David in Swaziland

Siyabonga

2009-08-28T23:49:00.000-07:00

I first glimpsed him one day as I was walking through one of the hospital wards -- just a flash of a young boy's smile behind a closing door as I passed, a big toothy grin that made me smile too. A week later I noticed him again, same big smile, worn by a boy of around twelve years old, who was also wearing a blue hospital gown. I greeted him as I passed by: "Unjani, bhuti?" (How are you, brother?) "I'm fine," he responded in English as he kept walking the other way. Evidently we both had places to go and people to see.

From then on I saw him often around the hospital hanging out in his hospital gown. He was always in good spirits and seemed energetic and full of life. It was clear the hospital staff -- nurses, doctors, and orderlies -- liked him too. He was clearly a favored patient. One day I asked him his name. "Siyabonga," he said, which means "we thank you." I asked him why he was in the hospital, and he simply said "I'm staying here." That sort of vague answer is not uncommon, and I assumed he must not know or understand his diagnosis and that he was a long-term patient being treated in one of the wards. Whenever I saw him I'd say hello and have a brief chat, always exactly the same: "How are you?" "I am fine." "Sharp!" (pronounced more like "shop!"). Sharp is the all-purpose word of approval used by boys and young men here, sort of like "cool" is used in the U.S.

Scott got to know Siyabonga as well, and one day he came home from the hospital and said "You know that boy Siyabonga with the big smile? He's not actually a patient at the hospital -- he's been abandoned there." It turns out that Siyabonga had come into the hospital several months before with his sick mother. Siyabonga was sick himself with some relatively mild malady, for which he received treatment and was quickly cured, but his mother had died soon thereafter of T.B. They lived a long distance from the hospital, and no other family member ever showed up to claim Siyabonga or his mother's body. After making some rudimentary efforts to locate some of his relatives, the hospital eventually buried his mother in a pauper's grave, and allowed Siyabonga to stay on at the hospital indefinitely, sleeping in a bed in the male ward. Siyabonga said he didn't want to go back home anyway; there was no one there who wanted him, and we later learned from one of the nurses that he told her he'd been beaten and abused at home. He always wore a hospital gown because the only the clothes he had were the ones he walked in with, and the hospital had no other boy's clothes of his size.

Maybe it's an indication of how much we've grown used to such sad cases that even after learning Siyabonga's story, we made no special efforts to help him. Of course, I continued to greet him and to feel happy at seeing his smile, while simultaneously feeling a little tug at my heart for his strange life as a ward of the hospital.

One day, about a month ago, Scott and I happened to be in the administrative wing together. Sitting on a bench outside the personnel director's office was Siyabonga, wearing new street clothes with a small grocery bag containing the few possessions he'd gathered since coming to the hospital. He was clearly going somewhere. "What's going on, bhuti?" we asked. "Where are you going?"

"I don't know," he shrugged. The look on his face was scared, brave, and excited all at once, and his smile quivered a bit.

"We'll find out for you," we told him as we headed into the personnel office.

The very good news was that he was being sent to Bulembu, the city of orphans I've written about previously. But I couldn't help feeling sad for this young boy when we went back out in the hall to tell him where he was going. As we explained to him what Bulembu was, and told him not to worry, that he'd be happy and well-taken care of there, I thought to myself what a strange, hurt existence this boy has already had: to leave his home with his sick mother, to watch her die in the hospital, to have no family to claim him or to return to, to live for months in a hospital ward surrounded by sick and dying people, and then to be moved again to place filled with other lost children like himself -- what sense of stability, or human relationships, or love must he have?

And yet his face is rarely without a big smile -- that brave, excited, cocky smile we've all seen on the faces of boys the world over. His smile endures without the things that bring smiles to the faces of other young boys. Scott and I walked him to the social services van that was to take him to Bulembu. As he drove off, he waved at us from the back window. His smile was bigger than ever. Siyabonga, young man.

Swazi Houses

2009-08-21T01:56:00.000-07:00

These pictures should give you a good idea of the different types of Swazi homes we see every day. The poorest Swazis, who comprise a good percentage of the population, build their homes of mud, rocks, sticks, and reeds. Those who can afford to, build with bricks and cement, although as you can see, not always of the best quality.
(Click on photos to enlarge.)

Thabiso loses a shoe

2009-08-02T23:41:00.001-07:00

On the surface this little tale may seem entirely insignificant, but it exemplifies in a concrete way the heightened importance of things we would hardly think about in the United States, and the complexities involved in resolving even small problems here.

About six or seven weeks ago, when Thabiso was still living with his aunt, I ran into his teacher one day in town, and she mentioned to me that Thabiso had not been in school that day. He'd had a perfect attendance record ever since we'd insisted on him going to school as a condition of his being able to visit us. So later that day I called his aunt to see if she knew why he hadn't been to school. "Oh yes," she told me, "his shoes don't fit him anymore. They are too painful to wear, but the school will send him away if he doesn't have shoes." I recalled seeing his feet squeezed into a pair of shoes he'd probably had for a couple of years -- a long time for a growing boy -- so after I picked up Scott at the hospital that afternoon, we took Thabiso into town to buy a new pair of shoes. He got the basic black leather lace-up dress shoes which are a part of all school-boys' uniforms here. The shoes cost about 155 rand ($22) -- very expensive for many families here.

Thabiso went back to school the next day proudly wearing his new shoes, and we considered the problem solved. It would seem that the story would end there, but nothing is ever that simple here. About ten days ago, Thabiso showed up "to greet us" one afternoon. It seemed as if something was on his mind, and eventually he told us that one of his new shoes had been stolen. He fingered his erstwhile friend and partner in crime, Senzo, as the culprit. "But why would Senzo steal just one shoe?" I asked. Thabiso just shrugged and insisted that Senzo had stolen his shoe one night when they were at a mutual friend's home watching their current favorite movie "Spiderman" on DVD. (The mechanics and intricacies of how they manage to watch these bootleg DVD's on homesteads with no electricity will have to wait for another entry (it involves a car battery). The thought of these kids having "movie nights" together amused my mother no end while she was visiting. The reach of American pop culture is truly astounding.)

In any case, once movie night was over, Thabiso discovered that one of his shoes was missing (the Swazis remove their shoes and leave them at the door before entering someone's home). One of the other kids said they'd seen Senzo making off with the shoe, so he immediately became the prime suspect. Senzo gets blamed for lots of things that go missing or get broken around here -- some of it deservedly so, but at other times he gets blamed simply because he's already got a reputation as a trouble maker. By the time Thabiso told us about his missing shoe, a couple of days had passed. Neither Scott nor I were inclined to run out and buy him another pair of shoes. Scott went as far as going to visit the homestead where Thabiso had been watching movies the night his shoe went missing. He talked to the mother of the home, as well as several of the children who'd been there that night, and he had the brilliant idea of offering a reward (10 rand, about $1.30) for the missing shoe. On the way home, he ran into Senzo, who vehemently denied stealing the shoe, but Scott wisely offered him the same reward if he should come across the shoe.

Scott and I shared a laugh that night at the thought of these kids scouring the neighborhood for a missing shoe. Thabiso hobbled to school for the next week or so in his old tight shoes, and I seriously doubted his missing new shoe would ever show up. But this past Saturday, I ran into Senzo waiting on the road that leads to Mabuda Farm, and he told me that he knew where the shoe was: he didn't have it, but it was back at the home where they'd all been watching movies the fateful night the shoe disappeared. One of the kids at that homestead had found the shoe and was ready to claim the reward. The only problem was, the family was away and the shoe was locked up inside their home. Senzo promised to come and get us when the shoe was available to be claimed.

The next night, Sunday, Senzo showed up at our door to lead us to the shoe. As it happened, Thabiso was there as well for his daily visit "to greet us." Scott bundled both of them into our car and took off into the dusk in search of the shoe. He returned a short while later, minus the two boys, but with a smile of success on his face. He'd given rewards to both Senzo and the boy who'd found the shoe. He'd then taken Thabiso home to make sure the shoe was a perfect match for the one he still had, and it was. We both hope that this Swazi school-boy Cinderella story is truly at an end, but don't be surprised if there's a sequel. You never know around here...

July Update

2009-07-23T01:07:00.000-07:00

I'm sorry it's been so long since I've posted. Sometimes it's a bit difficult to see and experience all that we do, especially some of the more sad and painful situations, and then to relive it by writing about it. Often I just want to forget it all with a good book, a cocktail, or by watching a movie on my laptop. But I've heard from enough of you that you enjoy and/or get something out of reading my entries that I promise to try and write more often. Following is an update on some of the people and situations I've written about previously, along with one or two new ones:

THABISO

Thabiso is the hardest to write about, so I'll start with him. After his mother's death, he went to live with an aunt, Make Sacolo. His aunt seemed genuinely to care for Thabiso, and with eight other kids of various ages in the family, it seemed that he would have companionship and a good support structure at her home. We had high hopes that he'd fit in with his new family. Unfortunately, things were rocky all along, mainly because Thabiso is used to running wild and doing his own thing. On the bright side, he has been going to school almost every day for a few months now. He seems to realize the importance of that minimum amount of structure in his life. On the down side, he simply didn't like living with his aunt, and he often ran away when required to do simple chores like fetching fire wood or tending the family's goats. A couple of weeks ago, he left for good and simply refused to go back to his aunt's house at all. He returned to the empty hut where he had lived with his mother, and is now living there alone. An older male cousin and his girlfriend live in a separate hut on the same compound, but they provide little real supervision or support for Thabiso. Essentially he is now an eleven-year-old boy living on his own. Sadly, this is not uncommon here. I feel very sad about his situation, but I have begun to distance myself from much further involvement with him, as I am not sure we will be able to do much more for him in the four months we have left in Swaziland. (You can read more about Thabiso here and here.)

