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.
Thursday, April 16, 2009
Sunday, April 5, 2009
Thabiso: An Update
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.
Tuesday, March 24, 2009
Pretty in Pink
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.
Thursday, March 19, 2009
Kruger
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.
Tuesday, March 10, 2009
A Death in the Family
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.
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.
Thursday, March 5, 2009
Family Drama & Highway Robbery
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....
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....
Thursday, February 26, 2009
Four Lollipops
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?
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?
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