Cecil's Final Farewell

You will all laugh if I start this post with “I am speechless” because I am probably about to write another book here. But none of the words I can find will capture today’s experience in the slightest, so really, I am speechless. I got home at around quarter after three, needing to work on my paper, and, more importantly, needing to journal about the day, but it was like I had left all of my energy at Cecil’s house. I wasn’t tired in the “I’ve been working on a paper all night and can’t keep my eyes open” kind of way – I was tired in a “I just had a heart transplant and think they forgot to put in the new heart” type of way. In short, I immediately passed out and dreamt of the day’s events for about an hour-and-a-half. I’m hoping that now I will be able to write about them.

In my last post, I mentioned that Cecil’s funeral was to be held today (though I guess I won’t get to put this up till Monday). I spent last night frantically making phone calls, trying to find a ride so that I could be there today to show my support for Cecil’s family and the counselors. Disgustingly enough, no one from the Desmond Tutu HIV Foundation headquarters was attending and no one even took interest in finding out when or where the service would be. For a short while, I thought I had a ride with David, the doctor who sometimes drives me to the clinic, but when I told him the time and the length he said that it was “too early and too long” for him. Nice.

Finally, at around 11 pm, I thought I would have to throw the towel in. No one would give me directions for where to get off on a minibus because no one wanted me to take one alone (even though by this point Chris had volunteered to come with me because he knew how much it meant to me). I texted Nokwayiyo and begged her to please inform me if she heard of anyone else coming from Cape Town so I could get to them and they could bring me. Ten minutes later, she called me offering to come all the way to Cape Town to pick me up, again because she didn’t want me to travel without someone who knew the way. This wouldn’t have been as big of a deal had the service been later, but this meant that Nokwayiyo would be leaving her house before 7 am to meet me downtown at the taxi rank at 7:30. The first service actually began at 7:30, but she said it would be fine for us to get there by 9. So Chris still came with me, just for the support and to make sure I had someone to come home with (Mom, Dad, he’s the type of kid that should make you feel better about your daughter studying abroad). We took a taxi downtown and met Nokwayiyo and then found that there was a bus leaving at 8 for Gugulethu so we hoped on board. Nokwayiyo hadn’t even had the money to come and meet me; she had to borrow it from her sister, but she still came. Of course, I reimbursed her for her fare once we met and paid for her return trip, but she came without the guarantee that I would do that. It’s just an example of how giving everyone is, even when they have nothing to give.

Anyway, we arrived shortly before 9, which was when the main service was to begin. As we walked up Cecil’s street, Nokwayiyo turned to us and said “We are just in time, Cecil is just arriving.” It struck Chris and I as awkward and unusual to speak of the dead as arriving as if he was walking here with the rest of us, when really he was pulling up in a hearse, but that comment would just be the beginning of the evidence presented to demonstrate the desensitization of death here. It’s really not fair for me to refer to it as desensitization, especially as you will soon see just how meaningful and sentimental the funeral was, but I don’t think there is another word to describe the reception of such tragedy here. It’s like, no one expected that Cecil would die, and not in this way, but everyone expected to be attending a funeral of a loved one sometime in the near future. And while I suppose no one overtly expects death anywhere, it seems as if everyone always has up their guard and prepares themselves for such events. Death is routine here, and somehow it is experienced as mundane enough to numb the pain, but still tragic enough to illicit a type of memorial like I’ve never seen.

I’m not sure I’m making any sense. I can’t make sense of any of this from start to finish. For the fact that Cecil died at all I am heartbroken. For the fact that he was murdered my blood boils. Furthermore, knowing that his killer is roaming the streets unpunished makes me dizzy and brings me close to vomiting. But then there is the community response to consider, and that just leaves me lost. The anger I feel, coming from someone who knew Cecil for only a short time, seems unjustified if I do not feel anger in those around me. It’s almost as if everyone here has been trained, as if part of your schooling here teaches you to bypass that step of the grieving process altogether, because if you cannot, you will never live another happy day in your life. The sadness that I feel seems unwarranted when in the midst of family and friends to whom he meant so much, especially when their sadness seems more poised and under control. In every way, the experience of death here is foreign to me. It is refined in a way that it should NEVER have to be.

