The Africa Track at the US Social Forum (#USSFafrica)

There are a number Africa-related organizations represented at the US Social Forum focused on bringing Africa into the larger US social justice context and ensuring that there are African voices represented.

During the June 22-25 conference there will be 14 workshops presented by: Africa Action, TransAfrica, HealthGAP, Support Darfur Project, All African Peoples Revolutionary Party, University of Kmt, Priority Africa Network, Community Alliance for Global Justice, African Security Research Project, Athletes United for Peace, Detroit to Dakar, and International Development Exchange (IDEX). See list below:

24 Thursday (10am-12pm)

  • Africa & Pan- Africanism in this hemisphere: fighting neo-colonialism, racism, class, and gender oppression
    • All African Peoples Revolutionary Party @ Cobo Hall – Rm. W2-61
  • Building a Pan-African Solidarity Movement in North America
    • Support Darfur Project @ WC3 – Rm. 317
  • AIDS isn’t over: Solidarity in the fight for justice for people with AIDS worldwide
    • HealthGAP @ WA – Rm. 1472
  • Gender Militarism and US Corporate Violence in Oil Producing States
    • Priority Africa Network (PAN) @ Cobo Hall – Rm. O2-40

24 Thursday (1-3pm)

  • Africa Unity Toward What? (Pan-Africanism & Nationalism are not enough!)
    • University of Kmt @ Cobo Hall – Rm. O2-38
  • The Politics of Exploiting Need: AGRA (Alliance for a Green Revolution in Africa), the Gates Foundation, & the Food Crisis
    • Community Alliance for Global Justice @ UAW – Rm. Taurus
  • Migration & Militarization of U.S. and European Borders: A Comparison & Contrast
    • Priority Africa Network @ Cobo Hall- Rm. O2-40
  • Youth-led Activism in NYC’s Public High Schools
    • Support Darfur Project @ WBC – Rm. WB2
  • The World Cup, Sports & Social Justice: The Beautiful Game & Beautiful Struggle, Together
    • Athletes for Peace @ WSU S – Rm. 29

24 Thursday (3:30-5:30pm)

  • International Financial Institutions & Climate Change: Community Impacts in the Congo
    • Africa Action @ WC3 – Rm. 337
  • The New Africa Command & U.S. Military Involvement in Africa
    • African Security Research Project @ UAW – Rm. Pres

25 Friday (1-5pm)

  • Prioritizing Africa & the African Diaspora Agenda from Detroit to Dakar (D2D)
    • Priority Africa Network @ Cobo Hall – Rm. W2-69
  • Educating African People: K12 through Ph.D. levels
    • University of Kmt @ Cobo Hall – Rm. O2-38
  • GM Crops – the poisoned chalice: perspectives & victories from South Africa
    • International Development Exchange (IDEX) @ Cobo Hall – Rm. D3-23
  • Power Sharing Deals in Africa: Implications for Democracy – The Case of Zimbabwe & Kenya
    • Africa Action @ WSU S – Rm. 261

Crossposted from SCOUT BANANA.

the coming revolution in african health care

 

african power fist Pictures, Images and Photos

Before you have anything else, you have your health. Hopefully if you have nothing else, at least you have your health. Unfortunately, for millions across the African continent this is not an absolute fact. Even more unfortunate is the fact that many Africans have no ability to change their health status. They are trapped in a system that is driven by Western market based, profit driven health care systems. As the failures of Western development practices come to light, alternatives to what has been are becoming increasingly visible. These alternatives will form a revolution in African health care delivery. This revolution will be fueled by health care delivery models that will give local communities agency in the provision of their own health care. Community-based models involving cooperative financing, proven para-professional training, new information technology, and social enterprise for the social good will drive the revolution in African health care. People will be able to determine for themselves, their level of health.

What does “Health” mean anyway?
This is a question often left to remain ambiguous. For the purposes of my writing I will provide a comprehensive view of “health” and all that is entailed in sustaining and maintaining health. “Health” in all instances will refer directly to the “basic needs” of a person in regards to health care.

Healing, like health, is obviously rooted in the social and cultural order. […] To define dangerous behavior, and to define evil, is to define some causes of illness. As the definition of evil changes, so does the interpretation of illness. To understand change in healing, we must understand what it is that leads people to alter the definition of dangerous social behavior. It can easily be accepted that health and healing in Africa are shaped by broad social forces.

