Cato Manor Clinic: Round 2

After our school visit on Tuesday, we had a normal day of class on Wednesday. We talked a lot about policy and the framework for primary health care. Informative, but to be honest, it can be pretty boring. The lectures were given to us by Clive, who is one extremely intelligent and creative man. After school I played stones again with Smu and Bri, one of her friends, and I actually won a round! Granted I won by one stone, but it was still a big deal. Speaking of Smu, below is a picture of Smu and our neighbor (I forget her name, but I know she’s in first grade!) who she walks to school with every day. They are wearing their uniforms, which unlike in the US, is required by public schools, not private.

Thursday was another clinic day! Maalika, Rachel, Liz and I were at Cato Manor Community Health Clinic again, and this week I was in the maternity ward instead of primary health care, so naturally everyone was either pregnant or carrying a baby, all of which were some of the most adorable children I have ever seen. All I really wanted to do was run a day care in the clinic where I played with all the kids while the mamas got their check ups. Unfortunately that wasn’t an option, so I settled for taking blood pressures, heights, weights, BMI’s, etc. The highlight of my morning was when a baby had started crying, but it was in one of the little crib things because its mother was getting its vitals, etc. taken, so I went over to it and got to sooth it!!

 My first reaction to the maternity ward was how clean it was. I guess when dealing with wittle babies with frail immune systems you have to take extra precaution, but at the same time there are also lots of HIV patients with compromised immune systems… so maybe my logic doesn’t quite apply… Either way, I was impressed with the use of gloves, and the way that the nurses sprayed down the tables and carts before the patients started coming in for the day.

In general there were a lot less people than I had experienced last week. Because of this it seemed the mothers and children got more privacy in meeting with the head nurse of the department. They went in one at a time, where last week there were multiple patients and nurses in the same room. This privacy (or increased privacy) came at the cost of having to wait longer. Although there were less patients waiting in line, they were there for just as long as the patients in primary health care. You win some you lose some I guess.

I started the morning at 7:30 taking bloop pressure and pulses for all the returning patients. This lasted until like 9:45 when it was then time to do  vitals for the "first visits," meaning, as the name implies, newly expectant mothers who were visiting the clinic for the first time. For these patients I had to take their height, weight, MBI, measure the circumference of their arm (there was a special name for this like MUAC or something, but I can't remember), and also take their blood pressure and pulse. Then it is standard to take two vials of blood from these mothers (I just watched this part). One is used for a CD4 count and the other is for a syphilis test. After my tea break, I got to help the nurse do some of the lab work where we determined their blood sugar, hemoglobin, and did a rapid rhesus test. There were only 6  new patients that day so it went pretty quickly. For the rest of the day I helped out with some paper work, filling out forms to accompany the blood to get further tested, and other office related tasks. At 12:15 I took my lunch, and then came back and talked to the nurses for about 20 minutes before Thula came and picked us up at 1.

Clinic Thoughts/Observations:

As with the school, the clinic experience was eye opening, uplifting, and heart wrenching at the same time. Many of the expectant mothers that were coming in were 15 or 16 years old. All of the charts that I read listed their marital status as single, and many of them listed their occupation as student. This always makes me wonder what the motivation for this is and why this is happening? On one hand you have the large number of young teenage girls getting pregnant, and on the other hand you have all of these women coming in who aren’t pregnant. We have talked a lot in our lessons about the child support grant, which gives poor mothers R300 a month for each child they support. Some people have expressed the opinion that this grant encourages young women to have kids and have lots of them because it acts as a source of income. It also makes me question the education and health education and how effective it is. On another note, I’m sure culture plays a large role into the large number of single mothers that are seen. While I was surprised, it is also almost to be expected. It made me sad to think that this is what these girls futures were coming to, granted most of them will still probably get jobs and be just fine. I guess its part of the whole youth empowerment issue in the country that I find so fascinating yet depressing. I wonder who is looking out for these kids and helping them to realize their potential.

Another thought I had on this matter was the prevalence of HIV/AIDS in this demographic of the population. Looking at some of the log books that the nurses have to keep, I noticed that on any given day, the testing results showed that approximately 50% of these mothers have CD4 counts below 350 (the value at which they start treating HIV). Is the lack of marriage and prevalence of single mothers contributing to the spread of the disease.

