VENDA-lize

1We all sat around the table drinking milkshakes from the Khoroni, a local hotel in Thohoyandou, after a long day in the field observing Community Health Workers as they made patient home visits. Everyone was discussing amicably the day’s events and necessary next steps for the project. Eventually the conversation steered away from work and towards activities for the weekend. Awe, a 3rd year Univen nursing student, suddenly became very excited and brought up the pressing need for everyone to go shopping at a local dress shop, Mr. Price. Her eyes gleamed and with careful inflection in her voice, she told us in that moment, “I need to VENDA-lize you guys!” We all stared back, curiously, a bit confused. A short silence was given before we all erupted in laughter. Of course, “VENDA-lize” means “to make someone of the culture of the Venda people, native to Thohoyandou and surrounding area of the Limpopo Province.” Of course. So in honor of Awe’s new meaningful word and offering of cultural inclusion, we have each provided you here with a small paragraph of our most meaningful Venda-lizing moments.

Ashley

2It always amazes me how the idea of a simple hug can truly traverse cultures and languages. The act of enveloping arms for just a brief second, with small but sweet contact, brief phrases of interaction, may seem trivial and may seem inconsequential. However, it is this brief moment that I have found here during my time in South Africa, working with such an amazing and smart team of students, to be indelible and sustaining in a way that I feel connected to my team, to this brief home. The hug makes me feel Venda-lized. I remember first meeting the Univen students we were going to be working with for the next 5 weeks on the Community Health in Limpopo Motivational Interviewing project. We met with a simple hug. From then on, with every project meeting or get-together of any kind, we would all greet each other with that simple hug, that simple connection. I truly felt like I knew each student that much more deeply because we hugged with every meeting. In the United States, hugging with every work meeting is practically unheard of and seems almost unnecessary in order to work effectively as a group, but here in South Africa, community and group sharing is priority, which makes the act of hugging a key link towards integrating all members into that same community and work group. I will carry this sense of brief, profound connection to community with me as I travel back to the United States and engage again in those less physically-engaging work meetings. I will remember how profound that brief touch can be, how it makes one seem connected to many, and how it makes all members feel valued.

Megan

3When I think of the Venda culture, I think of a strong sense of community and a true camaraderie between those who share this open and loving culture. My Venda-lizing experience thus rests on a moment where I felt somewhat initiated into the Venda life. The Venda have a traditional marriage dance. It involves some stomping feet, some singing, strong arm gestures, lively movement, and- at its core- a man trying to convince a woman to accept his marriage proposal. The dance involves some play-acting with the man trying to first entice the woman to rise off the floor, and then offering her some money pulled from his pockets. The woman generally looks at the gift with some disdain before eventually agreeing. The entire affair is vibrant; full of shouts and claps from the audience. I first saw this dance at the orientation put on by the University of Venda (Univen). It was performed by a dance troop from the university. I realized however, that unlike in the US, where the majority of people do not know dance routines (unless of course the electric slide counts), in the Venda region, almost everyone knew this dance and the accompanying song. Not only did the Univen students pick up immediately what the dance was and spiritedly sang and clapped along when the dance troop performed, several of the students also performed it for us at the talent show organized with our departing braai. I was also able to learn a bit of this dance. In a true Venda-lizing fashion, Univen nursing students Chuchu, Ntombe, and Hope- after learning I had no comparable dance of my own- set out to teach me the steps. At its base is a simple one stomp, two stomp, three stomp, hop. I would not say I mastered the dance, in fact I believe my teachers were a bit dismayed at my innate lack of beat. However, through the instruction and joint dancing, I had a brief glimpse into this unifying community. Being part of the tradition, even for a brief period of time, made me feel Venda-lized.

Nathan

4In terms of Vendalization, I would say that my favorite encounter with this concept was the appreciation that I witnessed with local people whenever their traditional clothing was worn by any of our team members.  One example of this was when a member of the UVA team, Dr. Idil Aktan wore her traditional dress that she had bought at the market one day, and multiple people came up to her to talk with her.  All of them were thrilled with her new dress.  I personally love the colorful pattern of the Venda people and even bought a custom made shirt from a local tailor.  When I wore this shirt to our Nurse training event, the amount of compliments, smiles, and even astonished expressions that I received was mutually surprising.  Even when making a quick errand to the bank wearing this shirt elicited a genuinely thrilled response from one man while waiting in line.  This positive reaction whenever any of our members have made an effort to participate in the dress of the local culture has been consistent throughout our time here, and is always heart warming.