ORPHAN FAMILY

I first reported on this family of seven children living on their own in this post. Unfortunately, since then, not much has changed. The social worker who had promised to help us, has turned out to be even more severely mentally disturbed than I first thought, and she now refuses to see me when I go to see her to check on their status. On the bright side, it appears that an adult female relative from another town has moved in with them and is now providing some supervision. Our ultimate goal remains to get them moved to Bulembu, the old mining town that is now a well-run "city of children," where hundreds of orphans just like them are receiving caring supervision, a secure roof over their heads, regular meals, and good schooling.

KHULILE: "FOUR LOLLIPOPS WOMAN"

I wrote about our wrenching experience with Khulile here. Since then, Scott and I have been regularly providing her with food for herself and her family. Khulile has gained weight and seems to be doing much better than when we first met her. It is amazing how just a little food makes such a big difference especially for people on HIV medication. Scott and I spend less than $50 a month to provide her with basic food supplies, but this has helped her to tolerate the drugs much better, giving her a whole new lease on life. Unfortunately, on a visit to her just over a month ago, her young six-year-old son, Ndu, who had been looking sickly, tested positive for HIV. Since then we have been trying to work through the truly Orwellian system of trying to get him initiated on anti-retroviral drugs, but even with our help it is taking a long time. It is amazing that anyone gets started on the drugs given the bureaucratic obstacles and incompetence we have encountered at every turn.

ELSIE'S NEW HOUSE

I think it's time for something more uplifting. I haven't written about Elsie and her family before. They are Home-Based Care patients who Scott visits each month, and whom we have come to know and like. Elsie is a strong, intelligent, independent, and very likeable woman in her 40's. She lives with her six-year-old daughter Siphesihle and her 18-month old son Thembenkhosi on a very poor, rocky homestead. Two of her adult sisters live in separate huts on the same homestead. As they will be the first to tell you, they are a family of sick women: everyone on the homestead is HIV-positive. But Elsie is doing well on ARV's and is seemingly strong as an ox. She wants to work to support her family, but there are no jobs. Her daughter Siphesihle is an adorable girl and one of Scott's special favorites; we call her his "girlfriend."

Elsie has long needed a new house. The mud hut she lives in is literally falling down, and the thatched roof is disintegrating such that it provides no shelter from rain or wind. On her own, Elsie had begun work on a new hut made of sticks, stones and mud, but she had stopped half-way through because she had no money to buy nails to continue building the frame. When Scott's good friend John visited us a few weeks ago, he generously volunteered to pay for completing the structure Elsie had begun. That new hut is nearly complete, but as Elsie was finishing it, it became apparent that it would only be a stop-gap building; what was really needed was a more permanent structure to house her ailing family. Scott and I decided that we would help her build a one-room brick house with a tin roof. My parents are now visiting us, and when we took them to visit Elsie, they fell for her infectious good humor and hardy work ethic. They are now generously funding the entire project, which is also now well underway. For about $1,500 Elsie and her children will now have a well-built, warm, and dry new home to shelter them for years to come. Again, it is amazing how just a little money goes so far in helping such a needy and deserving family.

MOM & DAD VISIT

I'll end this post on a happy personal note: my parents are visiting us right now. They arrived in early July and will be here until the end of the month. This is their first return to Africa since they served as lay missionaries in Kenya from 1969 to 1972. They have immediately taken to our life in Swaziland and are as moved and impressed by the struggles of the ordinary Swazi people as we are. They have visited the various families we are engaged in trying to help, have spent a day making Home-Based Care visits with Scott, and, as noted above, are helping build a new house for a particularly deserving family. We just got back from a few days in Kruger National Park, where we had an extraordinary number of great encounters with the big game there. All in all, it is being a very meaningful experience to witness them reconnect to this continent which played such a big role in their lives many years ago.

All the News That's Fit to Print

2009-06-03T04:07:00.001-07:00

Sorry I haven't posted anything on here in a while. I've been busy catching up on the news... or what passes for news in the Swazi press. Following are some of my favorite recent headlines (and, yes, they're all real). More of my own news to follow soon.

Social Work in Swaziliand: "Do you believe in demons?"

2009-05-14T02:28:00.000-07:00

For a few months now we've been very concerned about a family of seven orphan children living on their own, without any apparent adult oversight. The oldest child in the family is a girl of fifteen, and the youngest is around three years old. Scott first visited them with the Home-Based Care Team about three months ago. He came home shell-shocked by what he'd seen: seven kids fending for themselves, living in squalor, with no food. The team had examined the children and left them some food, but, unfortunately, such families of orphans are not uncommon here, and the team had felt there was little else to be done for them other than to keep an eye on them each month. After Scott told me about the dire situation of these children, we both felt that we had to do something. Unfortunately, as is all too common here due to the extreme need we encounter at every turn, every day, we did nothing at the time.

Two of the children in front of their house.

After the Home-Based Care Team visited the children again about a month ago, we made a renewed commitment to help these kids. We had heard of a place called Bulembu, an abandoned mining town which is being converted into a non-traditional orphanage -- a sort of "city of children," in which small groups of eight children live together in refurbished homes under the care of a Mage (pronounced MA-gay, and meaning "mother"), who runs the house, provides emotional support, and teaches life skills to the children. Siblings are kept together in the same home. In addition, Bulembu has an excellent primary school, which students attend free of charge. The whole operation is supported by a consortium of Christian groups, and there is no charge whatsoever for children to live there. (You can read about our recent visit to Bulembu on Scott's blog.)

As good as Bulembu is, there are some obstacles to getting children accepted there. Approval is needed from a government social worker to take children from their families. Though this would seem to be relatively straightforward, since these children have no parents and no one at all looking out for them, it's not quite that simple. Due to the way the extended family structure works in Swaziland, permission is still required from some member of the family, no matter how remote, and they may not always be willing to send the children away. It's a sad fact of life here that some adults benefit from having vulnerable children at their disposal -- perhaps to help them in the fields, but often for more unsettling reasons. For example, when the children receive food donations from Home-Based Care Team, relatives and/or neighbors will often descend on the home to take the food for themselves, leaving only a small portion, if any, for the children. You can also imagine how the children are vulnerable to other serious types of abuse, including sexual molestation and rape.

Two more children on the homestead.

After we visited Bulembu, and found that they had the capacity and were actively seeking to enroll more children, we decided to make a concerted effort to get this family of seven children accepted there. In the process we found out that there is only a single social worker for the entire eastern region of the country, comprising a population of around 250,000 people. Consequently, she is only in her office in Siteki on Mondays and Fridays, spending the rest of her time in other parts of the region. This past Monday (May 11) I went to the social worker's office with Deborah Maphosa, one of the Home-Based Care nurses, to act as translator.

I was immediately impressed by the efficiency of the social worker. She wanted to know all about the children -- where they lived, how many of them, what ages, their family situation, their health status, were they in school or not? Deborah and I filled her in on their situation, and then, without prompting from us, she declared that she knew the perfect place for them: Bulembu. As soon as the words were out of her mouth, however, she announced that she could do nothing further for us that day, since she had another pressing appointment: she had to go and pray over some of her other clients. "I hate to tell you this, doctor (she, like so many others here automatically assumes I'm a doctor), but pills, injections, operations, medicine in general just don't work. It's all about demons, and until you get rid of the demons you will never cure anyone."

As I was processing this pronouncement, she looked me in the eye, and said "You do believe in demons, don't you?"

"Yes, there certainly are lots of demons in this world," I replied, not wanting to risk her help with the orphan family. She then proceeded to tell me that she is a prophet, sent by God to help the poor. Like all prophets, she has been marked by a special sign from God; in her case, she has had nothing whatsoever to drink in four years -- not a single drop of any kind of liquid, including water.

She didn't seem to expect any response to this as she went on that she is "still awaiting a sign from God to begin my own radio show so that sick people can call in and be healed over the phone." I wished her luck with that, and then asked when I might return to take her to see the orphans. She immediately snapped back into business mode and asked me to return the next day. As Deborah and I drove back to the hospital, Deborah said with classic understatement "That woman has two sides to her personality -- but she's wonderful at what she does."

The next day, Tuesday, Deborah and I, along with Scott this time, returned to the social worker's office. She was ready and waiting for us to go. At the orphans' homestead, we found the children preparing their breakfast, a small pot of maize meal. The social worker quickly surveyed the homestead and then began gently interviewing the children, focusing on the oldest girl. I couldn't understand most of what was being said, since they were speaking in SiSwati, but the social worker was taking copious notes, and seemed to put the children at ease. After about 45 minutes, the social worker came out of the small house and said to Deborah, Scott, and I, "These children must go to Bulembu." She then began explaining to the children just what Bulembu was, a place where they would live together in their own home, and receive food, clothing, education, and health care all free of charge. One of the little girls began jumping up and down and clapping, and all of them had big smiles on their faces. Scott said it was the first time he'd ever seen any of them smile.