Also, the nurses asked me if I had a child almost as if they were assuming that I did have one. They seemed very surprised when I said that I didn’t have one. One of them had had a child when they were in high school, and I was again shocked but also glad to see that she had still managed to become a nurse. It just goes to show that this is the norm here. How do you change this and stop the cycle? How do can you work to educate and empower these girls so that they can realize their potential? Especially when you have to work against culture and tradition and beliefs.

On a lighter note, as I was leaving I went into the staff area to pick up my back pack and lunch container and I passed one of the receptionists. She smiled and waved and said hi, and I responded with a cheerful “Sawubona!” She then stopped dead in her tracks and exclaimed something in Zulu. I told her I only knew a little bit of isiZulu and I didn’t understand what she had just said and she blurted out “Who taught you Zulu!!?!?” I told her we were learning some in school and she got so excited and said something else in Zulu. I reminded her that I didn’t know that much, but then said “Unjani?” which means how are you, and she got so excited and carried on the conversation saying “Ngiyaphilla, wena unjani?” (I’m well, And you, how are you?), I replied “Ngiyaphilla” And her face lit up even more. She was so excited that I was trying to learn Zulu and making an effort. As she was leaving I said “Hamba kahle!” (go well – basically like saying goodbye), and she smiled and said something in Zulu again, and then translated saying you have made me very very happy. It was a good note to end my clinic visit on.

I then went home to Mama Ruby. I was running out of t-shirts and underwear so I asked mama if I could do laundry. I scrubbed my clothes in the small red tub, rinsed them, and then mama showed me the best way to hang them up on the clothes line so that they dry quicker. Afterwards my arms, legs, knees, and generally my whole body hurt from kneeling and scrubbing. I don’t know how my mama manages to do that every day.

Smu came home and made us some fries in the microwave (she says her mama doesn’t let her fry them so she doesn’t get too fat), we made sure to add plenty of salt and tomato sauce though. Also, FYI, tomato sauce may sound like the equivalent of ketchup, but its not… not even close. The only similarity is that they are both tomato based. After our fries I helped her with her math homework. She was learning about prime and composite numbers and reviewing what factors and multiples are. Post homework we went to play stones again. As usual I lost, but I am getting better! Even Smu was impressed with some of my tricks that I pulled out.

Last night was also the State of the Nation address by President Zuma. We watched the whole introduction with all of the judges, etc. walking up the red carpet, and Mama and Smu made fun of the way the presidents wife walked and the style of her dress. (Apparently he has 7 wives? And this was his second.) Becky came over during the 21 gun salute and Breanna came over during the middle of the speech (typical). As usual as soon as she walks in Mama and I start laughing at her. This time she couldn’t figure out how to close the door behind her….

Anyways, surprisingly… impressively? Either way, Becky and I were shocked to see that all of the parliament and officials that were there started off the speech with a slow clap! And also that through the duration of the speech there was a lady translating the speech into sign language. Now I’m not going to bore you with details of the entire speech, but it mainly focused on building/increasing infrastructure and creating jobs to address the unemployment. I liked how he included an email and a letter that citizens had sent him and then addressed how his administration was addressing the issue. However, I cant help but question how true this is and how much of the money that he says is going to various projects is actually making it there. In terms of education, he mentioned that we have seen a lot of advancement in terms of matriculation rates increasing, but that there is still a large number of grade ten drop outs, especially in the farming communities. While this may be true, how much of the increased percentage of matriculating students is due to the lowering of standards in schools? Towards the end of the speech he also mentioned sports, which surprised all of us in the room. He said that South Africa’s sports teams need to do better this year. My mama then began commenting on the importance of exercise and exclaiming “I’m going to the gyms!! I’m going to the gyms!” while alternatingly pumping her fists in the air. Everyone in the room immediately started laughing.

Now I am sitting at school in the SIT house yet again. We had our usual isiZulu lesson for two hours this morning, followed by our 10:00 tea break. Pleasantly enough, our 10:30 lecturer never showed up, so we are now just hanging out and have an extra two hours before lunch to catch up on some work, reading, blogging, email writing, socializing, you name it. I took advantage of the time to write out this blog post and now I am probably going to go work researching or brainstorming for some upcoming assignments. Either that or I’ll have a snack/early lunch…at least its Friday! Smu says she is ditching me this afternoon. She is going to Chesterville, presumably to spend time with her mom there.

Hope everything is well in the US! It’s been cloudy here and it rained last night, but it is still unbearably humid and extremely hot.  Right now I am sitting outside on the small porch like thing of the SIT house with Becky and Josh.

I guess that’s it for now!

Sala hamba! (Stay well)