Chris

5Everyone was resting in the shade by the main road. Despite being winter in South Africa, the sun was still all-powerful. Aptly, this enormous tree served as a meeting point, complete with a bus stop and a small snack stand. While cell phones in Limpopo, South Africa are ubiquitous, with each Community Health Worker carrying 2-3, consistent transportation remains an issue. Thus this large tree acted as our departure and meeting point as we fanned into the community during our daily observations.

My Venda-lizing moment came while waiting for a ride under this tree. Awe, the University of Venda nursing student mentioned above, offered a handful of neon colored food. Never seeing such a snack, I needed further investigation before indulging. Audibly, I smelled the sugar covered sweet popcorn. Having satisfied my analysis with a handful of the neon treats, I heard Awe suddenly exclaim, “You are RUDE!” She described that in Venda it is improper to smell food, which has been offered; rather, one must immediately accept and begin to eat. The only alternative is to refuse and to politely explain that one is full.

Grateful for this tip, I was able avoid similar offensives over the next several weeks. It was surprising that such a small unconscious act could stir such a reaction. While we can do our best at being culturally aware and appropriate, certain things simply need to be experienced.  In this exchange, I could not leave without one Virginia-lizing tip for Awe. When Virginia wine tasting one must smell the wine before taking a sip.

Callie

6“Now repeat after me, darling girl…” says Ms. Patty, one of the housekeepers at our lodge and also one of the most loving, warm people I have ever met, “Ndi matsheloni! It means ‘Good morning!’” “Day macheroni?” I hesitatingly ask, my mouth forming shapes it has never experienced, my brain working to absorb these new sounds. But alas, I quickly realize my first try is a no-go. Ms. Patty says, “No, no, no. Slower now. Ndi… Mat… She… Loni.” After many more repeated attempts and some coaching from my new friend, I finally said it, a proud smile upon my face – “Ndi matsheloni!” While I would still receive corrections on my pronunciation in the weeks to come, it was in this moment that I was finally able to say my very first words in Tshivenda; it was my very first time to be Venda-lized.

Following this encounter, I became fascinated with this new language. I wanted to keep practicing and, once I mastered one phrase, to learn new words, too. Each time I pursued this endeavor of mine, I shared a moment with my teacher—whether he or she was Ms. Patty, one of my Univen colleagues, a patient who we met, or a stranger in the local grocery store—during which I took a little piece of the Tshivenda language, internalized it, and, effectively, experienced Venda-lization once more.

Above all, though, the most rewarding result of this Venda-lization occurred when I was able to put my newly acquired knowledge to use with anyone I met. As soon as I would say, “Aa! Hu ita hani? (Hello! How are you?),” my new friend’s face would light up as clear as day, pleased to find Tshivenda, not English, traveling from my lips to their ears. Instantly, this small moment allowed the two of us to begin from a common ground and, thus, laid the foundation for what was soon to be a newfound camaraderie. In this way, my Venda-lizing moments allowed me not only to gain new syllables, sounds, and words, but also, and most importantly, to make memories with new friends that will last long after our time in South Africa comes to a close.

Sylvia

7I found myself holding a huge plastic bag full of at least 15 giant avocados, freshly shaken from the tree, as I walked down a dirt road with two community health workers and a University of Venda student. During a home visit while doing field observations, a patient had asked if I wanted any avocadoes and, at the encouragement of the community health workers, I accepted, expecting to receive one or two. I was ecstatic at the rainfall of avocadoes from the tree. I tried to explain to them that in the U.S., one avocado can easily cost $2. Aghast at American prices, they proceeded to explain how people in their neighborhoods rarely buy avocadoes, oranges, mangoes, papayas, spinach, cabbage, tomatoes, or sweet potatoes, since so many people grow them in their yards. They explained that even if one household doesn’t grow avocadoes (or any other crop), a neighbor surely does, and they’ll have plenty to share. I was struck by the strong web of community in the Venda culture and the pervasiveness of sharing, and wondered how communities in the U.S. would be different if the success and happiness of the community were valued over that of the individual. Venda-lized, I shared my windfall of avocados with the rest of the team.

