Omar In Africa: Rising To The Challenge

When I last wrote, the Tithembheni Tshamahansi HIV Testing Drive had just started and I had gone through the very stressful process of planning and holding the kick-off function. At the time, I was upset at the apparent theft of tee-shirts by the local Municipality. I had thought that the next four weeks would be comparitively easy, that I would be able to spend some time at my schools, and that planning the final function would be easy.

Alas, things were so simple back then.

I did have a meeting with Madam Speaker from the Municipality to discuss the tee-shirt issue. When I brought it up, a look of surprise flooded over her face. She had no idea what I was talking about, and she seemed as upset by the news as I was. She immediately called Lilly, one of the other Municipal staff members assisting with the project, and got the entire story. It turns out, the Municipality had promised us 5,000 Rand worth of tee-shirts; at the going rate, that would give us 125 tee-shirts, which would all be given out on a first-come, first-serve basis. The supplier ended up printing up extra tee-shirts, which Lilly decided that the Municipality should keep (being that it was over the 125 promised) and give out to Ushers at their Women’s Day Function. In theory, that’s not a terrible idea, but as Madam Speaker told her, it sends a terrible message. The tee-shirts are for those who tested, and those who tested only. Madam Speaker basically chewed Lilly out on the phone in front of Erica and I, and I was happy to see that. So, one issue was solved.

During the Month-Of-Testing, as we called it, (it was only 28 days, actually) we were encouraging people around Tshamahansi to get tested. There were two ways for them to do this: the first, and most recommended, was to go to the Tshamahansi Clinic for free VCT any day they chose. The second was to attend one of our HIV outreach days (we had 6 in total), where I had arranged Mobile Clinics and Red Cross counselors to set up for a day at certain locations throughout the village.

The first problem was with the Outreach Days. We had scheduled three days at high-schools (one at each high-school in the area). This was a HUGE success, but a bigger success than we had imagined. Students queued up in long lines, seemingly desperate to test. I’m sure that most of them just wanted to test for the prizes, but some of them were insistent, “I only want to test to know my status. I don’t care if I get any prize at all.” Whether or not they were just saying what they thought I wanted to hear is up for speculation. At the end of each day, when the nurses and counselors were tired, the queues had not ceased and many eager learners would still be waiting, having stood for hours, to test. The look on their faces when we had to tell them that they couldn’t test was palpable; they were very disappointed. I mentioned to them that they could get tested any day at the Clinic, but I never saw those long queues at the Clinic (I’ll mention why soon).

The other three days of outreach were held at the residences of the three Indunas (headmen) in Tshamahansi. Because people trust their Induna, and the Induna has a wide platform on which to encourage them to test, I approached all three indunas requesting assistance, and was allowed to bring the Red Cross and Mobile Clinic for one day at each. When Indunas told people and encouraged them, as Induna Matjeke did, the turnout was huge (35 people were tested in one day at Induna Matjeke). When Indunas forgot to tell people, as Induna Baloyi did, the turnout was negligible (only 3 people were tested at Induna Baloyi).

The second, bigger, problem was at the Tshamahansi Clinic. On a near-daily basis, I would stop by to visit the Clinic, and to visit Deborah, the local VCT counselor at the Clinic. She would tell me her progress, I would thank her for her help, and that would be that. I’d see small progress at the Clinic—10 people tested one day, 5 another, 8 another. While that was commendable in itself, it was not in line with the long queues I had been seeing at the schools. I thought that the students just didn’t want to go to the Clinic (maybe they were lazy, I thought). I was very wrong: in numerous conversations, I started to hear that students don’t like the local Clinic. They don’t want to go. The nurses are mean to them. Some of the nurses know their families and will tell their parents what they are up to (in violation of any rules of confidentiality). The nurses tell them to go away.

At first I thought that maybe this was an exaggeration, but I started to hear more and more stories of learners being turned away at the Clinic. I was extremely frustrated, and I decided to see what was happening for myself. I confronted Deborah and the Sister In Charge (Head Nurse), Sister Maphoto. Deborah said that because the Clinic is very busy during the day (only partially true), often the nurses are too busy to help doing the VCT prick, and would not be able to help her to do any HIV testing. Thus, she would sometimes have to turn people away. In addition, the Clinic “closes” at 4pm every day, after which time, only emergency services are available. And on Fridays, closure is at 1pm. Not to mention that the clinic is “closed” Saturdays and Sundays. For a kid in school all day, finding time to go get tested turned out to be much more difficult than I had planned on.

The irony of all this is that there are Nurses at the Clinic, 24 hours a day, 7 days a week. All nurses are trained in HIV VCT—they just refuse to do it. For months and months, I had been working with the Department of Health, with the Clinic, getting repeated promises that we would work together to make this month a success. But, when push came to shove, they did not go out of their way one inch to accommodate the extra demand. Broken promises are as much a staple of South African life as mealie meal, I’ve come to discover. And so, because the nurses refused to take on any extra work, and because Deborah was only there for limited hours (7-4 Monday-Thursday, 7-1 Friday), people who wanted to test couldn’t always come. Add on top of that, the fact that Deborah wasn’t always doing her job properly, and the situation looks dire. Often times I would come into the clinic to find a line of people waiting and Deborah in the back, drinking coffee or eating bread. One one occasion I even heard of her turning people away because she “wasn’t feeling well.” There were frustrations on top of frustrations.