I had another appointment that day, but Scott spent the rest of the day with the social worker, trying to track down an adult relative of these children to sign off on their referral to Bulembu. In the end, Scott came home and informed me that, amazingly, the children are not orphans at all -- both parents are alive and living in different parts of Swaziland -- they have simply abandoned their children. Despite the horrible implications of such a situation, the good news is that, based on their abandonment, the children are still eligible to live at Bulembu. If all goes well -- that is, if one of the parents who have abandoned these children will sign a piece of paper releasing them to Bulembu -- they will be transferred there by the end of May.

One of the orphan boys.

This entire experience is, to me, indicative of the way things run in Swaziland, for better and for worse. The situations we encounter here daily are often quite stark and dramatic -- a family of seven children living on their own, for instance. But our attempts to help can be stymied by the most mundane bureaucratic procedures -- getting a permission to help such children from an over-worked social worker and a relative who has already abandoned them. On the other hand, Bulembu exists, and will help improve the lives of these children exponentially. Even our interaction with the social worker was generally positive; while I may not share her views on modern medicine, she acted quickly and efficiently to help these children.

Just for the record, I do believe in demons -- we encountered clear evidence of them throughout this experience. The demons I'm referring to may not be the same ones the social worker believes in, but nonetheless she helped these children immensely in beginning to exorcise the demons from their lives.

Young Heroes: One Way You Can Help

2009-05-06T04:31:00.000-07:00

Young Heroes is a non-profit organization in Swaziland which provides direct food and clothing aid to over one thousand children orphaned by AIDS in Swaziland. These are children (like these ones) without mothers or fathers, who are now living on the generosity of their relatives, who are themselves most likely severely financially stretched by their own needs. I have been providing some administrative assistance and consulting work to Young Heroes since I've been in Swaziland, and can vouch for the excellent work that they do. 100% of your donation will go directly to supporting these vulnerable children; all administrative & overhead costs are covered by the Swazi government.

Below is a message from the president of the Young Heroes Foundation, U.S.A., outlining a fun way to help this worthwhile organization. Please consider hosting a party as described below. The Young Heroes Foundation in the U.S. was established to channel support to the Swazi organization, and all donations are tax-deductible in the U.S.

* * *
Friends:

Every year, the Day of the African Child is celebrated on June 16th. But all too often, it’s just another day of empty promises for many children.

This year, Young Heroes Foundation would like change that by turning it into a day of action on behalf of the AIDS orphans of Swaziland, the nation with the world’s highest rate of HIV/AIDS.

Our goal: To encourage 100 people to hold house parties on or around that day in order to raise funds for children who have nothing. Already, people from Montclair, New Jersey to Bellingham, Washington have responded to our call. We hope you’ll consider joining them. Doing good doesn’t have to be hard work – it can be fun, too.

The kind of party you hold is up to you. While we ask that each party have a goal of raising $500, any amount you raise will go directly to helping children in need. Young Heroes now supports just over 1,000 children, but we have many more who need our assistance. We guarantee that 100% of donations we receive will go directly to supporting the orphans in our program. (Young Heroes Foundation is a 501(c)(3) nonprofit corporation based in Northampton, Massachusetts, USA. All U.S. donations are fully tax-deductible.)

You can find full information about this effort – and about Young Heroes – at http://youngheroes.org.sz/dayofaction.asp. Or check out our video at http://www.youtube.com/watch?v=1nrzNdNDsSg.

If you join us, we’ll feature your party on our site and on Facebook at http://apps.facebook.com/causes/41443?m=5ce60ecc&recruiter_id=10757026. And we’ll send you material to help you spread the word.

There’s one more way you can help the cause: Please consider forwarding this email to your friends and colleagues who might be interested. We’re a small organization that has grown person-to-person from the grassroots because we believe in the power of individuals helping one another.

If you have any questions or comments, please send an email to dayofaction@youngheroes.org.sz.

Thank you,

Steve Kallaugher
President
Young Heroes Foundation

Help the orphans of Swaziland -- become a Young Heroes sponsor at http://
youngheroes.org.sz.

Farewell to Summer

2009-04-22T06:06:00.000-07:00

It's been cold and rainy here for the past couple of days. Scott and I spent last weekend in Durban, South Africa, where it was warm and sunny, but when we returned it seemed as if the seasons had definitively changed. The seasons here are the opposite of those in the U.S., so we are well into fall here. I didn't expect it to get quite as cool as it has (in the upper 50's F right now), and I miss the warm weather already. We live on a high, windy plateau, and everyone tells us it will get even cooler over the coming months. Before summer becomes too distant a memory, here are some photos from around the farm where we live taken this summer.

Scott on the road leading from town to Mabuda Farm.

More of the 1 km road leading to the farm. You can see some of the farm's vast cornfields to the left.

Walkway leading down to our house on right.

Scott standing in front of our house. Kitchen windows to right, living room/Scott's room in middle, and bedroom/my room (w/chimney) to left.

A view of one of the farm's pastures taken on one of our evening walks. The farm is huge -- about 10,000 acres -- and we still haven't explored all of it.

One of the grass pastures where the farm's dairy cattle graze. The old bathtub is used as a trough.

A view of the main house, where our landlords, Dr. & Mrs. Pons, live. In the foreground is one of the two dairies on the farm. You can also see some of the Pons's horses grazing in the field in front of their house.

Another view of the main house. We live several hundred yards distant in the farm's old "lodge."

Me on one of the dirt roads on the farm.

Scott in one of the pastures they started harvesting for hay back in late January (mid-summer here).

Another evening view of same pasture.

Karen Wong and I at the farm's lily pond, which also serves as a source of drinking water for the farm.

Scott on the way home from an evening walk, gorgeous African sunset in background.

Scott and I walking through some cornfields ready for harvest. Much of the corn is used to make corn meal, so they leave it on the stalks to dry completely before harvesting and grinding.

It feels odd to be heading into winter as everyone at home heads into summer -- another mark of the great physical distance between us. Remember us as we settle into the winter months here!

Where Have All the Swazis Gone?

2009-04-16T00:14:00.000-07:00

Here is a link to an excellent newspaper article from the Toronto Globe and Mail documenting the unprecedented population decline in Swaziland caused by HIV/AIDS. The article does a great job of outlining the factors that have led to Swaziland's sad record as the country with the world's highest rate of HIV infection. Though the article is over a year old, nothing has changed, and it does a good job of elucidating the situation we see on the ground here every day.

The author of the article, Stephanie Nolen, has also written a great book called 28 Stories of AIDS in Africa, which tells the stories of 28 AIDS patients from different countries across Africa. The book's introduction provides a fascinating overview the genesis of the AIDS pandemic in Africa (and the world). I highly recommend the book to anyone interested in learning more about how AIDS is affecting the developing world.

Thabiso: An Update

2009-04-05T23:44:00.000-07:00

It's tough being a kid in Swaziland.

It's difficult tell how Thabiso, whose mother, Busisiwe, died four weeks ago today, is actually doing. (You can read Busisiwe's story here.) In some ways he seems fine, perhaps even better off than he was when his mother was alive: he has a stable home with his aunt, and he is now attending school regularly. But there have been some bumps along the way, and he definitely faces some big obstacles. He resisted going to his aunt's at first, preferring to remain at his mother's homestead with the young male cousin who took it over. His aunt's homestead is in the same community where he was living with his mother, but significantly further from the main road into town, and thus from town itself, including his school. I don't think he was too worried about being farther from school, but the additional distance certainly cramped his style as budding man-about-town in Siteki.

His aunt's homestead seems like a more stable, well-run home than what we saw of his life with his mother. (This is not a judgment on his mother; the poor woman was trying to hold it together for herself and three kids as she was dying.) One of the good things about the Swazi culture is the strong extended family ties which function to absorb orphaned children like Thabiso. There was no question of him or his siblings going to an orphanage or being left to fend for themselves on the streets. Though both of his parents are dead, Thabiso has two living grandmothers and a network of aunts and uncles on both sides of his family. They came together after his mother's death to decide who would care for the kids. Unfortunately, no one was in a position to take all three of them. Thabiso's older sister was already living with her grandmother, so she will now live with her permanently; Thabiso's younger brother was taken in by an adult male cousin and his girlfriend who as yet have no children of their own; and it was decided that Thabiso would live with one of his father's sisters. Though Thabiso's aunt is by no means wealthy, at least her husband has a steady job with the local electric company, and it appears that they are able to feed and clothe their own several children along with the addition of Thabiso. Other of Thabiso's extended family have pitched in to help with additional support for school fees, school uniforms, new shoes, etc., so that the full financial burden doesn't fall to his aunt alone.

That said, Thabiso still seems lost. In the United States we would expect that of an eleven-year-old who has just lost his mother. But here it seems that children are simply expected to move on as if nothing unusual has happened. Perhaps that is precisely because early encounters with death are not at all unusual here. Just last Friday, Thabiso's entire class was excused from attending school so that they could attend the funeral of one of their classmates who had been "sick since birth," as the official notice put it.