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Elise Huppert: Fourth of Ju-Braai

IMG_6548Fireworks, hot dogs, red white and blue everything: these are the Fourth of July traditions that I think make our good old fashioned American Independence Day so special. This year, I was confronted with the prospect of missing these standbys on account of not actually being in America. I had failed to consider this fact before arriving here in Thohoyandou, South Africa, and my packing definitely reflected it. Instead of red white and blue everything I quickly settled for some red, I’m white, and denim counts as blue, right? I had no clue where to buy fireworks and was met with expressions spanning blank, amused, and annoyed on the faces of the grocery store employees I pestered about hot dogs, so it did not take long to realize that this Fourth of July would be an adventure in improvisation.

Though I had forgotten about America’s favorite holiday, I was extremely lucky in that the lodge where I and many other American students stayed was kinder and more aware than we deserved. The lodge threw a traditional South African braai, similar to a barbecue, in ours and America’s honor including tons of amazing South African food (sorry to betray you, hot dogs), great music, and the company of friends of both nationalities. I was touched by their generosity and surprised by how natural new traditions felt on a holiday so often defined by them. Ultimately the spirit of the Fourth of July – patriotism, pride, and camaraderie – became more evident and more universal when stripped of all the bells and whistles. Our multinational event got to be less US-obsessed and more celebratory of all cultures and countries. Bottom line: when I’m planning my Fourth of July activities next year, hot dogs might not necessarily make it on the menu and traditional South African pap could be making an appearance.

Stories Behind the Statistics

a1“They know they should, but they don’t like to boil the water because they say it spoils the taste.” The women in front of us, dressed in a rainbow of brightly colored saris and headscarves, laughed loudly. Meanwhile, our team exchanged perplexed glances. This was, quite honestly, something we had never considered.

Before coming here, we did not know these women. We had an idea of the number of hours they walked to get water, which sicknesses afflicted their families and how frequently. While we certainly did not assume that our readings and statistics created an accurate representation of their lives, we also did not fully understand how the issues of water and sanitation are small pieces that fit into a much larger narrative. As a result, we had packed and brought with us more assumptions than we initially realized.

a2For some context, we are in Bangalore, India working with an organization called Navya Disha. They work on creating awareness surrounding the importance of Water, Sanitation, & Hygiene (WASH) and in partnership with their parent Microfinance Institution, Grameen Koota, they mobilize Water Credit loans. These loans are used for the construction of WASH projects like water connections to the house and personal toilets.

Much of our focus coming into the project was on how these material changes—the presence of a water connection or toilet could be the gateway to improvements in health, wellbeing, and livelihood. These amenities can lead to decreased sickness, increased time for female children in school, and increased income-generation. Through our focus groups, though, we have found that in order to make these changes happen and in order to make them sustainable they must come in conjunction with other changes.

For example, several women have talked to us about their water collection process. Water is available, for some, two days a week from night until morning. They take plastic pots to the water tap and make multiple trips to their houses and store their water in large drums and containers that line the floor of their kitchens for use during the week. This process takes them approximately 2 hours each time and they pay 300 rupees a month for this access. If they paid a little bit more each month, they would be able to build their own personal water connection and have consistent water access without having to travel. At first glance, the choice seems obvious—get the water connection.

a3More often than not, we found that the majority of the women were renting their homes, and therefore did not find it necessary to invest in a living situation that was relatively temporary. It made more sense to them to invest it in their children’s education or celebrating big festivals, an integral part of the culture. So in this case, in order for the water connection to become a priority, other material changes must come beforehand.

In a conversation with Anand Yadwad, the Executive Director of Navya Disha, we gained another sliver of perspective. “Urban people are forced to have sanitation… because in urban areas they do not have a place to go for open defecation. In rural areas, you just walk 50-100 meters, you are out of the village and you can sit in the open air, so the external pressure is not there.” Demand-generation, in this instance, takes a very different form, since they have a viable alternative available, free of cost.

The motivation for construction and use of a toilet has to come from behavioral changes. There is no singular presentation or incentive that can create this kind of change—it requires patience, persistence, and a nuanced knowledge of the target audience. This nuanced understanding comes from listening to the stories of the individuals and seeing how WASH issues fit into their personal stories.

a4The more time we spend here, the more opportunities we have to unpack the assumptions we first came with. In doing so, we are constantly learning about how much we do not know.  We continue to unfold the ever-present layers of the women’s stories before us in order to gain a greater understanding. Although our team wishes we had more time in JP Nagar 9th phase, we intend to dedicate our last two weeks to seeking out the stories behind the statistics.