As Feierman and Janzen state, health (and healing for that matter) are directly linked to social forces. If a comprehensive understanding of health is to be understood, it must be studied in the context of politics, economics, and other societal structures.

Health is defined by the World Health Organization (WHO) as, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The WHO and many other international organizations recognize that this broad and encompassing definition of health. Where this definition becomes ambiguous is what qualifiers meet, “a state of complete physical, mental, and social well-being.” In 1978 the WHO made primary health care its number one objective with the Declaration of Alma Ata. However, even this statement had no clear definition of health or its qualifiers.

Feierman and Janzen provide a more clear definition of the qualifiers of health in the preface to their volume: The Social Basis of Health and Healing in Africa,

[…] it [health] is maintained by a cushion of adequate nutrition, social support, water supply, housing, sanitation, and continued collective defense against contagious and degenerative disease. Such a view is necessary if we are to understand those contexts in today’s Africa where health levels deteriorate, and where they improve.

These authors provide a complete set of qualifiers, or “basic needs,” of health that can be researched further to understand where political, economic, and social structures interfere with sustaining and maintaining health and where health care is inadequate.

Health care should thus be understood as the system and structure that works to provide the above defined “basic needs” to each individual. Often this role falls to governments, but sometimes is taken up by communities and organizations when government’s fail to provide these basic needs.

This blog series will cover four key areas identified that will fuel this revolution in African health care: cooperative financing, para-professional training, information technology, and social enterprise. SCOUT BANANA works to tackle social medicine (social, economic, structures) while enabling others to provide medical services. Be sure to follow closely to learn more!

Written for the SCOUT BANANA blog.

global health is everyone’s responsibility

ban
People young and old across the US have connected with seven different communities across the African continent to support locally initiated health projects. Using the vibrant color of bananas and the enthusiasm of youth, a new nonprofit has grown to support the coming revolution in African health care.

It all began with one individual, Fr. Joseph Birungi, who had the dream of providing access to basic health care in a remote area where he worked. His dream was transferred on to me through his stories of those who died because they did not have access to basic health care. At the time I was a 14 year-old who knew little of the world beyond Michigan’s borders, but I was inspired to do something. Just entering high school, I was full of naive optimism with a goal to figure out how I could make an impact in the world. Although I was youthful, naive, and optimistic I had an incredible mentor, my mother. She helped me form basic assumptions that laid the foundation for my understanding of “global health as everyone’s responsibility. ”

One assumption that grew from my optimism was the belief that everyone had the potential to make a difference in the world. From Fr. Joseph to myself to my mother, the chain of individuals who embodied this grew to include hundreds of families, church congregations, school assemblies, and individuals from across the country working to fund an ambulance. These individuals, linked by a common cause, were able to raise over $67,000 in less than three months for the health center in Uganda.
It is easy for many people to take for granted the small things: clean water from a sink, medicine readily available in your cabinet, adequate food sources, etc. In the summer of 2002, I was able to traveled to Uganda. During my one-month stay I met and lived with the people who would benefit from the ambulance project. The people I met were so friendly and, even in their poverty, they wanted to share what little they had. I have seen that all people of the world share the same needs and wants. Everyone needs food, shelter, clean water, and necessary health care. We all want to know happiness, health and love. Parents everywhere want the best for their children and children want to learn and grow. But not everyone gets the same chance for success. And so keeping in mind the interdependent and similar nature of our world it is not so difficult to see “global health as everyone’s responsibility.”

As I graduated from high school with my classmates so did SCOUT BANANA. My friends began expanding our work into Chapters at colleges and universities across the US and Canada. This allowed our outreach to grow along with our ability to support more local projects. We became seriously focused on community-based solutions and empowering young people in the US to take responsible action when “making a difference” in Africa. Just because you have the means to do something doesn’t necessarily mean that you should. With an expanding support base and the desire to empower young people and community leaders we decided to pursue 501c3 status in order to better serve as a resource. Utilizing privilege in the US to connect communities in Africa with inspired students, SCOUT BANANA has been able to raise almost $200,000 to date and engage over 50,000 young people in partnering with African projects to provide access to basic health care.
SCOUT BANANA believes that global health is everyone’s responsibility and that everyone has the potential to make a difference. We look at global health issues systematically and our solutions are focused on revolutionizing structures as well as shifting paradigms of development thinking in regards to education, power, and privilege. We seek to create lasting social change in African health care and believe that solutions come directly from communities in need. SCOUT BANANA is dedicated to empowering community solutions as well as young people who want to responsibly make a difference in Africa. By connecting communities in long-term cooperative partnerships, we will build a movement dedicated to fundamental social change in which global health is everyone’s responsibility and every individual’s human right.