Thabiso's mother was buried the Saturday after she died. The following Monday Thabiso was expected back at school. He didn't go. He put on his uniform and acted as if he was headed to school, but instead he headed into town and hung out there playing with other children either not enrolled or skipping class like himself. He kept up this charade all week. Scott and I caught onto him pretty soon, since Siteki is such a small town it's hard to hide there, and we'd see him ducking out of sight when he saw us in town. On Friday of that week, he and his partner in crime, Senzo, showed up at our house first thing in the morning, with a confused, scarcely understandable tale of being kicked out of their respective homes, being chased by the police all night, being beaten by town thugs -- on and on it went. We've experienced these tall tales from the boys before, and though both Scott and I felt sorry for their predicament, we didn't want to be taken for yet another ride by these eleven-year-old con men in training. So instead of the sympathy and warm breakfast they were probably hoping for, we packed them into our car and took them to school.

As serendipity would have it, just as we arrived at Thabiso's school, the headmaster was exiting his office with Thabiso's aunt. Their jaws fell open when they saw us walk up with Thabiso, since his aunt had gone to the school to file the equivalent of a missing child report -- Thabiso had not been home in days, but, as we soon found out, had been running wild night and day with Senzo. Both of the boys took quite a tongue-lashing from both the headmaster and Thabiso's aunt. (It was probably only Scott's and my presence that prevented them from receiving a physical lashing as well.) Scott and I got embroiled in a de facto parent-teacher conference about what to do about Thabiso. The upshot was that Thabiso was sent home that day in his aunt's care, and told to come to school on Monday only if he wanted to. There would be no more forcing or coercion. Essentially, the school washed their hands of him unless he decided to attend of his own free will. He was given the weekend to think about it. Scott and I told him he could not visit us or expect anything from us until he had proved that he had attended school every day for a week.

For the last two weeks, everything seemed fine. Thabiso went to school religiously every day. After the first week, he showed up at our house to show us his school work. I visited the headmaster the following day, and he confirmed that Thabiso had been attending school every day. Thabiso's teacher even bought him a new pair of sneakers to wear for P.E. By the end of last week (when he showed up to show us the note excusing him from school on Friday to attend his classmate's funeral), Thabiso seemed very proud of attending school every day for two weeks.

Unfortunately, events took an abrupt turn for the worse over this past weekend. I sensed something was wrong on Saturday when Thabiso told us that he was spending the weekend at Senzo's house. (Senzo's is another sad story, which I won't go into now. Suffice it to say that he comes from a desperately sad, chaotic household, where he lives alone with a less-than attentive aunt.) I couldn't imagine Thabiso's aunt letting him stay with Senzo, so soon after trying to establish a stable home environment for him at her homestead. Nonetheless, Thabiso assured us that everything was fine and that his aunt knew and approved of his weekend with Senzo. It turns out she didn't.

Yesterday afternoon (Sunday), as a reward for attending school for two weeks straight, we took Thabiso, along with our two "good" kids, Nosipho and Mancoba, for pizza and a swim at the country club attached to the sugar cane company town of Simunye, which is about half an hour from where we live. The kids had a great time playing in the pool and gorged themselves on pizza and french fries and cokes. It was great fun seeing them frolic in the pool and have such a rare, care-free time. On the way home at dusk, we dropped off Nosipho and Mancoba first, and were on our way to Thabiso's home, when we encountered his pal Senzo crying at the side of the road. Another long, twisted story ensued, about beatings and police and threats of what sounded like a lynching. I have to admit I soon lost interest, and Senzo's tears, which flow frequently, didn't move me. Thabiso, however, jumped out of the car and said he was staying with Senzo. We said no, it would be best if he went home to his aunt's, especially after being away all weekend. But Thabiso was adamant that he wouldn't return home, most likely because he was supposed to have been there all weekend and would now face stiff punishment upon his return. It was getting dark by this point, and I was getting impatient with all the stories and stubbornness on their part. We admonished Thabiso to return home on his own, knowing that he wouldn't, and then left them on their own.

This morning (Monday), on his way in to the hospital, Scott encountered both Thabiso and Senzo hiding up in a tree by the side of the road, where they'd apparently spent the night. They were both exhausted, but Scott delivered Thabiso to school so as not to spoil his attendance record from the past two weeks. We intend to visit Thabiso's aunt this week to get her point of view on what's happening with Thabiso, and to work with her to prevent a recurrence of this weekend's events. Unfortunately, it seems that Senzo, as sad and charming and needy as he is, is not a good influence on Thabiso, and we'll have to address that situation as well.

I write this long description of events to illustrate the myriad problems caused by the overwhelming number of AIDS deaths in this country. Thabiso's is just one story among thousands upon thousands of AIDS orphans who are rapidly becoming a lost generation in Swaziland. Yes, Thabiso is receiving basic support from his aunt and extended family, but is he really receiving from them the same level of love, discipline, and attention that his own parents would give him if they were alive? And what about the psychological trauma of not only losing both parents but being separated from siblings as well? Such questions are rarely addressed here. The extended family network which has traditionally worked so well for Swazis is being taxed to the breaking point by the continual onslaught of AIDS. Such families are already overstretched in trying to provide for their own children, which often already include other orphans they've had to take in. I don't know what the answer is -- it certainly seems like an insurmountable problem as long as AIDS continues to devastate the population here. Long-term, large-scale solutions which can only come from better education, increased economic opportunity, and improved health care are what are needed. In the meantime, we're just trying to help kids like Thabiso who are right in front of us.

Pretty in Pink

2009-03-24T10:13:00.000-07:00

This little girl caught my eye on a recent day of home visits with the Home-Based Care Team. On a busy homestead full of other children and adults, she sat off in a corner all by herself.

I can get most kids to crack a smile pretty easily, but she was shy and reserved, lost in her own world -- which made me like her even more.

I gave her some candy, which is usually a fail-safe means of getting a smile, but still no go from this serious young girl. I left her to her thoughts and walked over to help Scott. Later I found out from her mother that the girl's name is Fikile, but her mother calls her "Pretty," which I think is more than appropriate.

As we were leaving, I went back over to her and waved good-bye, unexpectedly prompting this sweet smile. It was worth the wait. We encounter dozens of young children like Fikile every day. As I've written before, the kids on the homesteads both make my day and break my heart at the same time.

We leave tomorrow for a week in Cape Town. We are taking the opportunity of Karen's visit to explore a bit more of South Africa, and we're very much looking forward to spending some time in a big city for the first time since leaving New York City four months ago today. It's hard to believe that one-third of our stay here is already over.

Kruger

2009-03-19T07:35:00.001-07:00

Just so you don't worry that it's all work and no play for us here, here are some photos of the four-day trip we took last weekend to Kruger National Park in South Africa, which is only about three hours from where we live. It was a great trip -- magnificent game viewing and some much-needed down time. Above is Crocodile Bridge Gate -- we had to cross this river to get into the park. (Click any photo to enlarge.)

Above is our car crossing the bridge. Karen is waving out the right-hand window.

Once we were in the park, some elephants put on a show for us.

The three female lions above held up traffic for quite a while. They didn't seem bothered that a long line of cars was right behind them. Luckily we were right in front.

Here's a close-up of one of them.

Kruger is vast and awe-inspiring. We saw lots of big sky like that above.

I actually got up at 4 a.m. on Monday morning to take a guided game walk with Scott and Karen. Above are Scott and I making our way through the bush.

Above are Scott and Karen with our guides Saskia and Albert, surveying the terrain for signs of any big game.

Unfortunately, all we saw that morning were lots of giant spiders like the one above.

Scott and I taking a breakfast break around 8 a.m. I look like I've been up since 4.

On the way home, we saw a giant herd of water buffalo.

After the strenuous morning activities, I spent the afternoon with a good book while Scott and Karen played Scrabble.

This was the view in front of me as I read -- the Letaba River which winds its way past camp and where elephants and other animals come down to drink in the evening.

All in all, we had a great trip and came home refreshed and rejuvenated.

A Death in the Family

2009-03-10T10:12:00.000-07:00

The mother of one of the boys we're sponsoring died yesterday (Monday, March 9th). We knew her for only a few short weeks, but her death has affected both of us strongly. Her name was Busisiwe (Boo-si-see-way), and she was about 36 years old. She leaves behind three children -- 14, 11, and 3 years old -- who are now orphans, as their father died a couple of years ago.

We met Busisiwe through her eleven-year-old son, Thabiso, an exceptionally bright boy who speaks excellent English and has surprisingly good manners, but who also skips school more often than not, preferring to hang out in town acting like a tough guy. I first met Thabiso back in December when I was filling our new car at the only gas station in town. I noticed him circling the car at a distance and flashing a wide grin my way. I smiled back at him, and he came over and said "You have a beautiful car, sir." He then asked for money. I reflexively said no, but then on impulse gave him 5 rand (about 50 cents). I drove off thinking what a charming little con man he was and never expected to see him again.