Smith, Barab, Burgess, Wallace: Water Filtration in Ha-Mashamba

This summer, four UVA undergraduates (Civil engineer Matt Smith, French & International Relations major Max Barab, Global Development Studies major Alice Burgess, and Environmental Science major Anna Wallace) are on a mission to learn how to make ceramic filters that purify contaminated water using colloidal silver (an ongoing UVA research effort for the past six years under Civil Engineering professor Jim Smith) and to build another open-air filter factory in a village named Hammanskraal, based on a pre-existing factory in a village named Ha-Mashamba.

Stage One: Learning to make filters in Ha-Mashamba, June 14 – July 5

wf1After an 18 hour plane ride and many hours on the crazy roads — donkeys, goats, cattle, huge potholes, hitchhikers, and getting used to the left side — we arrived at our home in the Limpopo Province. We spent these three weeks learning how to make the ceramic filters (some with a colloidal silver wash) at the Mukondeni filter factory is at the same site as the Mukondeni Pottery Cooperative. Actually, the filters aren’t the main “output”, and instead the focus is on making and selling different sized urns, jugs, and bowls — all handmade, very detailed, and with a varying designs based on each potter’s signature style. While we say “filter factory”, we do not mean a big industrial complex, and instead are referring to the open-air, tin-roof, dirt-ground space where the clay gets mixed, pressed, and dries out before the kiln.

The potters who make both the filters and their own pottery are our teachers, mentors, and friends. They wear patterned African skirts and wraps, but many have American tee-shirts (brands like Adidas and Hanes) and wear sandals or wellies. They smile lots and they teach us new Venda words each day. They are very patient with our crap pronunciation!

Boas was our community partner in Mashamba — he is a kind young man who has superb English and who is in charge of the filter factory in Ha-Mashamba. We first met him back in February, when we took him out for soup to warm him up during his Virginia visit!

We were lucky to spend a day at the University of Venda, where we met some other undergraduate students who are from a range of American universities working on similar projects in the villages of Limpopo, ranging from diabetes and hypertension to medical pluralism. We also got to meet some of the UniVen graduate mentors, who are getting their PhD’s and masters in engineering and microbiology. It was very cool to see what a South African university was like, and it sounds like the student life at most universities across the globe are quite similar… dancing, arts, sports, cafeteria food, lots of studying, a nice barbecue, and imbibing spirits for unwinding! The UniVen faculty kindly are helping us to test the filters using the membrane filtration method.

One of the coolest experiences was when we got to meet the chief of the village, Chief Mashamba. A very handsome high school teacher escorted us to the Chief’s home overlooking the village, and we all knelt on the ground and clasped our hands together next to our knees when Chief Mashamba approached. The teacher translated the Chief’s warm welcome to us — “this friendship between UVA and the village bears good fruits”; “we like to benefit from your great ideas, Prof”. The Chief jokingly expressed interest in traveling to America, as Boas did this past February. I still cannot believe their first ever flight was 15 hours across the Atlantic! Professor Smith presented the Chief with a photo that the team last year took with him, which he seemed to like very much! People here love photographs of themselves, as they do not have mirrors, let alone cameras or printers. The Chief told us that 80% of the residents of the village are unemployed, and that the pottery cooperative and a few government social grants are the only sources of income for the people of Mashamba — thus, they are overjoyed for the big filter orders that have started coming in.

wf2We also got to meet Chief Lucas, who was much less formal than Chief Mashamba. Chief Lucas visited UVA for Pure Madi 3 in February 2014, and he seems incredibly committed to every house in his village having access to safe and clean water. He had rented a big flat bed truck to load up about 160 filters and bring them back to his village, thus creating more storage space within the Mukondeni Factory.  This means the potters can start back up, “full speed ahead”, with the filter production.

As for practical matters, we wore long skirts, trousers, and tee-shirts — anything less would be culturally inappropriate but anything more would be boiling. All the South Africans wear long sleeves and wooly hats — they think it’s freezing despite the fact it’s normally a sunny high-70/low-80 by 2pm! The mornings were chilly but warmed up fast.

wf3Our team got really close during our stay in Ha-Mashamba. We bought cheap CD’s at the market and burned our favorite songs onto them so we could listen in the car. At night, we cooked “gourmet meals” (burned grilled cheese, tuna salad, and soggy pasta with sauce from a can!) A few nighttime power-cuts led to many rounds of charades, candlelit card games, and even a few chick flick films we persuaded the boys to watch! The best weekend featured a trip to Kruger National Park–  we saw elephants, giraffes, crocodiles, zebras, hippos, and kudu (a WILD trip indeed!)