SCOUT BANANA is a nonprofit organization that works to provide access to basic health care in Africa. Focusing on community-based solutions and empowering community leaders as well as young people who want to make a difference in Africa, SCOUT BANANA is supporting the innovation in African health care. The organization connects student Chapters with local health project in Africa.

Learn more about the Chapter network & apply to launch a Chapter at your school HERE!

Written for Change.org’s Global Health Blog.

vvocf education fund


17 June 2008
Sphe and Nhlanhla helped me learn some more Zulu today with even more Swahili similarities coming to light. The Bantu peoples spread from central to east and south Africa, thankfully they kept the same language structure and vocabulary similarities.

Today we began the VVOCF Education Fund! We had the idea of collecting the 5 cent pieces that everyone throws on the ground to be collected and used as a way to provide educational scholarships for the VVOCF students. The four teams will have a competition with the winner getting some prize determined later – the students in secondary will be able to apply for the scholarship later. This will be a way for the children to invest in their own education while providing ground to approach other investors overseas or in more wealthy neighborhoods/ SA businesses. Funding cannot solely come from the outside so this is a great start. “Our future is in our hands” education campaign begins today!

The on-the-ground of running a project and NPO is exciting and a great experience for me to see to be able to find out how SCOUT BANANA can be most helpful to our own projects later. Linking education with health development will be important. Giving youth a voice in-country is just as important as giving developed youth a voice to help other youth.

Implications for Foreign Aid Across the Continent: The Shifting Africa Policies of China and the USA

China’s growing influence in Africa has been a topic that I have followed for a long time starting in 2006 when I recognized the increase in economic investment by China is various African countries. Since then I have been following China’s development investments and arms deals as well as the USA’s increase in “anti-terrorism” training with African militaries, notably in the Sahel region, via AFRICOM. This research paper was completed as part of a senior level Capstone course on the historical relationship between China and the USA, specific to international relations and policy.

Related blog posts:

a day wasted on the youth

15 June 2008
There is a sort of perpetual dance party on the weekends. Many people remain drunk off of the South African Breweries – remnant of apartheid appeasement of township and settlement peoples – and they blast their old tunes and techno beats to the high heavens and well into the late hours of the night. Is this their escape? Is this the real South Africa? Where the people are, is the real South Africa – not Sandton, Florida, or Alberton – but the townships, the majorities, the people that make South Africa; in their miseries, poverty, diseases, lack of family, absence of hope and utter lose for future dreams attained – the real South Africa resides with these people who have yet to realize and actualize their potential with support from uncorrupt (transparent) organizations that can give them and their children the resources to overcome, but never forget.

16 June 2008
The day rings hollow for the busloads of excited school children and township youth as ANC propaganda is spoken and popular music performed for unattentive throngs of young people with a new freedom and privilege to throw away. Politics is wasteful when it is departed from the masses and cannot compose a meaningful message to the future of the country – the youth!

Township youth are bussed in from all over. Politicians speak of real multiracial unity, but we are the only white people in the entire stadium. Speeches talk of 1976 and the youth movement, but there is no real remembrance or understanding of the past events inspired by youth. It has become less a national holiday and more a day wasted on youth, who are unguided in their development. ANC politicians talk of “all to the polls” but there is no real attempt to register youth and get them active in the governmental process. The youth were there for the pop music show as opposed to the meaning of June 16th 1976, those who died, or what it represented for their country. It is a day that has become a market opportunity for many to sell food, clothes, candies, and anything else. It is a day that has become more of an excuse than anything. An excuse for youth to skip school, to leave home, to do things their parents may not approve of, to hear popular music. An excuse for the government to feign caring about the youth, to spout their slogans, and to give lip service to their ideals. An excuse for many to forget the past and waste the future.

Reflections: 17 July 2009
The day rang hollow for me and my understanding of South Africa history, present, and future. Everything I wrote I still believe, especially now with the World Cup coming ever closer, I can only see it as another wasted opportunity. The government scrambles to hide its poor and failed systems, workers have to strike to get a fair wage, politicians have a field day with what this all means for South Africa, but again it is the masses; the majority of the population that suffers or is forgotten.