We were still living at the School for the Deaf at the time, which is on the opposite side of town from the filling station. The very next day Thabiso was at my door, flashing the same wide grin. "I've come to greet you, sir," he said. I asked him how he'd found me, and he pointed to the car -- he'd recognized it as he prowled around town that day. I asked him what he'd bought for himself with the money I'd given him the day before, expecting him to say he'd bought some candy or a soft drink, but he replied, "I bought some bread for my mother." Con or not, he had me right there.

From then on Thabiso came to greet me regularly. I'd give him cookies and milk or a peanut butter and jelly sandwich, and he never asked me for any more money. One day he brought his friend Senzo with him and announced that they were going to wash our car. I got them some soapy water, and then Scott and I watched them go to town on our car. They didn't do a great job -- Scott and I had to rewash the car later to get rid of all the soap streaks -- but I gave each of them 10 rand anyway. I have never seen kids' eyes light up the way theirs did when I handed them each a 10 rand note. They ran off whooping.

Scott and I moved to Mabuda Farm shortly thereafter, and it took Thabiso a while to find our new home. But within a couple of weeks he'd resumed his regular visits, often bringing along his sidekick Senzo. Scott and I soon came to realize that they have a pretty bad (and well-earned) reputation in town as truants and trouble-makers, but they've never caused us any problems -- they just come by to get fed occasionally. We regularly urge them to go to school, and sometimes they do.

Thabiso on left, Senzo on right.

About four weeks ago, Thabiso told us that his mother was very sick. We hadn't met his mother or seen where he lives, so we asked him to take us to his homestead, which is in one of the desperately poor communities Scott visits with the Home-Based Care team. Thabiso's homestead ranks among the poorest we've seen -- just a one-room hut with no running water or electricity, and no food in evidence. Thabiso's three-year-old brother, Machaha, was playing happily in the dirt outside, naked except for a smile as big as Thabiso's.

Thabiso's mother, Busisiwe, was indeed very sick. Though she spoke English very well, she was very quiet with us. She seemed confused and distant and had a wracking cough. Scott arranged for her to come into the hospital to meet with a doctor the next day. From then on, things moved very quickly. Like so many thousands of others here, she was already far gone with HIV-related opportunistic infections. The process of getting on anti-retroviral medication is an arduous one here, but Scott worked hard to expedite the process for her. We began supplying her and her children with food, in order to build up her ability to tolerate the strong drugs. At first we had high hopes that the medication might help her, but as each successive test or examination came back, it became clear how very sick she was.

In the end, Busisiwe never had a chance to begin the medication. Last Wednesday, she was admitted to the hospital with swelling around her heart and severely congested lungs. She remained in the hospital over the weekend, where she was visited by her two young sons. The infections were too far gone, however, and she died on Monday afternoon.

Scott called me from the hospital that afternoon to give me the news. He asked me if I'd seen Thabiso. I hadn't, but as I was driving with our visiting friend Karen to the hospital, I spotted Thabiso and Senzo playing in the churchyard below the hospital. Both were dusty and dirty and covered in grass; it was clear that neither had been to school that day. I honked and pulled over, but Thabiso, perhaps thinking I was going to berate him for not going to school, took off running. In the back of my mind, I also wondered if he didn't also sense that I had bad news about his mother. I jumped out of the car and chased him briefly, but he had a good head start on me and vanished down into the valley below.

I called Scott and told him I'd sighted Thabiso, and it turned out that Scott was with Thabiso's uncle, who lives on the same homestead, and who had come to the hospital to check on his sister, Busisiwe, not knowing that she had already died. Scott said he'd bring Thabiso's uncle down to the church and that we'd look for him together. When they arrived at the church, Thabiso's uncle thought it best to drive back to their homestead to wait for Thabiso there. The five of us, including Thabiso's friend Senzo, who'd materialized just as we were getting into the car, started down the muddy, rutted, dirt road that leads to their homestead. Thabiso's uncle soon saw Thabiso in the distance and jumped out of the car, running after him. Miraculously, he caught him and brought him back to our car idling by the side of the road.

Scott, Karen, and I got out of the car with Senzo. I could tell from the confused, mistrustful look on Thabiso's face that his uncle hadn't told him what had happened, and that he probably still thought he was in trouble for skipping school. As we approached him, I suddenly wondered how we were going to handle this delicate situation. Scott was already very emotional from the shock of Busisiwe's quick death and having to break the news to her brother. Thabiso's uncle, having caught the boy, was pacing distraught by the side of the road, lost in his own thoughts. It suddenly became clear to me that I was going to have to tell the eleven-year-old boy standing in the road in front of me that his mother had just died.

I successfully fought off the tears I felt welling in my own eyes, and took Thabiso gently by both shoulders. I simply said "Thabiso... you know that your mother has been very sick. You did all that you could to help her, but she was just too sick. She didn't make it, and she died this afternoon." He looked around at his uncle, then at the rest of us, taking a minute to comprehend the news, and then he burst into tears. I pulled him to me, his head only reaching my stomach, and held him close while he sobbed into my shirt. The bunch of us stood there for several long minutes which will live in my mind always -- Thabiso's uncle pacing off his grief; Scott comforting Thabiso's teary friend Senzo; Karen standing silently by, and Thabiso clinging to me crying: a strange tableau, the group of us standing there at the side of the dirt road, next to our car with its doors flung open, curious people on their way home from work and school passing by, wondering what was going on....

As I stood there comforting Thabiso, just letting him cry, I looked out over his head and across the beautiful valley before us bathed in late afternoon light, and I thought of the countless similar deaths that had taken place in homesteads right before me and all over Swaziland. The scope of the problem seems so daunting and insurmountable that we often wonder if anything can be done to stem it, and if our presence here makes any difference at all. But as I stood there, the thought came to me that perhaps this is what brought me here; perhaps I was meant to be here for just this moment, for just this one person, to hold this young boy who came into my life at a gas station three months ago, and to stroke his head upon the death of his mother.

Family Drama & Highway Robbery

2009-03-05T00:28:00.001-08:00

A busy couple of weeks. We've become progressively more involved with helping two families, and, as with all families, drama abounds. We're dealing with a couple of kids who don't want to go to school and prefer to play hooky all day, a couple of sick kids, a sick and probably dying mother of one child, and none of them have enough to eat, so we're trying to keep them all fed as well. Numerous mini-dramas and family scenes, and ferrying to and from hospitals and schools, and even a midnight rescue (really) have played out all week. I know I signed up to help the people of Swaziland when I came over here, I just didn't anticipate that it would get so personal so quickly. I could write several blog entries about all that we've been through in the past week, but I don't have the energy to relive it all so soon, so instead I'll fill you in on our adventure from last weekend....

We've been wanting to visit Mozambique ever since we got here. We live only thirty minutes from the border, and from there it's only an hour and a half to Maputo, the capitol city of Mozambique, situated right on the Indian Ocean. Mozambique is supposed to have some of the world's greatest beaches, so we were eager to spend some time relaxing in the sun after all the week's dramas. On Saturday morning, we picked up another volunteer at the hospital -- Dave, a medical student from Australia -- and the three of us headed to Mozambique.

We'd been warned that the Mozambique police sometimes set up road-blocks and stopped drivers on trumped up charges in order to extort money, but our drive to Maputo was uneventful. I enjoyed the almost immediate change of atmosphere from land-locked, Anglophone Swaziland, to the more laid-back, tropical, and Portuguese-influenced feel of Mozambique. When we got to Maputo, it was exactly what I expected a recently war-torn, formerly communist, formerly Portuguese colonial city of three million to be: run-down, chaotic, slightly scary, and strangely intruiging. We found the "good" part of town recommended in our guide book and stopped for a great lunch of fresh prawns and cold caiparinhas. We sat over our al fresco lunch for a long time, enjoying the warm sun and ocean breezes. As we sat there, I thought to myself how much I enjoyed being back in a big city, and how I prefered the easy rhythms of Latin cultures to the more buttoned-down Northern European ethos.

By the time we left the restaurant it was nearly 4 p.m. At lunch we'd decided that since it was getting late in the day, we'd simply look for a small beach resort to spend the night and enjoy a full day at the beach on Sunday. We weren't certain how to get out of town and find the beach areas. We were driving down Mao Tse-Tung Blvd., when we saw a sign for "beaches" pointing in the opposite direction we were headed. Scott was driving and he made a quick U-turn at the next light. I was sitting in the front passenger seat with my head buried in the guide book, so I didn't realize at first that Scott was pulling over to the curb. I looked up to see a policemen armed with a large rifle approaching the car.

At first he seemed fairly professional. He asked for Scott's driver's license and asked him if he knew he'd made an illegal U-turn. Scott said he hadn't seen any signs against making a U-turn, which turned out to be the wrong answer. The policeman asked if we were questioning his knowledge of driving laws in Mozambique and took a more belligerent attitude. He kept Scott's license and waved us down the street to where a small group of his fellow policemen were standing. We pulled over as directed, and the original policeman plus one of his comrades began interrogating us on what we were doing in Maputo. We explained that we are volunteers working in Swaziland, but that didn't seem to impress them at all. They kept saying that we'd done "a bad thing" and that we'd have to pay a steep fine for it.

