so, my new year's resolution will be to try to keep a better journal. I will at least start this month and try to write 2-3 entries per week which I will enter when I am in town. Christmas was hectic. All of the girls were at the orphanage, plus the housemother's son and the new little boy, Zita, with whom I have bonded, so there were 30 kids and the two of us adults. It was great having the girls home (the older ones generally have to spend the whole 6 wk break in Manzini weeding the maize fields of the old woman who owns the property where the orphanage is situated) as I didn't think gogo would let them come. As is was, I had to pay transport for all of them, but at least they were home. I got them all kangas (colorful african cloth worn as clothing) while I was in Tanzania with my sister and they all dressed up in their kangas and did some African dancing and singing. I will try to post a couple pictures.
My new year's eve was quiet. My 3 good PC friends, JZ, Mel, and Steve, were all out of the country, and Simphiwe was busy with his friends. So I went to a nature preserve to try to re-find my spiritual center (which has been eluding me these past few weeks). I was not successful and just pretty much lonely and exhausted from Christmas. I did have a great dream about Joel that night- he had come back after being gone a long time and it was great to see him. For some reason I also ate a lot of pralines & cream ice cream in the dream, scooping up extra pralines. After Joel and I had a happy reunion, he said he was going off to see Alex for a while. So Al, if you saw him, he came from my place. Don't dream of him much, but the dreams are always good.
So, more entries and more sadness. But as important as it is to remember us here, and what is happening, it is also important to celebrate the goodness in your lives and squeeze out the best of all of it.
best,
Simphiwe 1/20/06
Simphiwe is leaving next week and I am struggling right now. For those of you who don’t know or remember, Simphiwe is a 28 year old Hlatikhulu resident who has spent the last several years as a volunteer "operations and youth coordinator" for AMICAALL, a Swazi NGO dealing with HIV. He is well trained in HIV outreach as well as youth empowerment. He has worked, literally, 7 days a week. If he is not engaged in AMICAALL projects, he is helping me in whatever effort or project I have underway, sometimes as simple as taking food to people in the neighboring community at 8 o'clock on a Sunday morning, but also as noteworthy as securing the location, approval, and estimates for our youth center renovation (the building of which he has overseen and which is almost ready to open to the youth of the town) or organizing an HIV educational program. He has overseen the development of the soup kitchens in the Hlati area, has organized and overseen the AMICAALL peer educators as well as the AMICAALL-trained home based caregivers, has been responsible for the implementation of Hlati HIV surveys, the allocation of food for the needy, and the organization of HIV educational events. I am sure there are a number of other AMICAALL duties he performs that I have not listed here. He has done this all despite a well-paid inefficient absentee local coordinator who is generally either in another town or somewhere at a conference, workshop, or meeting and who, when she is around manages to delay, obstruct, or foul up whatever is going on here. And he has done so for about E100 (<20 USD) a month (a volunteer's stipend here) for 3 years.
Ah, this week is too hard. Generally I try not to make this about me, but this separation is difficult for me. damn. damn damn damn.
Tag board 1/30/06
I was disappointed to see all the supportive tags erased from the board. I think this happens automatically because there are so many spam tags coming in and no way to control for those. Knowing you are all reading and checking in was stunning for me, and very helpful.
As is often the case when people leave, the final week or so of parting did not go well. It is not uncommon, when people are close and are having to say goodbye, that they create tension or arguments in order to (subconsciously ) manufacture some emotional distance that makes parting easier. Teenagers do this when they leave home, a phenomenon called separation and individuation. So it is with adults as well. So it was with Simphiwe and me as well. We did not part well. Enough said.
I have had some success with regards to getting people interested in new CD4 technology from the states that would facilitate getting timely estimates of immune function in HIV+ people. For those who don't recall, there is essentially one piece of equipment (a flow cytometer) in the country to process the immune cell counts, and it is located in Mbabane. For every HIV+ patient, they must go to the nearest hospital, from miles around, to have their blood drawn on only one day, Wednesdays, following which the blood is sent to Mbabane to get the CD4 count. The results aren't available for another week (unless the truck breaks down, or something goes wrong, which can add another week or two). As volunteers, we have seen people die for want of a timely CD4 count. There are technologies available in the US that would equip every clinic in Swaziland with the capability for CD4 counts at the cost of about one new flow cytometer and I have been trying to capture someone's interest in these technologies for about a year. Just recently the Ambassador's office expressed some interest and we might actually get some movement.