All of that is forgivable, though—its ordinary South African ineptitude. What is unforgivable was something that I discovered over half-way through the testing drive. My committee and I had made 600 prize bags (each with a Certificate of Bravery, a raffle ticket, a beaded HIV pin, and sweets, among other things) to be given out to people who tested. These were kept at the Clinic, in a supposedly secure room. However, after about 320 people had tested, I heard the news that there were only about 25 prize bags left. Where had the rest of the prize bags gone? I asked Deborah about this at one of the outreach days; she took me aside and said that she thinks they were stolen by the nurses at the Clinic; she mentioned that sometimes she would walk into her office in the morning to find empty prize bags on the floor. I was furious—why hadn’t I been told about this? Why were the nurses, who were supposed to be taking care of my prize bags, stealing them?

I scheduled a meeting with Sister Maphoto, Deborah, and another nurse from the clinic to discuss the issue of the missing prize bags. At the meeting, Deborah basically denied having told me anything about finding empty prize bags, and the nurses would refuse to accept any blame. They blamed the Red Cross for leaving the prize bags unattended for a few minutes at the kick-off function (even if that were true, nobody could have stolen almost 300 prize bags and walked away without being noticed), and then assumed their work had been done. At the end of that meeting, they seemed to agree that the problem had been solved and everything was ok.

“What about the missing prize bags? What about the 6,000 Rand that I (on behalf of the United States government) had spent on them? The 6,000 Rand that were STOLEN from me?” I asked.

“Well, we all make mistakes. We learn from our mistakes and move on.” was the reply I received.

When I mentioned that I would have to go to the Police, they all stressed how they had done everything to ensure the prize bags’ safety and would not be held accountable, because it was not their responsibility. I walked out of that meeting frustrated and bewildered. I spoke to the woman in charge of the Department of Health for the area, whom I had been working with in planning the project, and mentioned what had happened. She said that this was a serious matter, that the police should be informed, but that we could not do that until we had a meeting with her, myself, and someone from the Red Cross to figure out what really happened. I told her that this would be fine, although I really wanted to go to the Police immediately, and told her that I would wait until our meeting to report anything.

Is anyone else surprised at the fact that the meeting still hasn’t happened? I tried to schedule the meeting on two separate occasions and both times it was cancelled at the last minute (and I only knew about the cancellations because I kept on calling). I still haven’t reported anything to the police, but if this meeting doesn’t happen within the next few weeks, I will go to the police anyway.

It may sound cynical for me to say, but working on this project has really made me lose faith in the people who are in important positions to help South Africa. We worked with a lot of stakeholders in planning this project, and every single on of them (except for Coca Cola, oddly enough) disappointed me during the project. The Municipality, obviously, was a disappointment on many factors, especially the tee shirts. The clinic disappointed me on everything I mentioned above. The Red Cross disappointed me by agreeing to attend things and then not showing up (at one point, I called someone from the Red Cross, who said that they were on the way to an Outreach Day in the village. When I was there waiting for them, I was told second-hand that they wouldn’t be coming). Anglo Platinum disappointed me by agreeing to donate money to the project but then failing to deliver the funds on time. Both the Red Cross and the Department of Health were supposed to send high-level speakers to my Final Celebration, but cancelled. The local pastor in my village led a sermon at my Final Celebration about how, even if you find out you are positive, if you pray hard enough you will become negative again. The traditional healer said the biggest problem facing South Africa today was that people wanted to “know too much.” Local businesspeople made agreements to provide services for the project and then changed the agreements at the last minute, at which point we’d have no alternative but to accept the changes begrudgingly. In fact, aside from Coke, the only people who haven’t disappointed me are my committee and Erica.

So, with all of these frustrations and failures, was the project worthless? Was it a failure? ABSOLUTELY NOT. In my mind, the project was a HUGE success, even more so because it overcame all of the challenges. Even with the Clinic’s antics, and everything else, people kept on going back to test. When the pastor mentioned about praying leading to negative status, people booed him. I saw so much during this testing drive to give me hope; real hope in the future of the country. It’s a fragile hope, indeed; the youth of 1976, who were so instrumental in challenging Apartheid, are now the systematic oppressors and incompetent leaders who are ruining South Africa. I truly hope that the new generation, the youth, who are so positive and so dedicated, don’t lose that. It might sound incredibly cheesy, but in South Africa, the children are the future.

And, so, what about the testing drive? How many tested? From the beginning, I had a goal of over 400 people testing. I didn’t know if that goal would be reached, and with all of the issues that we came across during the project, I was sure we wouldn’t reach it. But, in the end, FOUR HUNDRED AND TEN people were tested as part of the “Tithembheni Tshamahansi” HIV Testing Drive. I reached my goal; I can’t imagine how huge those numbers would have been if things hadn’t been made so difficult for people wanting to test. Rising to the challenge; that’s what these youth are doing. That, right there, is hope.

And so the testing drive ended, and on this past Saturday, 1 September 2007, we held our Final Celebration. Apart from some small mishaps (i.e. the pastor, the cancelled speakers), it went very well. It was much less stress and much easier to plan than the Kick-Off Function had been. And, at the function, we gave away our donated prizes: some gift vouchers, a DVD player, 5 prizes of 1000 Rand each, and one grand prize of 5000 Rand. The prize-giving was the most fun I’ve had in the village in a long time; the crowd was so excited, and the winners so happy. When a middle-aged woman I know in the village, Johanna Mhlaba, won the 5000 Rand prize, her friends ran up to hear and hugged her, she jumped up and down, and was practically in tears. She gave me a big hug and promised that she would spend the money to buy her family a refridgerator.

And so, in the end, it was all worth it.