Tag: Germiston

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

Health, Research


(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)

exploiting whiteness

Development

24 May 2008

Saturday – John Metzler’s (MSU Professor) study abroad group stopped in the morning to see the center. It is just their first week spent in Pretoria and now on the Durban. It was interesting as usual to throw college kids into the harsh environment of the informal settlement especially during violent times. They talked with some of the older kids from the center and went on a walking tour to see some schools, the library, clinic #2 and everything in between. Some of the MSU students had good questions – some did not.

When they left (John was sure to check if we had an “exit strategy” – xenophobia) we planned on relaxing with the older kids until China sauntered up – again called me Mr. Napoleon Hill and inquired if we were ready for church. We all were very reluctant to go (somewhat interested) mostly because he planned the day without consulting us. Needless to say the Church of the Nazarean is far from a traditional African take on Christianity or a remnant of colonial legacy. Founded by their prophet in 1920, after he saved Kwa-Zulu Natal (KZN) from a tsunami – depicted on the front of a prayer book and based on Exodus 35 (keep holy the Sabbath) with your cars, cell phones, and portable music players. It turns out after three and a half hours (we were told 45 minutes) the “temple” of the Nazareans was a hot tourist spot in Zonke and we were encouraged (somewhat forcefully) to take pictures and there was an expectation to donate to the offering collection. Nearly well classified as a farce with a living prophet (the current prophet is the son of the original prophet), yet in July 800,000 faithfuls trek to KZN in unity? We were much disappointed in China (and very upset about a wasted day).

Our woes were quelled by a nice pasta dinner and searches for chocolate that ended with white chocolate covered wafer bars still very delicious and 570 Rand raised for VVOCF in shirts bought by John Metzler’s study abroad group.

25 May 2008

Sunday, rainy Sunday
the sunday rain so grey
makes the cold linger and stay
Michigan has arrived in South Africa
gray skies (lighter than MI)
pitter patter on the roof
constant rains
The dry wash will not be done
hanging soppily on the line
washed with care so fine
hidden sun un-utilised

26 May 2008

Today we split the kids into four teams of mixed ages old and young, much like Boy Scout patrols – they made a team name, song, and picked an animal – the song performances were a lot of fun. This is going to be a great way to grow young leaders and foster stronger relationships between VVOCF children. Older children can help younger and older children can learn to take responsibility and lead their peers. China seemed to not favor having all the power in this situation and had no chance to assert his ‘superior’ academic dominance over the children. He is a force that needs to be reined in to increase its positive nature in VVOCF.

Here youth development is essential to community development and country development. Growing young leaders and capable young citizens is essential to fostering a strong and healthy community.

South Africa grant writing is a crazy process – nearly more complicated and involved that US forms. Instant coffee is disgusting. Planning for Lesotho now. I always do things for the experience – not for how easy it will be or how safe it will make me feel in my mind. Everything can not always be as you want it to be.

Today we also went to the administrative center of Zonkizizwe (formerly the Greater-Germiston Council). There is not much there – an unknown Red Cross office, social worker, other random offices, local Department of Social Development office and a great view of the surrounding Zonkizizwe and all its extensions. Got some great pictures.

There is now a massive winter rainstorm headed our way, thunder and lightning all the way, I think it may even be two storms – hopefully it will be dry tomorrow. It gets colder ever night here and it is almost time to break out the winter coat. A lady at the taxi rank was selling winter coats today with the brisk wind blowing.

27 May 2008

We finally left for Germiston by 2ish or later. China and Mr. Ndaba held another meeting without informing anyone. So we had a meeting with a teacher before finally leaving for the taxi rank. The teacher is a great connection to the library and her husband does NGO work with the UN and the government (supposedly). There is a conference with great potential for funding for the center.

At the taxi rank the waiting game begins since you have to wait for a full taxi before leaving for your destination. Uneventful ride to Germiston, saw much of the surrounding area.

In Germiston we headed to the Mall to use internet and pick up supplies. Celumusa and Rachel went to the Social Development Office to take care of the grant, but the person they needed to talk to was not there. I was able to check all my mail and do some blogging. Many people are worried about me because of the news coverage of the violence. No worries. At the Mall we ate at Wimpy’s, a fast-food burger place, oddly sitdown unless you want to take away food. The name fits what the burger looks like when it is placed in front of you – wimpy. Really it was delicious. Bacon and burger with cheese and avocado spread. Kumnandi!