I expect to be on the upswing next week. This has been an especially difficult couple months for me on a number of fronts, not the least of which has been the end of this important relationship, and I was unprepared for the fall out. I hope to resume the stories here that I so hope provide a small window into what is happening here.
Thank you all for your love and support.
Help for ‘in the woods’ 2/7/06
I just met with a couple from a German organization, "Hand in Hand", who are interested in an idea for a shelter for homeless women with small children. As you remember, Simphiwe took me to visit the 2 women and 8 children who were living in the woods in an abandoned car garage. All of the chlidren were extremely ill at the time from malnourishment. Women, when their husbands die, have no real rights to property so the husband's family can come and evict them from the homestead. It happens all too often and these vulnerable women and children are left to squat on whatever property or abandoned structures they can find and eke out whatever meager and hopeless existence they can. Simphiwe and I agreed that it would be good to try to interest someone in a women's shelter that could serve as a shelter for some of these women as well as a free or inexpensive preschool for people in the area who cannot afford to send their children to normal preschool. Since then, we have developed the idea a little further. In Swaziland, the government is encouraging the formation of Neighborhood Care Points, NCPs, which would provide a cooked meal for orphans, vulnerable children, and the elderly who have no means of support. We thought the shelter could also serve as one of these NCPs for children and elderly in the Hlatikhulu area. The women who live in the shelter could help with the preschool and with the cooking for the NCP, as well as run a laundry service to support the shelter and provide a little income (we need to get someone to donate an industrial washer and the clothes can be hung to dry). Recently, a very active German NGO in Swaziland, Hand in Hand, has been talking with Peace Corps Volunteers about needs in their communities. I am only one of a couple who are living in relatively urban areas. I discussed the idea with them today and they are very interested. If we can get the town board to come up with the land and can demonstrate commitment to the idea, they will build the structure and have already drawn a rough plan of a potential shelter. Some things they will not provide, e.g. furniture, the industrial washer, pit latrines, etc., but we can probably come up with those. I am very hopeful and will meet with the town board at the end of next week to put together a group who can work on this. This would be the first structure of its kind in the urban areas here and it would be a potential pilot for other such endeavors.
On a very positive note, the primary school in the area has agreed to let Ayanda attend even though her mother cannot pay school fees. The mother somehow managed to come up with an old hand me down uniform and, when I saw little Ayanda at the school, barefoot but happy, well, suffice to say she has school shoes and notebooks now. She is so vulnerable out there around men who are also "squatting" and drinking and dangerous. At least for a few hours a day I will know she is safe. At a shelter, I would know she is safe most of the time.
Getting it right 2/10/06
Simphiwe's study visa was delayed, so we had a chance to get it right. We got it right.
Failed resolution 2/22/06
I have been in Pretoria for the last two weeks undergoing medical exams subsequent to our midservice physicals. Needless to say, I am fine; however, I regret that I have not been able to keep my resolution to post more frequently. I will return to Swaziland tomorrow and hope to pick up where I left off. While here, I was able to visit an incredible youth group in Kliptown, a shanty town that gave birth to the movement that helped end apartheid. SKY, Soweto Kliptown Youth Association is supported by the National Basketball Assoc (god bless america) and they are doing amazing things. There is a co-op where the youth learn to make arts and crafts, the sale of which go to support the organization. They also have a drama and dance troupe, comprised of local kids living in the shanty town, and we had the good fortune to watch them practice one of their performances. We were in a dark, rundown old building, lacking electricity, with a small battery powered lamp illuminating the makeshift stage. A couple young boys were on either side of the room, drumming an exotic beat. The girls appeared, probably 20 of them, and proceeded to dance and recite prose about Africa to the drumming. It was spellbinding, dark and eerie, and I thought it might be a great idea to bring some of our kids out, especially the girls at the orphanage, to show them what is possible. This effort could coincide with the opening of our new youth center and it would be great to see the kids from Hlatikhulu put together a similar project. I will be working on this with another volunteer from Botswana, Colman, who toured Kliptown with us and who is attached to a governemental agency overseeing HIV outreach. If anyone wants to read about SKY, just google Soweto Kliptown Youth and you will get an idea of where I'm going with this. Hopefully we can get some of the kids out there and I can follow their experience for you.
