afford contraceptives to prevent the spread of HIV. An overwhelming percentage of the HIV positive people in South Africa are from very poor areas. This creates a problem when the hospice patients become outpatients, as they have to return home regardless of their condition. Many of these people are from informal settlements, where sanitation is severely compromised, making them more susceptible to opportunistic infections. The proper nutrition that is also necessary to make their ARTs effective simply isn’t available. This only makes the spread of HIV more likely to occur. We also had the opportunity to talk to some of the current patients at the hospice. I met a man named Buba, who had been admitted on the first of the month. While he was so thin and frail, he was very excited to have visitors to talk to. Though we were instructed by our teachers to talk to the patients about their condition, I couldn’t bring myself to do so. I figured Buba was reminded of it every moment he was in the hospice, so I decided to talk to him about other things. I asked him about his family, favorite foods, and hometown, among other things. It was nice to just speak with him and learn more about him as a person. One thing I learned was that Buba is a big Chelsea soccer fan. I hope he had a nice time celebrating the Real Madrid’s loss to Bayern Munich in the most recent Champions League game; now he will get to see his favorite team take on Munich next month in the finals. What really got to me was the fact that, though Buba looked happy, he was still so frail, and he had very little time left at the hospice. While he could have easily stayed several weeks longer, it was the 13th, and his fourteenth day was just a short 24 hours away. I found it hard to believe they could discharge someone in his state, but I guess that’s what has to happen when you are facing a wide-scale epidemic with such little resources. The man next to Buba was in the worst condition I have ever witnessed. He was admitted the day before with a t-cell count of seven. Yes, you read that correctly… seven. I didn’t even realize it was possible. But apparently most people don’t want to face the reality of their potential status, so they go as long as they can without treatment. The nurse explained that in this very patriarchal society, many men especially, will bring themselves literally to the brink of death before they will ask for help or go to a hospital. The fact that South Africa has many patriarchal cultures residing within its borders brings up another whole slew of issues surrounding the spread of HIV/AIDS. The nurse explained that women often do not have a choice when it comes to safer sex. In many instances, domestic violence can lead to the spread through unprotected sex; studies suggest that nearly one in every four women in South Africa is abused by an intimate partner. Furthermore, polygamy is accepted in many cultures and, therefore, people have many more partners, which drastically increases the chances of spreading HIV. These are just a few of the major issues we talked about with the nurse at the hospice and then again in class following our visit. This whole trip really made me see another side to South Africa. I really had the chance to think about the many developmental issues facing the nation today. I will be honest, it was hard to see fellow human beings in such feeble states, but I do believe it was beneficial for all of us to see. It is often easy to become so engrossed in university life that I forget about all of the work that still needs to be done outside the bubble that is this big, developed, metropolitan city of Cape Town. Putting a face to such a widespread issue was difficult before this visit, but I will now forever picture Buba’s face when I think about the epidemic that is sweeping across sub-Saharan Africa. I can only hope that more people like Buba will have the chance to be nursed back to health by the amazing people who work in hospices like Mitchell’s Plain. Seeing the Mitchell’s Plain hospice and being exposed to the reality of the HIV/AIDS epidemic in South Africa really gave me a new perspective on the country.
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