“It is best to rely on the freely given support of the people”
Nelson Mandela

With Mandela Day being today, Madiba’s 91st birthday, the world recognizing the imprint that one man left on his country and the entire world community. The problem, much like last year’s Mandela Day, was that it was a publicity event. Yes, it was a time to honor a great man and inspire others to action, but it was as if he was begin used, ushered around to coordinate yet another large money making event. Let’s not forget what Mandela did for so many people, let’s not forget those still in so much need across South Africa, the continent of Africa, and the world.

why there is no doctor: conclusion & works cited (12)

The sea of gravestones near Zonkizizwe was almost unimaginable. I would not have believed it myself if I had not seen it firsthand. This scene conveys the real implications and impacts of HIV/AIDS on a health care system and a country that has been stripped, divided, and neglected by apartheid.

While I often asked why there is no doctor, I was able to track down a traditional medicinal doctor who seemed to see no patients as well as the private clinic doctor who did not seem to care about providing real health care to the residents of Zonke. Writing has been done on where there is no doctor and what to do when there is no doctor, but the number one question in South Africa is why there is no doctor. This question is answered through history: apartheid, oppression, denial, and failure to recognize a crisis. The reality of apartheid health policies continuing to affect Black populations and responses to HIV/AIDS can be seen firsthand in the Zonkizizwe informal settlement.

Health was a weapon of apartheid and it worked. Denying medical access and training to the Black majority has kept the population in submission even 16 years after the end of apartheid. The critical period of 1993-2000 saw the new democratic government with its hands tied behind its back. There was no way that the health care system could be so dramatically scaled-up to meet the human and social needs of the HIV/AIDS crisis. As Seedat stated in Crippling a Nation, 1984, “Health in South Africa is inseparable from the economic, political and social structure of the apartheid state.” The health and HIV/AIDS realities that can be seen Zonkizizwe are direct result of apartheid’s legacy. HIV/AIDS in South Africa is not a direct result of apartheid policies, but the impact of HIV/AIDS and the health care system of South Africa is still inseparable from its apartheid past.

Works Cited
Beinart, William. “Labour Migrancy and Rural Production: Pondoland c.1900-1950.” In
Black Villagers in an Industrial Society, edited by Philip Mayer, pp. 81-108. Cape Town: Oxford University Press. 1980.

Boseley, Sarah. “Mbeki Aids denial ‘caused 300,000 deaths.” Guardian News UK. 26 November 2008. .

Chirwa, Wiseman Chijere. “Aliens and AIDS in Southern Africa: The Malawi-South Africa Debate.” The Royal African Society. African Affairs 97:53-79, 1998.

E. O. Nightingale, K. Hannibal, H. J. Geiger, L. Hartmann, R. Lawrence and J. Spurlock. “Apartheid Medicine. Health and Human Rights in South Africa.” Committee on Health and Human Rights, Institute of Medicine, National Academy of Sciences. Vol. 264 No. 16, October 24, 1990.

‘Forced removals in South Africa 1977-1978’, paper prepared by IDAF for the United Nations Centre Against Apartheid, No. 44/78, Oct. 1978, p.9.

“HIV and other STDs. Chapter 3, Part 1” Population Reports. Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health. Volume XXIV, Number 3. November, 1996.
http://www.infoforhealth.org/pr/J45/j45chap3_1.shtml.

“HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm.

J Yawitch, Betterment. “The myth of homeland agriculture” SAIRR: Johannesburg, 1981, p.86.

Kon, Zeida R. and Nuha Lackan. “Ethnic Disparities in Access to Care in Post-Apartheid South Africa.” American Journal of Public Health. December 2008, Vol. 98, No. 12.

Lodge, Tom. “The RDP: Delivery and Performance” in “Politics in South Africa: From Mandela to Mbeki”, David Philip:Cape Town & Oxford, 2003.

Lurie, Mark N., Brian G Williams, Khangelani Zuma, David Mkaya-Mwamburi, Geoff P Garnett, Michael D Sweat, Joel Gittelsohn, Salim SAbdool Karim. AIDS:17 October 2003 – Volume 17 – Issue 15 – pp 2245-2252.

Packard, Randall. White Plague, Black Labor: Tuberculosis and the political economy of health and disease in South Africa. University of California Press, 1989.