Germiston is like many big cities – dirty streets, street vendors, shops all over, hustle and bustle – the taxi rank is huge. The line for Zonke was all the way in the back and manny people could not believe that three white kids were taking the taxi to Zonke. There is no regular Zonke line so you have to wait. Finally a taxi came and we all crammed in. This is when the ride became interesting. You pay by row – all I had was a 50 Rand bill. So I took the money of the person next to me and waited for the others to give me theirs. Instead, the young man next to me took my R50 and passed it to the front saying “four” to mean paying for four passengers. He never gave me his or the guy next to him’s money. They sent back two R20 bills for change, which was too much. I thought the other guys had paid separate (which sometimes happens), so the young guy took a R20 and gave me the other plus R1. I thought this was the fare for the others so I waited for my change. It never came and so I asked Celumusa. An argument ensued for the remainder of the ride back where the young guy lied left and right (in Zulu so I really had no idea what was said) and I thought Celumusa might hurt someone. The argument was so heated that the taxi fogged up. In the end it was determined that they had sent back too much change and that the young guy took his neighbor’s money and never paid me and also took my change. He never gave it up even as everyone in the taxi yelled at him (in Zulu). An old man who was known in Zonke, who we met in line, told the young guy that if it had been lighter out he would have called him out and beat him – which is common for people who steal money on taxis. As we got out at our stop I stared down the young guy to remember his face. Exploiting whiteness comes in many forms. Yet my only regret in losing the R30 something (about USD $5) is that I could not argue my own case in Zulu – because no one arguing for me actually understood what happened. I am one who sticks to culture and remains thrifty no matter where I am. Just because I am white doesn’t mean that ripping me off makes anything less worse. Even though it was only $5, it is much more valuable here (almost half a day’s pay). I can’t lie even in the US losing $5 would suck.

I can’t say what I’ll do if I ever see this young guy again. I feel like I will see him again since he lives in Zonke. I plan on taking the taxis again so I just might run into him around Zonke or at the taxi rank. I was taken advantage of fair and square, but a thief is a thief no matter what language they speak.

End of the day thoughts:
Africa is not the place to go rid yourself of your capitalist or privileged splurges. Being the big, white American with money and gifts does not lend you legitimacy or prestige. Pawning off your past worldly desires on people is not leveling the field or making you less accountable, Having money does not give you a ticket to “make things better” or easier or nicer. Using your money in effective ways does. That isn’t to say that giving small gifts is a bad practice, but just being the constant giver and ATM is extremely poor practice, especially in development.

29 September 2008 Reflections:

Exploiting whiteness is in no way meant to mean that I deserve to be treated as a god or king on the African continent. I just would like to touch on the different ways that people get used. In my case it is because I am an outsider, I don’t know the language, I can’t understand everything in this new community. Sometimes that gives people the idea that you can get used.

We met a neighbor named Bongani. He was in Secondary School and repeated over and over how black people were bad people. They liked to beat people, steal, etc. He warned us many times to be wary of black people because they were dangerous. We attempted to tell him that white people can also be bad and that you have to look at each person separately. He told us he had many white friends and it seemed that he almost preferred to be associated with white people as opposed to black. I am not sure where this stems from, but he had a lot of difficulty with violence from people close to him in the past.

In the case of China and the visit to the Temple of the Nazareans, it seemed to make complete sense to China that we would want to attend and take pictures and enjoy the ‘African’ novelties of religion. He kept telling us that it was a popular tourist spot. We kept telling him that we were not tourists. We came to Zonke to work because we understood the difficulties and the needs. We did not come to watch people, but to engage them.

The history of whiteness in South Africa is nothing pleasant at all and so I place no blame on anyone for their reactions to us or their actions towards us. White people do not have a great respect in South Africa, especially in the informal and township areas. This is no surprise, but once people found out we were American, then it was all ok and different misconceptions were employed.

American popular culture is something that you can never get away from. There is a iconizing of gangsters, just like in the US. The N-word is regularly used to refer to people and Americans. This was a tough conversation to explain that ‘nigger’ in the US is like saying ‘kaffir’ (derived from an Arabic word meaning ‘rejector’ often translated as ‘infidel’) in southern Africa. The image of Americans was of a person wearing baggy jeans, a jersey, and a sideways cap saying, “what’s up my nigger.” American pop culture gave us a troublesome time, but how else are people to think about America when the only image they see is on MTV or from pop music.

When I was in Ghana I experienced much the same misconceptions of Americans: people with so much money and a large house, read image of america: blinding lights. The misconceptions go both ways.