The last day at the factory was a cultural experience indeed — we bought the potters bottles of soda, 4 live white chickens, and 12.5 kg of pap as a “thank you” gift! The chickens got their throats cut off on site, and about 3 hours later, we were munching on perhaps the freshest bird we have ever consumed! Leaving the factory was so sad, but after many “roh-le-voo-ah”s and “kabisari”s (so long’s and thank you’s) we said goodbye!

Our time working in Mashamba flew by! In Mashamba, were able to successfully mix and press two different batches of filters with silver mixed in (saving time and money, since it hopefully will not have to be painted on later on in the process). One batch had more silver than the other, plus some additional sawdust got added along the way to compensate for the recent issue with many of the filters failing the flow rate test (adding sawdust increases the space between the silver nanopatches in the filter). The bad news was that had to leave before all these filters could be fired in the kiln and tested in the labs for total coliform and other contaminants at the University of Venda. Luckily our graduate student mentor, Katie, agreed to help us out with this.

We were shocked at just how many steps there are in making filters — before we arrived in Limpopo, we assumed you chucked some dirt and dust into a mixer, put that into molds, fired them, and that was that! We never realized just how labor intensive it is to make a filter… kneading, drying, testing, drilling, wrapping, painting, firing, smoothing, carrying, packaging, etc. A whole arsenal of potters are required to make filters. That being said, we now know how valuable the filters truly are. Alice had quite an upset stomach our first few days here from drinking from the tap, but as soon as we purchased a filter from the factory and used it in our own kitchen, she felt like “a million bucks” again. The water the filter gives us is clean, pure, and safe — such a simple technology with such great results.

 

Stage Two: Building a new factory in Hammanskraal, July 5 – August 2

The day after American Independence Day, we journeyed to Hammanskraal to set up the new factory. We arrived to see the big tin roof had been completed. Our work over the next month is cut out for us: install a bore hole to withdraw water from, build a brick office at one end to store records and valuables in, dig out a septic tank, and construct the wooden tools needed for the filter making process (drying racks, soak tanks, etc.)

Our first day, as soon as we clambered out of the car, we were enveloped in hugs from Grace and Paulina, a pair of sisters who are about 70 years old, who are wise Go-Go’s who are in charge of this community filter project. They call us “darling” and sit next to us each day, threading seed bead bracelets, and offering high fives with each completed step.

During this first week, we met with Zain, our new community partner, who got the ball rolling straight away. He has the best South African voice, and makes us laugh when he says things like ‘are you smoking your socks?’ and ‘these American kiddos are the happy helpers’. Zain interviewed some local builders, and chose Steve the builder, who charged a reasonable price for the office construction and had the best diagram of the space. A few hours later, we white kids were sweating buckets, attacking firm ground with picks and shovels.

Jack (Grace’s son’s best friend) has helped us so much with the construction, and together, Jack and Steve are an unstoppable team, making us students look so weak and slow. The zealous Pastor of the local church also volunteered to dig out the foundation of the office, alongside Jack’s friend Richard. They are patient with us, and seem excited at the prospect of having a filter factory that can employ them and their friends who are without work. As of now, the foundation has been dug — 2 ft wide and ½ meter deep for the 6×12 meter square– and filled in with a mix of cement, sand, and stone. Next week, we will lay the bricks, buy the windows and doors for the office, and install the bore hole.

We are learning so much, and thus far, our trip has been eye-opening, thought-provoking, and culturally fascinating. We have made great friends along the way, including our own teammates, and cannot wait to spend another month in South Africa. Thank you, CGH, for this wonderful opportunity.

Anna Eisenstein: The End of the World

In this photo, what do you see?

IMG_2985

Nestled in those hills, there are villages, homes, people. Mostly, they work the land to grow enough food to survive, selling a few of their sweet potatoes whenever they need to buy another item. If they need something, they must sell something. They are some of the world’s poorest of the poor.  I took this photo from their health center.

The Ruhija health center is the facility providing care for the people that live within these hills — yes, this one health center is for all the hills that stretch as far as the eye can see. It is a level III health center within Uganda’s public health system, which means it provides an outpatient clinic and a maternity ward for the entire sub-county.  Although every parish is supposed to have a health center II for addressing common diseases and offering antenatal care, many parishes do not. (The parish is the unit beneath the sub-county in Uganda’s land organization scheme – think states/counties in the United States.) Here in Ruhija, getting to the health center means climbing through the mountains, maybe even for days. Can you imagine making such a trip for antenatal care, while heavily pregnant? Or if your family member was too sick to hike, carrying them in a basket that stretched between you and another person, hanging from poles that rested on your shoulders?

