For the past few weeks I’ve been living with a host family in a township outside of Plettenberg Bay. My roommate Erin and I, plus Eli and Shawn living a couple blocks over, are the only four white people living in our township, despite the wealthy white suburbs and beach-front mansions 10 minutes away in Plett. Even over twenty years after apartheid ended, the area is still extremely segregated into the townships created for the concentration of black and colored communities that were forcibly moved out of the city. Most of our community, including our host family, speaks Xhosa, but almost everyone speaks English as a second language. Here we’re working with an NGO connected to the clinics and community health workers in each of the townships we’re living in. Over the past couple weeks, I’ve learned a lot about HIV and other infections (like TB) that often come with it, and how central these diseases are in people’s daily lives, and how treatment can often be so much more complicated than taking a prescription for ARV’s and other medications. Maybe a patient doesn’t have a car to go pick up the medicine, or can’t pay for the medicine itself. Maybe the doctor doesn’t speak the same language as you, so can’t explain your illness or medication, or missing work to wait in long lines at the clinic will result in not enough dinner to feed everyone that night. Maybe you don’t have enough food to take your expensive medicine with, or maybe you’d rather spend your paycheck or disability grant on food for your family than on medicine. Maybe your test results were lost in the clinic, or there’s only four doctors in your clinic serving 25,000 people, or as an orphaned minor you can’t pick up your own prescription even if you did manage to get there and pay for it, or maybe wealthier people from the suburbs are coming into your clinic for cheaper healthcare and to avoid the stigmatized where people know them. All of these are realities in the communities we’re living in.
But why don’t you just take the medicine?
We’re working with an organization called PlettAid, where for the first week I was filing test results into patient’s files in our township’s clinic. We’ve also been working with the wellness center, where we work with nurses and other staff in testing and screening people around our neighborhoods or at their workplaces (like hotels, a brick factory, a soap factory) for free. I’ve been taking notes and filling out forms for the staff I’ve been working with. With all the staff I’ve been working with I’ve noticed how easy it is for them to switch between English, Afrikaans and Xhosa depending on what kind of patient they’re talking to. Now I’m working with a community health worker named Sandra on her rounds to patients at home. Sandra also lives in the township herself, and has personal relationships with all of her patients. The community health workers with PlettAid will deliver medications to patients, make appointments for them at the clinic, redo bandages and clean wounds, purchase and deliver food parcels, check in if their patients are taking their medication and how it’s working, and how their patients’ lives are going otherwise (socially, emotionally, financially…). They also give their patients rides to the clinic, the social security grant office, the grocery store or to school, and help in any other way they can.
I’m looking forward to our work the next couple weeks, and to learning even more about the public health system. I haven’t been able to take many pictures so far, but more updates to follow!