Hello Soweto!

Apologies to my fan(s) (miss your face C-Beats) I’ve been terribly neglectful, but no more! 

Tuesday May 15:

Today was absolute madness at the clinic because not only were there twice the number of patients (because of all the appointments that were missed yesterday) but the power was out until just after 10 which meant a great deal of the morning was dedicated to tracking down a place in one of the generator-powered sections of the hospital where we could plug in the centrifuge. This afternoon I helped one of the study coordinators track down patient files and check through recording discrepancies. Got a good taste of the administrative mess that comes with running a project like this. I am still waiting for the red tape to clear around my access to the infant data. Apparently I have walked in at the exact moment of utmost turmoil for the project. Issues about funding and an announcement of canceling the study yesterday has absolutely everyone flying around the ceiling with stress. Not a great time to be a fresh arrival but everyone is still really friendly, and I’m getting great exposure to the South African Soap Opera scene which plays almost constantly in our clinic’s waiting room. 

Friday May 18:

This week i started making baby steps towards learning the ropes at the PHRU. Thursday I went with some of the nurses into Soweto for patient recruitment. It got to see some of the other clinics - drove past the block were Nelson Mandella’s house is (it was a few streets over but I”m going to make a trip back to see the museum inside). Soweto is an interesting mix between enormous glass-and-steel malls, subdivisions of various-sized brick houses each with a wall edging the compound and informal settlements of small square tin houses. The whole place is incredibly vibrant, with fruit stalls and outdoor hair salon on every corner, and people absolutely everywhere. Apparently you can bungee-jump from the top of the old reactors (see the picture), but I have yet to convince anyone at work to do it with me. 

Monday May 21:

This weekend my project’s study coordinator (and head nurse) invited me to stay with her and her family in Krugerdorp. She has two daughters, one in highschool and one in second year university - and it was absolutely wonderful just to be able to sit around and hang out with the whole family. We watched The Help and a couple of DVDs of a South African comedian named Trevor Noah. He is apparently touring the states at the moment - but he is absolutely fantastic! His stuff is really funny - but also really educational in terms of South African culture, politics, history etc. etc. Hope he’s this funny when there isn’t someone to fill in all the gaps for me! 

Friday May 25:

This week I got to sit in on the Provincial (Gutang) Meeting for AIDS comprehensive care. It was a gathering of all the district heads from across the province to talk about their successes and failures in attempting to meet various HIV-related targets (such as number of male & female condoms handed out, number of medical male circumcisions completed, +ve test rate, overall proportion of population tested, % of HIV+ antenatal women (about 20%!)) It was really interesting to hear them talk both about the administrative stuff and about the more practical issues that were hindering meeting the targets each district had been set.

One of the major issues brought up were drug shortages due to the inability of contracted suppliers to keep up with demand - which absolutely broke my heart - one woman made a very passionate speech about the unacceptability of shortages of Nevirapine syrup (which they give to newborns to prevent them from contracting HIV from their mothers) she spoke of being trusted to protect innocent souls from a lifetime of disease at a time when they had no control over their own health, life, or destiny. It was both incredible and devastating. 

Another big issue was a chronic shortage of condoms which did not seem to be resolved when the meeting ended after the second day. 

The third major issue was low numbers of medical male circumcisions, which had been a big focus of this year (evident by the huge number of billboards, posters and radio ads encouraging men to man up and get circumcised). The numbers were way below the targets that had been set, some mentioned that there were not many sites offering the service (only 2 in the City of Johannesburg District). 

The Hector Peiterson Memorial in Soweto 

It was most interesting to contrast this 2 day meeting of the higher-ups with a second trip to the clinics in the area (I went straight from the meeting on Wednesday to Soweto) which were different than the clinics we had visited last week. At one of them they were building a brand new building exclusively for MMC (medical male circumcision). We went into the clinic and found it was literally packed to standing room only. More than 50 people were crowding the waiting room (only 2 hours until the clinic closed for the night) and only 2 nurses were on duty to help them. We spoke to the head matron who was running the antenatal clinic, the HIV wing, the chronic and the acute wards by herself. I asked who was going to perform the procedures and run the new centre. She shrugged and said they were always unterstaffed, then shrugged again and shook her head. Not once had staff shortages come up during the provincial meeting, but it came up again, and again as the single greatest concern at almost all the clinics we visited that afternoon. Interest to see the disconnect first-hand, crushing to see it at such a fundamental level. 

This weekend I am headed to the Free State to visit Mark’s family! It’s supposed to be cold but very pretty! Keep you posted!

xxo

Someone sent this to Fildah - an article about how a politician in Zimbabwe thinks the HIV problem is fuelled by women being to beautiful