I had the opportunity to travel to Ruhija to visit some of Mbarara University’s students from various health professions. They were doing a community placement there, focusing on an antenatal care intervention. They traveled out of the health center and into the communities periodically, coordinating with “village health teams” to provide antenatal education and care on designated days. Members of the village health teams are volunteers from the community who receive some basic health training so that they are able to advise locals and refer them to the health centers. They are also supposed to distribute medicines, but the health teams are usually not provided even the most basic drugs due to government stock-outs.

The students’ contribution is noble, and they helped people. But the community’s needs are so much deeper than what a small group of students can provide. What about the ones who need antenatal care two months from now, who are too far from the health center to come for it? When we first got out of the car, I was stunned by a breathtaking view. But taking in a bit of the meaning of those hills for the people who live in them changed my perspective. This vista is not just a pretty glimpse of natural beauty, but a powerful image for thinking about access to care.

Tammy Cavazos and Siobhan Perks: UVA-Guatemala Initiative

Saludos compañeros!

1
One Saturday Morning, the UVa-GI team members hiked La Muela.

We are reporting from Quetzaltenango (Xela), Guatemala’s second largest city. We are a part of the UVa-Guatemala Initiative, a program dedicated to the development of mutually beneficial and sustainable relationships between the University and various communities in Guatemala. As a team (our whole team consists of five members), we are combining 1) cultural and language immersion, 2) engineering research, 3) collaborations with Guatemalan community partners, and 4) consideration of past projects and site-specific challenges to discover the best way to complete our project. Our project is to come up with a plan for a sustainable, cost-effective solar hot water system in one of Guatemala’s public hospitals, the Hospital Nacional de Totonicapán.

Based on prior research, we have discovered that solar power is a feasible energy solution in resource-limited environments. Therefore, we have focused on the solar heating of water as our sustainable and replicable solution. By researching the best way to implement such a system, we hope to achieve our ultimate goal, to improve hospital sanitation and patient care.

 From left to right: Grant, Tammy, Siobhan, Kyle
From left to right: Grant, Tammy, Siobhan, Kyle

Our first three weeks in country consisted of mandatory Spanish classes at Celas Maya Spanish School (25 hours per week), along with various orientations and project meetings with our In-Country Coordinator Jessica Gonzalez. A large part of our project is learning about Guatemalan culture; we believe cultural familiarity is important to any research project. Throughout our time in country, we are staying with local home stay families. The home stay experience has enabled us to learn from diverse perspectives, try new foods, and make new friends.

After our three weeks of Spanish classes, we began our daily 1-2 hour trek to Totonicapán (on “chicken” buses) to begin conducting field research to assess the hospital’s water needs. Our first day in the hospital we met Don Gustavo and Don Martin, two of the hospital’s maintenance technicians. We went on a tour of the hospital, and saw some of the existing water infrastructures. For the remainder of the week we split into teams, passing out surveys to a variety of clinicians and maintenance personnel. Survey results showed that the departments most in need of hot water are: maternity, newborns, pediatrics, emergency room, and operating room. Hygiene was a big takeaway – hand washing, postpartum baths, and general cleanliness seemed most important.

 Tammy and Kyle taking measurements of the hospital's roof.
Tammy and Kyle taking measurements of the hospital’s roof.

Aside from handing out surveys, we were able to get measurements and photos of the hospital’s roof, and take the water temperature of the near water tower. All personnel were extremely helpful and friendly. Three doctors (who visited UVa in the spring) made a majority of our visit to the hospital possible. All three are strong believers in healthy personal relationships; these relationships are the foundation of a productive work environment.

To this point, we have gathered a lot of good, reliable data from the hospital. The next few weeks we will be visiting with local technology companies, vendors of solar water heating projects, and engineers. Since we are here for a limited amount of time, it is unlikely our system will be installed prior to departure. However, we plan to gather as much information as possible to allow for future implementation. So far, this project has been a wonderful learning and enlightening experience. We look forward to the weeks to come, and will keep you all updated on our progress!

Siobhan climbing the hospital's water tower.
Siobhan climbing the hospital’s water tower.