Palitsza, Kristin. “A Burden that Will Only Become Heavier.” Inter Press Service News Agency. May 28, 2006. http://www.ipsnews.net/africa/nota.asp?idnews=33396.

Posel, Dorrit. “Have migration patterns in post-apartheid South Africa changed?” 4-7 June 2003.
http://74.125.95.132/search?q=cache:4Oor9pRwaTkJ:pum.princeton.edu/pumconferenc e/papers/1-Posel.pdf+the+economic+of+apartheid,+labor+migrations&cd=1&hl=en&ct=clnk&gl=us&client=firefox-a.

Seedat, Aziza. Crippling a Nation: Health in Apartheid South Africa. International Defence Aid Fund for Southern Africa, London, April 1984.

“The Demographic Impact of HIV/AIDS in South Africa – National and Provincial Indicators for 2006” Centre for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa. November 2006.

“The uprooting of millions, forced removals.” For their Triumphs’ and Tears. ANC, 1983.
http://www.anc.org.za/books/triumphs_part1.html#3back1.

UNAIDS 2006 Report on the Global AIDS Epidemic, Chapter 4: The impact of AIDS on people and societies
http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2006/default.asp.

UNAIDS 2008 Report on the Global AIDS Epidemic. http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/.

Appendix A

why there is no doctor: harsh realities in zonkizizwe (part 2) (11)


(photo: Zonke Testing Day banner on the back of a van used to transport people to the clinics)

While working in Zonke, a fact that shocked me was that an HIV-positive person can only access ARV treatment [for free, otherwise it is very expensive] if their CD4 count is below 200. This is official South African government policy and numerous studies have shown that accessing treatment earlier has greater long-term health benefits as ARVs are meant to be taken life-long. A World Health Organization (WHO) study in 2008 outlined four clinical stages of HIV progression. The WHO recommends that when a patient hits stage three with a CD4 count below 350, life-long ARV treatment should be started. Starting patients earlier negates complications later. However, in South Africa once the CD4 count goes above 200 again, treatment is stopped, which allows for greater complications and the need for new strains of ARVs. This year a push to increase the CD4 count threshold for treatment was rejected by the National Health Council on the grounds of affordability (85).

Prof Robin Wood, director of the Desmond Tutu HIV Centre at the University of Cape Town, is among the clinicians who have been calling for the South African government to raise the standard of treatment set out in its guidelines. However, he pointed out that better guidelines would be meaningless without improving the quality of care and access to services (86).

Professor Wood brings everything back to perspective. Anyone can call for greater access and more treatment, but if there is no distribution system for health services and care then what is the point. It would be like having a big supply of pizzas and no delivery drivers. This is the problem in many former “homelands,” townships, and informal settlements. There are inadequate or non-existent delivery systems for health services and treatment and so in areas where the HIV/AIDS crisis is most critical, there is no system to address the problem.

Today was the 2nd half of Prevention in the HIV/AIDS course. The kids are incredibly receptive with questions, comments, and the desire to learn more. We will be covering Treatment and resources this Friday. Celumusa did a great job of translating and really getting the course lessons through to the kids. Later in the evening she talked with us – her passion and drive to get people tested and aware and knowledgeable is amazing and so admirable with all she has been through. She is so excited about a Zonke testing day, the HIV/AIDS class, working with the staff and community to make more people talk and not be afraid to talk. Today she told the kids that she was HIV positive and they all did not believe her at all – they asked her to cross her heart that she was not lying. I could tell from the first class that the kids were learning much more than they had before beyond what HIV and AIDS stands for (87).

Much of the work at the center and the work that needs to happen in Zonke is HIV testing. Once tested you can learn how to take care of yourself, your children, and your community. When I asked Celumusa why people don’t test she said that people don’t know that they can live with HIV. So many people are involved in risky behaviors, she said, they have family members die from HIV/AIDS, but don’t test themselves. She also noted that pregnant mothers are tested and are given tablets, but not told their status. Testing is critical and we began working on this by planning a Zonke Testing Day for July 31st.

As I began organizing for the Testing Day, I came into contact with more of the health services available in Zonke. There are a number of traditional doctors and surgeries in Zonke. I can only imagine that this is because there is such a lack of other health services. Celumusa and others have bad perceptions of traditional medicine: evil, it kills people, and the traditional healers are crazy people. I was still having no luck finding any doctors, until I finally caught a traditional doctor in his office. He ran a clinic that was more Western than others and was supposedly trained by the government in traditional healing, but his office was empty every time I visited – no patients (88). Why are there no doctors?