We all knew what was going on, and I knew we'd have to end up paying our way out of the situation sooner or later. Scott, however, has a perhaps more finely tuned sense of justice and injustice than I do, and he continued to insist that there was no sign forbidding U-turns. I kept trying to whisper to him under my breath to just apologize for the "bad thing" we'd done and to get to the financial bargaining so that we could get out of the situation as soon as possible. But the back and forth between Scott and the cops continued for several minutes.

We'd read in the guide book, and heard from others, that if we ever encountered such a situation we should demand to go to the police station, where we were more likely to get a fair hearing than from cops on the take on the street. When the policemen continued to insist that we pay a fine, we finally asked to be taken to the police station. What we hadn't expected, however, was that they'd agree so readily. They opened the back door and two of them got in, both with their large rifles.

The presence of two armed men in the back seat certainly changed the dynamic for me. I immediately began envisioning all the ways the situation could go wrong -- a Mozambique prison was the good option, our bodies by the side of the road was somewhere down the line of thoughts that flashed through my head. The cops directed us back the way we'd come, and did point out a sign forbidding U-turns a couple of blocks before the intersection where we'd turned. They directed us a few more blocks down the main boulevard and then told Scott to turn down a small side street. Scott made the turn, but stopped short when we saw the small, rutted street and suspicious looking area we were headed into. It didn't look as if we were headed to a police station.

I have to give Scott credit for taking a stand at this point. I certainly didn't want to head down that street. When they told him to keep going, he said "No, I don't feel comfortable going down this street." They kept angrily insisting that we had to go to the police station as requested, and Scott kept refusing to move. They started shifting around and telling us we had "to pay" for what we'd done. At this point, I thought it's time to bargain. Luckily I've kept about $100 U.S. in my wallet ever since we arrived in Africa. I figured it would come in handy sometime -- and this seemed like the time. I pulled out $30 and asked if this would help pay for what we'd done. At first, they refused it, and said it was too little -- the "fine" would be much more. I put the money back in my wallet, and told them it was all I had on me. Scott continued not to budge, and the policemen continued to hassle us for a while, but they seemed to be running out of steam. Finally one of them said, that if we'd just drive them around the block, they'd "show us" the police station, but we wouldn't have to go in and they'd accept the $30 as payment for what they'd done.

Scott reluctantly drove forward, and the cops kept their word; they pointed out some official looking building and told us that if we ever "got in trouble" again that was where we should go for help -- as if they were now offering assistance! We turned back onto Mao Tse-Tung Blvd. and pulled over, and they got out. I handed them the $30 and they wished us a good journey. We drove on -- slowly -- and exhausted. The entire ordeal had taken about half an hour. We made a half-hearted effort to put it behind us and to find a near-by beach, but the experience had soured us on Mozambique for the time-being, and I was very happy to arrive home to safe, secure little Swaziland. We'll go back sometime in search of those perfect Mozambique beaches, but we'll definitely skip Maputo.

This coming weekend, we're off to another "fun-filled" city we've been warned about, Johannesburg, to pick up our friend Karen, who will be visiting for the next few weeks. Wish us luck....

Four Lollipops

2009-02-26T01:56:00.000-08:00

Every week I try to spend one day making home visits with the Home-Based Care (HBC) team Scott works with. The HBC team visits patients in communities within a 50-km radius of the hospital who don't have the means to travel into the hospital for health care. The vast majority of the patients are HIV-positive or suffering from full-blown AIDS. They live in traditional Swazi homesteads, which consist of a collection of huts for various extended family members surrounded by their maize fields and plots of vegetables. At each homestead we invariably find the patient(s) in bed or sitting on the ground, surrounded by other family members -- usually a go-go (old woman or grandmother) and lots and lots of children. Feral dogs and cats and random chickens, goats, and cows wandering around the periphery complete the scene.

Last Thursday we visited a community called Sitsatsaweni -- a very poor, remote settlement about 15 miles from where we live. It's not a village in any sense, just a bunch of homesteads scattered over a wide area of probably ten square miles. The day consists of driving from homestead to homestead, often down tiny, barely visble dirt tracks or footpaths. Scott has become very good at navigating these tracks where most sane drivers would fear to go. At each homestead, the team of three or four nurses assesses the patient and dispenses medication as needed. In some cases the patient is given a referral and money to come into the hospital for further treatment, and in really dire cases, we'll put the patient in the back of the truck and bring him or her back to the hospital with us.

A major part of the home visits consists of distributing food to the homesteads on an "as-needed" basis. Patients on HIV drugs receive the most: a food pack consisting of beans, peanuts, cooking oil, salt, maize meal, and milk. Other patient will receive only the maize meal or milk. The team takes only ten full meal packs a day, along with twenty additional packs of maize meal, and ten 2-litre bottles of milk. The HBC team visits each community once a month, and for some patients this is their only food delivery of the month, so you can understand that in many cases the patients and their families prize these food drop-offs even more highly than the medical care they receive.

On Thursday, as often happens, by the time we saw the last patients of the day, we were entirely out of food. It was an exceptionally hot day, and everyone in the truck, myself included, was tired and ready to head home. We thought we'd seen our last patient and we were all relieved to be headed back to the hospital, when suddenly a thin young woman materialized out of the dense bushes and grass by the side of the road. She held out her medical papers indicating that she is a regular patient and wanted to be seen. Everyone in the truck silently groaned, but Scott pulled over and got out to examine her. She is an HIV patient, but is not acutely ill (aside from being malnourished); she had come primarily to pick up her monthly food pack for herself and her three children. Her homestead is well back from the road and she had walked a ways to meet us when she'd seen the truck in the distance. Unfortunately we had no food at all left to give her. This poor woman looked miserable to begin with, but when we told her we had no food her face fell even further and she looked like the very picture of desperation.

As I wrote in my previous post, people here often mistake me for a doctor, she turned to me and gave me a long, pleading, desperate look. There was nothing any of us could do but get back into the truck and head off. As Scott started the engine, I remembered that we had a few remaining lollipops which we bring along to distribute to the young children at each homestead. I grabbed the bag and found four lollipops inside -- enough for her and her three children to have one each. I told Scott to wait a moment and got out of the truck to hand them to her. As I was doing so, however, I was overcome with guilt that they were all I had to give her. She received them gratefully, joining her hands together to take them from me in the traditional sign of gratitude and respect. We all drove away feeling rotten. Despite all the food we'd distributed that day, or any day, it's the ones you can't help that remain with you.

A postscript: Neither Scott nor I could get this woman and her three children off our minds that night or over the weekend. We talked about it and decided that we had to do something. We would have simply bought some groceries and delivered them on our own, but we had no idea how to find her in that remote area. We asked the HBC team on Monday morning go help us find her -- they know who she is and have records of her treatment -- but due to full schedules and hundreds of other people to help in the communities scheduled for this week, it wasn't until yesterday (Wednesday, seven days after our visit last Thursday) that I was able to go with one of the nurses to find this woman and deliver her some food -- for which she was very grateful. So this story has a happy ending of sorts, but one mitigated, as always, by the fact that she got lucky this time. Who knows what will happen to her in the future, or what will happen to all the thousands of others who aren't so lucky?

Dokotela David

2009-02-20T00:31:00.000-08:00

Virtually everyone I encounter at the hospital thinks that I am a doctor when they first meet me -- even many of the other doctors and hospital employees. I suppose I fit the part -- a tall white man, greying at the temples, and hanging out at a hospital. Both patients and people coming in for the first time regularly come up to me saying "Dokotela?" Dokotela is the word for doctor in SiSwati. Quite a few people, even those I have no recollection of ever seeing before, know my name and call me "Dokotela David." (The word for nurse is "nesse." I love the way the Swazis have appropriated English words and made them their own.)

Sometimes, if it seems pointless to do otherwise due to the language barrier or if I'm too busy to stop and go into long explanation, I don't correct the misapprehension, and I just try to help them anyway. This morning, as I stood outside of the Home-Based Care office, where Scott works and which is my unoffical base at the hospital, a young high-school aged girl approached me as "Dokotela Dave." She spoke good English, and told me that she was experiencing some sort of problem with her eye-sight, and it was giving her severe headaches. Since I've been having recurring headaches myself as a result of my tick-bite fever, I felt her pain and didn't want to ignore her complaint. She'd been waiting in the OPD (out-patient department) which is just upstairs from Home-Based Care office, and they'd referred her to the hospital's eye clinic. They'd also told her to buy some over-the-counter pain medication, but she didn't know what to buy and had no money anyway. I told her to buy some Paracitemol (local version of Tylenol) and gave her 20 Emalengani (about $2). She went away happy, and I felt that the interaction had gone smoothly despite the fact that I'm not really a doctor. Unfortunately, I hadn't considered the long line of patients standing nearby waiting to be seen in the OPD. As soon as the young girl walked away, a man and woman came over and told me that the woman had a terrible tooth-ache, she hadn't slept for days, and needed treatment ASAP. I was able to refer them to the hospital's dental clinic, and they too went away satisified. Next a woman with a sick child approached me holding out her child's medical papers. (Everyone here carries their medical records with them in much the same way we carry driver's licenses -- you never know when you'll need to have them on hand.) I've grown familiar with reading them during the home visits I sometimes make with Scott. I briefly looked at the child's medical records, and then gave the mother directions to the pediatric ward. As soon as they left I was surrounded by a sea of others who had witnessed my authoritative handling of the three previous patients. At first I just laughed to myself about the situation I'd gotten myself into, but these people were serious -- they wanted help now. I took the next patient's papers and looked at them briefly and then told him to go upstairs to OPD. The next in line was a mother with four young children in tow. It so happens the woman was a dwarf and was the same height as her children -- maybe three and half feet tall. She spoke excellent English and launched into a long list of each child's complaints. "This one has white spots all over his body. This one has a terrible cough. This one has nausea...." I finally cut her off and explained I was not a doctor. She looked at me incredulously; I don't think she believed me at first. She asked me again, "Can't you help my children, Dokotela?" I smiled at her and repeated that I wasn't a doctor, but an administrator. She smiled for a moment and then launched into a stream of SiSwati, which made everyone in line start laughing -- some of them uproariously. One old man started pounding his walking stick on the ground he thought it was so funny. I didn't understand a word the woman had said, but I caught the gist of it anyway: tall white know-it-all being told off by African dwarf. I laughed too -- partly out of nerves, but mostly sincerely -- it was all I could do in the situation. My nerves were totally unwarranted, everyone remained friendly, and I'm glad that my cluelessness gave them a laugh. Despite the fact that I'm not a medical professional, I've found ways to be helpful both at the hospital and elsewhere in the community, but perhaps this is an important new one: to entertain the people waiting in the endless line for the OPD. They could certainly use a laugh.