Con Cariño,

Tammy Cavazos and Siobhan Perks

P.S. If you are interested in reading more of a personal experience of our time in Guatemala, check out Tammy’s blog here.

Sasheenie Moodley: HIV/AIDS and Condoms in Nyanga, South Africa

I have never been in a South African taxi (see Instagram pictures for a description of this type of “taxi”). Born and raised in Johannesburg, I was blessed to have grown up in a privileged family. Although I led a sheltered life, I took pride in my knowledge of all the South African communities (privileged and not so privileged) and my awareness of the socio-economic landscape of the nation. Growing up with privilege meant that I was never forced to use public transportation on a daily basis. Thus, I had never used a taxi before. Sure, I had driven next to them, heard my family and friends rant about their dangerous driving style, and seen them weave through rush-hour traffic the way an ant navigates cake crumbs after a picnic, but I had never been in a taxi on South African roads.

s1Today I took a taxi from Cape Town (the urban sea-side tourist-trap) into Gugulethu (the main township on the outskirts of Cape Town on the way to the airport). I was traveling into Gugulethu to meet with the Community Action Trainers (CATs) from Sonke Gender Justice Network – the NGO I am working with in conjunction with the University of Cape Town. From their website: “Sonke strives to build a southern Africa in which men, women, youth, and children can enjoy equitable, healthy and happy relationships that contribute to the development of just and democratic societies. To achieve this, Sonke works to build government, civil society and citizen capacity to achieve gender equality, prevent gender-based violence and reduce the spread of HIV and the impact of AIDS.” More specifically, Sonke has pioneered a “One Man Can” program, advocating for men to become active in their communities to end violence against women and stop the spread of HIV/AIDS. Through “One Man Can,” CATs go out into the community (city clinics, health centers, and townships) and educate community members (specifically men) by explaining what men can do to 1) prevent the spread of HIV/AIDS, and 2) stop violence against women (and partners). In Sonke’s words, this can be achieved by 1) knowing your HIV/AIDS status; 2) educating yourself on HIV/AIDS, testing, counseling or treatment; 3) protecting yourself and others by practicing safe sex, getting circumcised, and reducing your number of sexual partners; and 4) getting involved with proactive programs in the community to increase awareness about prevalent issues as shown above. These were the thoughts going through my head as I silently sat on the taxi to Gugulethu (you see, I was reading Sonke’s brochure).

s2Being in a taxi was an interesting experience. Firstly, we had to wait until all the seats were occupied in the 18-seater taxi: the taxi had to be full of passengers before we could pull out of the taxi rank. Once we were on the road, the taxi began weaving in and out of traffic and I began reflecting on how different it felt to be transported in a taxi (I was grateful that we were making good time on our almost 20km trip to the township) compared to driving next to a taxi (I was normally anxious about reckless taxi driving). The driver had Celine Dion’s 20-year old album playing in the taxi, except that Dion was singing with a South African accent…it seems that knock-offs are universal.

After waiting for the taxi to fill up (30mins) and then making our way into Gugulethu (20mins), we finally arrived at Sonke. You see, Duma, a CAT from Sonke, had made the trip from Gugulethu into Cape Town to fetch me and ride the taxi with me. It was not advisable that I ride the taxi alone when 1) I couldn’t speak a word of Xhosa, and 2) I was a female in an unfamiliar environment. Once at Sonke, our team of 8 CATs (5 women and 3 men) got into Sonke’s taxi and drove to Nyanga – the Cape Town township where we would be distributing condoms and spreading the word about “One Man Can.” We would also be distributing the South African Department of Health’s HIV/AIDS campaign “Choice Condoms” according to a national campaign whereby free condoms are provided to community members as part of the initiative to reduce HIV transmission in sexually active populations around the country. Today, we travelled into Nyanga with 36000 male condoms and 1000 female condoms.

s3The taxi turned into the main dirt road of the township with its music blaring – an active choice by the driver, who wanted to announce our arrival. As we drove along the dirt road, children came out of their homes and ran behind the taxi. Once the taxi came to a stop, the kids began dancing around the taxi, laughing as they moved their hips and heads to the beat of the South African hip-hop jingle. The 8 of us disembarked, loaded our arms with boxes of Choice condoms and began our duty.