Across the road from his office was a private clinic run by a group of Indian doctors. I also had a difficult time finding them, as did many Zonke residents. I was able to visit the private clinic only when Celumusa had to schedule an appointment for her baby. The private clinic had become her last option that she was sure to see a doctor. This says a lot for the health care system in Zonke (and other overcrowded settlements and townships left over from apartheid era) that the poor will pay to see a private doctor because the government health services are unreliable. Celumusa said they always give injections at the private clinic. Yet again I wonder about the quality of care. The clinics give painkiller tablets and the private clinics give injections (antibiotics?). If care is inadequate and access to ARV medication is beyond the ability of most, then the extended scenes of cemeteries become less shocking.

In the past 2 weeks, 3 people have passed because of HIV and AIDS that we have been directly informed of because the Buthelezi family has been close to the deceased – a father, an aunt, and a neighbor. Living in an HIV positive community is so different when you can fully understand the impact of just one life (89).

It was as if I had seen the walking dead. The prospect of death is so intertwined with life in Zonkizizwe that the author who wrote that South Africans attend more funerals than weddings was supported by my experiences this summer. The hardest hitting example was with the passing of the father of one of the families at the center. Three of the children attended the center. The oldest was 17 years old and was taking care of her frail father as he withered away, making sure her younger brother and sister were going to school, and attending school herself. This small family had already lost their mother to HIV/AIDS. The burden of disease was not met by the health care system or any the government response. The burden of disease rests completely on those who are affected and they do not have the resources to help themselves.

A critical aspect of combating the effects of HIV/AIDS in South Africa is education. As one of my goals over summer I developed an HIV/AIDS curriculum, based off of the Peace Corps Lifeskills curriculum, that the youth could share with the friends and families as peer educators. The spreading of knowledge is a powerful first step in giving people the resources they need to prevent HIV/AIDS. It is especially important when there exists no other means to access this information. The Zonkizizwe schools are under-funded and teachers are under-trained. This translates to the lack of a teacher for the Lifeskills curriculum and therefore the lack of knowledge on sexual health and HIV/AIDS. VVOCF is beginning to fulfill a service where the government is horribly failing.

All of our kids were tested, plus about 20 others. In all over 60 people tested. […] The community and guardian support was incredible. There were a few positives that we expected from already young mothers […] and unexpected bad news surprise […] Many good surprises came out of the day as we learned of many negative cases that were expected to confirm our worst nightmares (90).

Year – Number of HIV Tests (*from clinic 2)
2006 – 128
2007 – 246
2008 – 412

The success of solutions driven by citizens was best evidenced by the culmination of the HIV/AIDS peer education courses, health classes, and the death of a father in an area wide testing day. I had taken the lead in organizing the testing day with the clinics, MSU study abroad volunteers, and various local organizations. Because of the stigma attached and sensitivity of the issue I was a bit nervous when the day came. July 31st 2008, the first Zonke Testing Day was a day of success fueled by the youth at the center. And while the numbers of people testing have made steady increases, the reality remains that the majority of those who need treatment after testing will not have access. Many in the generation just older than these youth mocked or scoffed at the testing day, but our kids were set on it.

We really are building a new generation of freedom fighters – not afraid of stigma, talking about sex, ready to be tested, and not about to turn a blind to HIV/AIDS. These young people stood today with a powerful support base of each other evidenced by yesterday’s action and the larger community is taking notice. The youth continue to give me hope and pride in being allowed to take part in such a community action (91).

The realities of Zonkizizwe paint a vivid picture of the effects of apartheid on health care for the majority of the South African population. The health system operating in Zonke is the ground zero of the failures of post-apartheid government policy to address the far-reaching impact of HIV/AIDS.

Notes:
85. “South Africa: Funding shortfall threatens treatment programme.” IRIN/PlusNews. 2 April 2009. http://www.irinnews.org/report.aspx?ReportId=83762
86. Ibid.
87. Hill, Alex B. Journal Entry. 30 June 2008.
88. Ibid, 17 July 2008.
89. Ibid, 6 June 2008.
90. Ibid, 31 July 2008.
91. Ibid.