Tick-Bite Fever

2009-02-08T23:32:00.001-08:00

I know there's nothing worse than hearing about other people's ailments, but I thought I should take a break from describing all the orphans and other suffering Swazis to elicit some sympathy for myself for weathering my first tropical disease. Sometime within the last ten days or so, I managed to contract typhus, or as it is more prosaically known, "tick-bite fever."

Two Fridays ago, I noticed a small red dot on my left forearm which looked like nothing more than a mosquito bite. Over the next few days it grew and turned red and nasty looking, sending pink branches up my arm along my blood vessels. I didn't feel sick at first, but last Monday evening, as Scott was consulting his medical manuals about the bite on my arm and reading me all the various symptoms and consequences of each possible disease, I suddenly caught a severe chill -- such that I literally ran to my bed and dived under the blankets (it was about 90 degrees out that day). Scott and I both thought it might just be a psychosomatic reaction to hearing too much information from the medical books, but as the night progressed I felt worse, and I didn't sleep much due to severe body aches. The next day, our landlord, Dr. Pons, stopped by and confirmed that I had a case of tick-bite fever, which is something like Lyme Disease, but luckily without the chronic after-effects. My main symptoms, besides the swollen red bite on my arm, were fatigue, body aches, and persistent on-off headache for most of last week. Luckily I happen to live with a very good nurse, so I received world-class medical treatment all week. Unfortunately, Scott himself came down with a pretty bad head cold on Thursday, so he spent the day home from work on Friday. All in all, we spent a rather low-key weekend at Mabuda Farm. Our weekend was brightened considerably by the arrival on Friday of five packages from home. Many, many thanks to Jocelyn, Aunt Peggy & Rick, Will & Stuart, Anne Abbott, and Steven & Gina for their thoughtful and much welcomed gifts. They arrived at the perfect time!

I am feeling much better now (as is Scott), and it seems to have been a relatively mild case of tick-bite fever -- and supposedly I will now be immune to future cases -- for which I am very thankful.

Monday Morning

2009-02-01T23:55:00.000-08:00

I've been intending to write about what I do each day here -- the various organizations I'm working with and the various projects I'm working on -- and I will describe those in some future post. But this morning has already been so busy and filled with so many different experiences that I'm simply going to describe my day thus far. (It is now 10 a.m.)

Scott and I arrived at the hospital at 8 a.m. I have been working with a nurse at the hospital, Deborah Maposa, who is also a community organizer -- or really a mother figure in her neighborhood of Makhewu, to whom many of the local people turn when they need help with problems of any kind: food, clothing, housing, school fees, or medical issues. She's part of the home-based care team Scott works with, and she's kept me busy with referrals of students who need help with their school fees. Deborah and I had scheduled a meeting to discuss three high school students that we have been working on placing in local high schools. When I arrived, the mother of one of the students was waiting to speak with me. She had come to the hospital by bus (actually, small vans, called "coombies" here -- the backbone of Swaziland's transportation network) just to thank me for helping her daughter. She thanked me profusely and at great length (all in Siswati, translated for me by Deborah), praising God at length for sending me to help her daughter. This sort of praise happens fairly often to both Scott and me, and is rather embarrassing, but is a formal and accepted part of the social exchange here. The woman had come a long way just to thank me, so I gave her bus fare for her return trip.

Next, Deborah told me about a particularly sad case, an orphan girl of 15, who had been receiving government support for her schooling, but who, at the end of last week was handed a bill for almost 4,500 emalengani (about $450) and told that her government support had ended. Deborah wanted me to go with her to see the headmaster at the girl's school to see if he would allow the girl to continue to attend classes while we worked things out with the department of education or found someone to sponsor the girl. So we hopped in my car and headed down the road to the high school. (That's one of the things that's both wonderful and exasperating about this place -- you can just show up somewhere, no appointments needed, and meet and work out whatever issue is at hand. In fact, it's probably best not to make appointments, as people often don't keep them, and even if they do, invariably show up late.) On our way to the high school, we saw another student we are supporting walking up the road toward the hospital from town (about a 1/2 hour walk). This student was the daughter of the woman who had come in earlier to thank me, and she thought that she was required to be there as well, so had walked all the way from town. I told her to hop in the back seat and that I would take her back to school when we were done with our meeting at the other high school.

We continued on to our original destination, where we stood in line with a bunch of other anxious parents waiting to see the headmaster. While we were there, Deborah realized that yet another student we are assisting (third one of the morning) was also a student at this school, and that I should meet him so that he could thank me as well. She sent for him, and the young man soon showed up and began thanking me profusely for helping him and vowing that he would be a diligent student and make me very proud to be his son! (I have given up trying to explain that I am not personally paying for each of these students, that I am only working to find other sponsors. To those of you who have sent money or offered to help support a student, I pass all this thanks and praise along to you, and I promise to take pictures of these students and pass them along to you ASAP.) We then met with the headmaster, who readily agreed that the orphan girl could continue her studies while we seek to get her government funding reinstated.

On the way home from that meeting, we dropped off the girl we'd encountered on the road at her high school, and returned to the hospital. I ran in to Scott right away, who was standing there talking with one of the hospital orderlies, a young man who wants to try to attend nursing school in the United States. We told him that he needed to research Swazi and U.S. immigration policies, and that we would do some research on nursing programs in U.S. that might offer scholarships or support to African students.

As we were speaking with this young man, we saw a woman who occassionally cleans and does our laundry for us walking down from the out-patient department with two of her young children -- one on her back and the other holding her hand. She is a lovely woman, and we greeted her by saying "Unjani" or "How are you today?" She hesitated for a moment before saying quietly, "I am not fine" -- her toddler had just tested positive for HIV. This came as a shock to both of us, and she must still have been in a state of shock herself, but, sadly, there is also something so every-day about hearing the news here. She is herself HIV-positive, and she is now very worried not only about her toddler, but also the new-born on her back. Scott counseled her a bit, and then she took off down the road to her house. Scott and I just looked at each other and shook our heads. We had thought she was one of the lucky ones; she has a steady job and seems relatively well-off, but more and more it seems to us that virtually everyone here is HIV-positive. The official statistic of a 40% infection rate, high as it is, seems vastly understated based on what we see everyday.

I have an appointement at 10:30 a.m. in town to meet with an Italian aid agency, so I decided to stop at the internet cafe to catch up on email and write this entry. On my way into the cafe, I saw one of the nurses from the hospital carrying a beautiful young girl of about two or three years old who promptly reached out for me with a big smile. I greeted the nurse, and I asked if the young girl was her child. She said, no, that she was a girl who had been abandoned at the hospital. I remarked how friendly and outgoing the young child was, and the nurse responded with a rueful laugh, "Yes, she is an adorable child -- she has no one, so she is friendly with everyone."

All of this occurred between 8 a.m. and 9:30 a.m. this morning -- a far cry from my quiet desk at the Russell Sage Foundation.

I write all this not to tug on any heart-strings, but just to provide some idea of what passes for normal here -- the continual, ongoing evidence of human need of any and all kinds. Though it can all be a bit overwhelming at times, I must say that I also find it rather bracing and invigorating -- perhaps only relative to what I used to think of as my own "needs."

Head of Household

2009-01-29T00:27:00.000-08:00

(click photos to enlarge)I'll let these photos speak for themselves, except to say that, yes, this family of orphaned children is living on their own, and is now headed by the eleven-year-old girl you see above. They receive one visit a month from the Home-Based Care team Scott works with, and they also receive monthly food packages from World Vision International.

Back to school

2009-01-27T03:22:00.000-08:00

One experience I never anticipated having while here (or ever in my life, for that matter) was going back-to-school shopping for kids of my own. Yet that's exactly how I spent my entire morning yesterday. Let me explain...