We moved in a pack of 8, walking from door to door, offering the women and men inside their shacks and outside their shacks free condoms. Most of the people we encountered knew what male and female condoms were, by evidence of their asking us for them. They knew how to use condoms, and why condoms should be used – evidence of progress made in the last 10 years by national HIV/AIDS awareness programs. We moved as one group because none of us had been to Nyanga before. It was not unusual for CATs to go into communities that they were unfamiliar with. Despite this, there was also apprehension when walking into an unfamiliar area. Because the CATs could all speak Xhosa, they were able to speak to the community members and explain our intentions, thereby paving the way for the team. What’s more, we were working in a poorer part of the township: there were only shack houses around us, complimented by one street lamp and one tap that supplied clean water (contrasting other township areas where the South African government has implemented a 10-year roll out Reconstruction and Development Program to build brick houses, and provide electricity and clean tap water – locally known as RDP).

Still, the CATs were anxious about our walking door-to-door because they did not know how the community members were going to react to our arrival: would they want the condoms, would they be interested in hearing about what we had to say, would they shout at us for intruding on their property, would they chase us away out of uncertainty. Sonke advocates for condom usage always, even between a husband and wife, because there is an increasing number of spouses who contract HIV in extra-marital affairs. When a condom is used in a marriage, one spouse can be saved from contracting HIV even if the other spouse has an affair and contracts the virus. However, there is cultural tension introduced with condoms. Tanya, one of the CATs, explained to me that if a wife asks her husband to use a condom in their marriage, then it means that 1) she is cheating on her husband, or 2) she does not truly love him. Because of this cultural tension, condom distribution in smaller, more traditional communities (as are seen in most townships) is risky, because it is the distribution of a resource that contradicts traditional cultural beliefs.

sasThankfully, there were no incidents when we were in Nyanga today. With one exception. There was a man who was sitting outside his orange/potato stall in a side alley in the township. He insisted on speaking to the only white (American) girl in our team and proceeded to ask her what he should do with the box of Choice condoms he had been handed. Janie (the American girl, MPH student from Brown University) responded that the man should distribute the condoms when he sells his produce and tell people about practicing safe sex. The man laughed at her, saying that when he packed up his cart and left for the day, he would not take the condoms with him because they were not his property. We did not know what he meant by this…perhaps he felt he did not own the condoms because they were from the Government, or because he did not pay for them. After a little more back-and-forth, he decided that he would distribute the condoms and spread the word about safe sex if we bought some oranges from his stall. We complied with his wishes, hoping he would stay true to his word.

After our conversation with the (somewhat) angsty man, we continued walking through the winding side paths between the silver, tin shacks. We had only 3 boxes of condoms between the 8 of us now, and we hoped that we had managed to cover most of the area. I was walking behind the group, watching my step so as to avoid the rubble, metal, glass and wire embedded or sticking out of the grey sand. I turned a corner, and looked up. In front of me, sprawled out as far as my eye could see were about 700 tin shacks, in a 5km radius around me. As I took in my surroundings, I saw women cautiously venturing out of their homes to ask for condoms. I was overwhelmed by the need in the area…not only for male and female condoms (both of which we had run out of), but also for primary health care, clean living conditions and clean water. It was hard to believe that 3km away, in Gugulethu, there were brick houses, roads full of cars, street lamps, and a functioning sewage system.

I was taken aback by the overwhelming need for resources in Nyanga. I had grown up in Johannesburg and frequently visited schools and orphanages in the surrounding townships (Soweto, Alex, etc), yet I had never seen conditions like those in Nyanga. The shack townships in Cape Town are the result of a political debacle in national government. You see, the cities of Johannesburg and Durban fall under the jurisdiction of the ANC (the liberal party that has been in office since the first democratic election in 1994), while the city of Cape Town falls under the jurisdiction of the DA (the conservative party that was in power during Apartheid). There are minimal shacks in Johannesburg and Durban (under the ANC), yet there is an overwhelming number of people living in shacks in Cape Town. This political issue is only further exacerbated by a large influx of illegal immigrants, foreigners (looking for employment in lucrative tourist trades in Cape Town), and family members of Cape Town locals. It is rumored that the DA will not provide better living conditions and resources for people living in townships because that portion of the population supports the ANC. I do not know how true this is…to my knowledge, the national budget has been allocated to RDP changes all over the country.

On the way back to the Sonke Center, the 8 of us sat in Sonke’s taxi, eating deliciously sweet oranges, letting the blaring South African dance-music wash over us. There was silence in the taxi – a kind of common shock…everyone was preoccupied with their thoughts, mulling over our time in the Nyanga township.

Click here for a video taken by Sasheenie of the streets of Nyanga, South Africa.