Coming next: Conclusion

why there is no doctor: harsh realities in zonkizizwe (part 1) (10)


(photo: Clinic #1 in Zonkizizwe, serving zones 1-4)

From May to August of 2008, I interned with an organization called Vumundzuku-bya Vana ‘Our Children’s Future’ (VVOCF). The organization is located in Zonkizizwe (Zonke), an informal settlement south of Johannesburg closest to Germiston. The informal settlement is best described as a peri-urban area much like a shantytown with convenience stores. Some live at a lesser degree of poverty than others, but everyone is impacted by HIV/AIDS.

I […] learned more about the extent of HIV/AIDS in Zonke. The intern coordinator reminded us that the statistic of students at MSU that have an STD is 1 in 4. We are only lucky that HIV/AIDS did not enter the mainstream population. Here in Zonke 1 in 4 people is HIV positive. The family at the center is more so affected by HIV/AIDS and now they work to care for children who come the center affected by the virus. There is still a very high stigma and a terribly ineffective ARV program. Many people refuse to get tested or even consider the idea. Each child at the center either has HIV […] has lost parents from AIDS or related illnesses or has not yet been tested to know. There are many who should be tested, but are not. […] It has come to my attention that much of what the government does here looks good on paper and on banners, but there is a huge, massive disconnect in implementation (78).

Zonkizizwe is a snapshot of post-apartheid health care development failures. It was founded when a group of displaced people set up shacks on a farmer’s land so that they could live closer to potential places of work. Many times the South African government tried to remove them, but they kept rebuilding. This is a story different than that of the Black townships or Bantustan “homelands.” Zonkizizwe was an area not meant to be inhabited by anyone, let alone poor Blacks. Understandably the story of health care here is one of an even greater lack of access. Informal settlements had no budgets of their own to even attempt to build their own health infrastructure and even if they did it would likely have been destroyed during forced removals. Under apartheid, health services would have been incredibly difficult to come by.

Everyone waves from their steel-corrugated shacks, children smile and get excited, parents and elders are welcoming – looking out over the shanty town roof tops that extend as far as the eye can see in each direction, you can’t help but wonder that within this poverty and desolation mixed with laughter and happiness – what potential can be harnessed, what community action can be inspired to make South Africa’s future brighter by and for those who live here (79).

My goals as an intern with VVOCF were HIV/AIDS education, HIV/AIDS peer educator training, and assistance with nonprofit organizational development. I was very glad to be able to focus my strengths and interests in the work I did. I also worked to formulate a rough community health assessment based on my interactions with people at the VVOCF center, neighbors, visits to the clinics, and interactions with Zonkizizwe residents.

Now Zonkizizwe has two primary health care clinics to serve its roughly 250,000 people. Health services are all free through government funding, including immunizations and treatments. However, the issue does not become access to treatments, but rather quality of care. The director of VVOCF, Celumusa, said that all the health clinics do is give out painkiller tablets for everything (80). She said she often just goes to the chemist [pharmacist] to tell them what is wrong and get something that will actually help. This appears to be a direct outcome of apartheid health policy. The lack of trained medical professionals, notably doctors, leaves local health workers with no better option than handing out painkillers. Quite possibly the training of these health workers remains inadequate as well. Zonke is an area much in need of the RDP’s action, but all that can be seen here are RDP building supplies for new houses.

“You can see people die, sitting at Natal-spruit.” – Celumusa (81)

The closest hospital to Zonke is in Natal-spruit, about a 30-40 minute taxi ride away. If you live in Zonke, this is the closest place to get ARV medications since the clinics are “not certified” yet to distribute (82). There is another hospital nearby, but the taxi fare is more costly and it takes longer to get there. Residents of Zonke don’t necessarily have the time or money to take a day to travel to the hospital even if it is critical to their health. Those who go to Natal-spruit notice a different level of care. People die waiting, people in great pain are not attended, people in need of good health care cannot access it. At Heidelberg I was told the staff rush to help you and are much more caring (83). The Natal-spruit hospital is set to be closed soon and a new hospital will be built in Extension 6, which is in Sandonga, much closer to Zonke. Maybe with this new hospital the level of care and access to care will increase, especially in regards to ARVs accessibility.

Notes:
78. Hill, Alex B. Journal Entry. 15 May 2008.
79. Ibid, 13 May 2008.
80. Ibid, 6 June 2008.
81. Ibid, 29 May 2008.
82. Ibid, 10 June 2008.
83. Ibid.

Coming next: Harsh Realities in Zonkizizwe (part 2)