The new school year begins in Swaziland today, and over the past week, many poor parents (and other child guardians & caretakers -- since so many kids' parents have died) have been desperate to get their children enrolled in school. The primary obstacle, as with so many things here, is lack of money. School here is not free. Everyone must pay school fees. Most primary schools charge around $200 per year, and high school costs around $500 a year. That may not sound too expensive, but in a country where the average income is less than a dollar a day, you can see that those charges put school entirely out of reach for many families.

Many of the other volunteers here pay for one or more student's yearly school fees. Scott and I had decided we would do so as well, but hadn't been approached -- until last Friday. Scott was wrapping up his day making home visits when he came across a particularly desititue family -- both parents dead of AIDS, and their two chilren, a 12-year-old boy, Marcoba, and and 13-year-old girl, Nosipho, are now living with their grandmother, who is herself ill, and their paralyzed uncle. It sounds like something out of Dickens, but it's all true -- and all too common here. Scott called me, and we agreed that this is the family we wanted to support. We got the necessary forms and spent a couple of hours on Saturday morning waiting in line at the local bank to pay the school fees for these two children.

Yesterday morning (Monday), Nosipho was waiting for us at the hospital at 8 a.m. She had probably walked about 3 or 4 miles to get there. We had arranged for her to meet us there so that we could give her the bank receipt verifying for the school that their fees had been paid. They also needed some school supplies, although they are going to make due with their uniforms from last year. Both are very small and slight kids for their ages; they look more like an 8 and a 10 year old than a 12 and 13 year old. Nosipho, the young girl, is shy and reserved, and seems wise and resigned beyond her years. Her brother, Marcoba, is a typical young boy, a bit devilish and charming and eager to show off.

In any event, Nosipho hopped in the car with me to go pick up her brother for a shopping trip in town. She lost a bit of her shyness in the car and gave me expert directions to her homestead, which isn't far from town, but is down many winding dirt roads ending in nothing but a rocky track leading to their home. We picked up Marcoba, who quickly relegated his older sister to the back seat and began telling me how to get back to town. We went to PEP, the local (much smaller) version of Target or Wal-Mart. It was a mad-house. Mothers with their kids in tow, were packed into the store buying back-to-school clothes and supplies. I was the only white person and the only male shopper in the store. Luckily, a kind saleswoman saw me looking lost, and came over and took charge. We ended up with new backpacks, sweaters, socks, underwear, and shoes for the kids. Marcoba wanted to buy everything in sight, but his sister, Nosipho, did a good job restraining him and letting me know what they really needed. After PEP, we went grocery shopping so they had some food to take back to their grandmother, and of course I had to get them some a couple of treats to mark the special day -- for them and for me.

The whole experience raised mixed emotions for me. Of course it felt good to be able to help those two cute kids. I fell in love with both of them, though Nosipho especially captured my heart with her sad, sweet smile. But it also made me feel sad for them that they have to live this way -- and they are among the lucky ones! They found someone to help them, while so many others have to go without. And what will happen to them down the line? There is something very wrong with a system that charges so much for school, asking so much of people who clearly cannot afford to pay. The problems here are immense, and school fees are only part of it. We, like most, are just doing what we can to help those in front of us, and I try to keep that in mind and to be content with that, but the thought of all those who aren't being helped, who can't go to school, who have no food or water, is a constant nagging thought in the back of my mind.

One Reason I'm Here

2009-01-23T00:07:00.000-08:00

(click photos to enlarge)

The glimpse of a child on a movie screen played a significant role in bringing me to Swaziland. Scott and I were still considering whether or not we really wanted to come here, when we went to see the documentary film "Without a King" sometime last spring. Towards the end of the film, there is a brief shot of a lost-looking young boy at an orphanage here. One of the king's daughters is distributing food to the orphans, and, when this young boy is given his share, he looks confused and vacant and almost hurt because he is so unused to receiving anything or having anyone notice him at all. His lost look haunted me long after leaving the theater, and whenever I wavered in my resolve about our decision to come here, the thought of the look on that young child's face sustained and strengthened my desire to come here and try to help in some way.

Now, it is the looks of children I have witnessed since we've been here that inspire me: of Thembeline, a 13-year old girl with TB and HIV, who is the only caretaker for her sick and blind grandmother; of a six-month old HIV+ baby, crying weakly because his mouth was so full of thrush; of an eight-year-old boy, Mthobisi, also HIV+, wandering down a muddy road in his pajamas all alone to meet our truck, because his mother was too sick to accompany him -- he wore a look of infinite resignation on his face, and showed only the faintest glimmer of satisfaction when we gave him some candy to suck on while Scott examined him. And last week, at a homestead full of children and HIV and TB, a young adolescent boy, perhaps 13 years old, nattily dressed in a shirt, vest, checked coat, and striped shorts -- all mismatched and ragged and dirty, but still worn with pride and a sense that he had chosen those clothes carefully -- and his wide, toothy, endearing smile, somehow yearning for attention among all those other kids. He wasn't sick, he was just one of a dozen or so children in that family, and I sensed he was a bit lost in the crowd. Whenever I'd catch his eye, he'd smile broadly but shyly shrink into the group of people gathered around the truck. I went over and shook his hand and said hello, but the language barrier kept us from communicating beyond that. All I could do was give him some candy and pat on his shoulder, but his shy smile has stayed on my mind -- all of their looks have stayed on my mind.

For me, a big part of this journey is figuring out how best I can help such kids. As I wrote in my first entry, I believe that even small steps can make some difference. Perhaps my smile and that pat on the back encouraged that young boy in some way that day. I'd like to think so, but I don't know.... I think I'll still be trying to figure it out long after we leave.

Mabuda Farm

2009-01-22T04:29:00.000-08:00

(Click photos to enlarge.)
This is our home for the next 11 months. In case you think it looks too grand for medical volunteers, the house is divided into three apartments. The three windows in the right side of the photo are ours. (From left: living room, bedroom, bathroom. There is also a large kitchen at the back of the apartment.) The French doors in the middle are part of another apartment. That said, it is a very nice place to live and we are glad to be here.

The view from our windows down the valley, across southern Swaziland, all the way to South Africa.

Sawubona: To New Beginnings

2009-01-21T05:24:00.000-08:00

"Sawubona" means "hello" in Siswati. Welcome to my blog. I've had rotten luck corresponding by regular mail (average delivery time for a letter seems to be about 3-4 weeks) and email is slow and spotty service at best. Scott has had such good luck with his blog (www.scottinswaziland.blogsport.com), that I thought I'd try this method of keeping you all up to date on what and how we're doing from my point of view. If you read both of our blogs you'll end up knowing more about our lives than you did when we lived in New York.

It's hard to believe we've been here for nearly two months now. So much has happened and we've experienced so many new things and met so many new people that I'm not going to try to cover all that we've been through so far. I'm just going to start from where we are, and I hope that over time you'll get a good idea of what life is like for us here.

Today, like most of you, I presume, we are basking in the good feelings from Obama's inauguration yesterday. A group of about 25-30 of us, mostly other volunteers and employees of the hospital, gathered at the Siteki Hotel to watch the festivities from Washington D.C. on CNN. It was a great experience to watch the inauguration with such a diverse crowd. Besides Scott and I and our American volunteer friends Susan, Andrew, and Kristin, also in attendance were Dr. Kalungaro and his wife Valerie, who are from the Congo; our parish priest Father Emmanuel, who is from Uganda; a TB nurse, Wiseman, who is from Zimbabwe; and about 20 Swazis. Everyone applauded loudly throughout Obama's speech, especially when he mentioned his father's village in Africa.

As you might imagine, the Africans are uniformly proud and gratified that the U.S. has chosen an African-American president. Ever since we've arrived here we've been peppered with questions about Obama and how he came to be elected. Because African politics are so based on tribalism and watching out for one's own, most Africans can't quite believe that a majority white nation would elect a racial minority candidate. One man asked me "What will happen to the southern states now? Will Obama punish them for not voting for him?" I explained that it doesn't work quite that way in the U.S., but I don't think he bought it. Some of the locals also play devil's advocate a bit -- as if not wanting to seem too biased for an African-American candidate. So I've heard a surprising amount of support for both Bush and McCain as "strong men." One man told me he supported Obama, but he is worried about Obama's policy toward Asia. I don't really know much about Obama's Asia policy, but I told him not to worry too much, that Obama will deal with Asia fairly.

All in all, I'd say it's a good time to be an American abroad, especially in Africa. Scott and I brought a lot of Obama memorabilia with us -- caps, calendars, political buttons -- and they've been a big hit. They've helped smooth our way out of more than one tricky spot. When Swazi customs didn't want to let us in the country without more documentation than we had for the medical supplies we brought with us, we distributed a few Obama caps and the customs officials grew much more friendly and amenable. Likewise when we went to establish electric service for our house at the deaf school: an Obama calendar greased the wheels of what could have been a bureaucratic nightmare, and it is now front and center in the waiting room of the electric company headquarters.

Everyone seems aware that Obama won't change things overnight and that slow steps are required. That attitude pretty much mirrors what Scott and I are experiencing on a personal level here. We know we're not going to change much in this thoroughly -- to us -- dysfunctional system. Nonetheless, it feels good to be part of the broad movement of volunteerism Obama has spoken of, and to be contributing our own small part toward creating change and helping some truly needy people here.