Back from Pretoria 2/26/06
Like refuse from a side-ended waste can, old foam mats and dirty blankets bearing sick used up men spill out from the men’s TB ward onto the floor of the hallway. The overflow is worse than usual and I wonder if this is it, if this is the beginning of the deluge that will last years. My charge this day is to visit two children of a neighbor. B is 29 and was admitted Saturday. His HIV status is unknown and his mother and I are there to encourage him to be tested. The daughter, “T”, 25, is on the women’s ward, positive for both HIV and TB, with fluid filled lungs. She is not on antiretrovirals yet, has not had the CD4 count done, and will not begin them until her TB treatment is further underway. The ARVs can interfere with the efficacy of the TB treatment. We see her first, her 5 year old son, wide eyed and silent, in tow. She is thin but able to sit up. She asks me to go with her Wednesday to get her results. I promise to come back in the morning with some juice, which is all she is able to hold down.
The son, “B”, is in bad shape, a long ebony stick figure, unable to sit unattended, weak as weak gets. It takes little convincing to get him to request testing for HIV. He know he will die without treatment, knows he may die anyway.
The mother and I go to the nurse’s station to ask the nurse to take him to the VCT in the morning. She is unable. She is the only nurse for all these men. The mother must go to work. It seems that I am the only one with free time to sit and wait with him at the VCT. I agree to come at 8.
I show up at 8 and am told “B” must go to X Ray first and there is no one else to take him. The nurse and I drape him over the old wheelchair, which is held together by pieces of rope, and I wheel him down the hallway to X-ray, where we find a line already well-formed. It’s going to be a long morning. I park the chair in the hall across from an old woman sitting behind a wheelchair with a boy of about 16 or 17. His head has fallen backwards and is resting on her frail chest. His eyes flicker open periodically, only to roll back into his head and shut again. I can’t take my eyes off of him. He looks so vulnerable. On few occasions his eyes meet mine with awareness and, even though I felt I should look away out of politeness, I am unable. I wonder what will come of him. I wonder if I should try to find him on the ward later.
When it is our turn, the X-ray doc expects that I will lift this 6’4” gangly man out of his wheelchair by myself and lay him flat out on the table. I struggle futilely until a female technician appears from nowhere to assist. Somehow we wrestle him onto the table, no help from the doc who stands by and watches, and I take my leave while they x-ray him. Getting him back in the chair is somewhat easier although lacking grace- sliding here, grasping there, dropping him down into the seat as carefully as I can. By this time it is near 11 and I wheel him to the VCT. We are back on the ward by noon, results in hand. It is a struggle to get him back onto the cot and I am not able to be gentle. I wince as I pull and push and tug, but there is no sign of discomfort from him. Once he is on the bed he folds his long limbs up, so thin, a dark praying mantis on an old hospital cot, praying for life or release from it. He will have his CD4 count taken on the ward and another week will go by before the results are in. They can treat him immediately based on a positive test and clinical symptoms, but they don’t always do that. It’s up to the mood and discretion of the doctor. It’s curious; yesterday, looking at him, I felt somewhat unmoved by him for some reason. This afternoon, after our day together and his quiet patient acceptance of the hours of waiting and rough handling, I found I had developed an affection for him. Unfortunate, because he is likely to die.
I stop in to see them both. “T” looks worse today, unable to lift herself up. I touch her forehead, she is burning up. I leave some juice and tell her to stay strong, that we will see the doctor at the ART clinic in the morning.
“B” is the same, barely able to even shift his position, much less sit up. It looks as though he has not even moved since I saw him last. He acknowledges me and seems pleased that someone has come to greet him.
There is a cockiness to young men in this country, many drinking and having unprotected sex with an air of defiant enthusiasm. They say that they’re “just gonna die anyway”. I wonder if “B” was like that a year or so ago. I wonder how it feels when the bravado falls away and death is sitting on their shoulders, a reality now. He looks only scared and sad, any arrogance of youth beaten down, trampled in the face of this awful sickness. I don’t fault them the stupidity of youth (I still carry some of that stupidity with me even today) and would not wish this ending on them.
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