So, moving along then, we got to Cecil’s house to find a crowd multiplying in size by the minute. Everyone was wearing black dresses and suits except for the men in yellow, who wore the t-shirts of the men’s support group in which Cecil was a leader, Khululeka. Zingisa, one of the two remaining counselors at the clinic, was wearing one too. I hadn’t even known that he was a member. Anyway, Nokwayiyo led us to the front of the tiny yard, where there was a small row of chairs facing out into the rest of the crowd. We assumed she was about to sit with us, and that we were sitting there because there was no other room, but in fact, she left us there and went to the back, positioning us there as some sort of VIP guests. It was uncomfortable, and we did not deserve such seats, but refusing things here is far more insulting that accepting an offer, no matter how undeserved it is. So we sat, just Chris and I, looking out at the singing crowds and wondering what we were supposed to be doing.

Things took a turn for the worse and the inappropriate when a man kept coming up to us making unintelligible statements and bazaar motions that we couldn’t decipher. Chris tried to ask him if there was somewhere else we should sit, but he took that to mean “where is the toilet” and proceeded to take Chris away to the side of the house. Have you ever heard the Matchbox 20 song that says “I’m the kinda guy who laughs at a funeral, can’t understand what I mean, you soon will”? That’s right. I am Matchbox 20. As if this wasn’t sensitive enough (and it’s not like I was sitting in front of the whole crowd or anything), I had to lose it with a giggle fit and excuse myself to the side of the house. I’ve always had some trouble with laughing at inappropriate times, but this by far took the cake. I joined Chris and this goofy old man, who was at this point telling Chris that he could get him beer and that he should never walk anywhere without him, because he will give him rides. I had to distance myself further, because I was starting to make Chris laugh as I choked on my own chuckling.

Quickly though, my moment of madness was put to a halt and I was sobered by the solemn sight of Cecil’s son, Xolani, being guided out of the house in tears by a sea of women. I hadn’t seen him cry at all on Tuesday, and if you had seen him, you’d understand why this was such a difficult scene to watch. Xolani, though only 16, is taller than most men (including his father) and carries himself with the composure of a soldier. He wore an HIV pin in support of his father on one side and a flower to show that he was a close member f the family on the other. His pants were noticeably too short, which only reminded me of the economic situation that he would now face him without a father. Throughout Tuesday’s service, I had been able to ignore that fact by looking at Xolani as a full-grown man. He waited on guests and made sure that everyone was comfortable. He was still in denial. But seeing him come out of his father’s house, after seeing his father resting dead in a casket, stripped all of his size and self-control away from him. Reality had hit, and I was sitting right in front of him watching it (laughing only a few moments before). Xolani suddenly looked like a child in a way I never thought he could. His aunts coaxed him to drink some juice like he was a toddler and they had to guide him off to a back shed because he could hardly walk. I clearly remember him looking up at the crowd as he rose, bewildered by the audience and overwhelmed by the reality of it all. His eyes met mine for a second and all I could do was stare back at him and try my best to convey sympathy through my own flooding face. His eyes were so bloodshot and his face was so lost; it was one of the most helpless moments of my entire life. From there on out, there was rarely a moment when my own eyes were dry.

It was then our turn to say goodbye to Cecil, as the family had finished and the crowd was making a line for the door. His entire body was covered up to his chin; only his face was visible from behind the glass that separated him from the living. His nose looked wounded and his forehead looked like it had sustained a blow; with the rest of him covered, I could only imagine what his ravaged body looked like. I had naively expected that with a stab wound he would still be viewed traditionally, because a simple shirt would hide the mortality of it all. But now I had images far worse in my own mind of what had happened, my own little horror movies films played through my head. And this time, unlike Tuesday, I couldn’t think of Kaity. I had prepared myself that today would be a difficult reminder of last April just like Tuesday had been, but the experience was so different and the emotions so foreign that when walking by Cecil’s casket, America did not even exist at all. Cecil, his family and Gugulethu were my entire ravaged reality in that moment.

After everyone had said there goodbyes and made it back to the lawn, the service continued. This time Cecil’s son sat off by himself outside the tent, eyes on the ground and hands clasped between his knees. He looked empty, as is he was in that stage I went through with Kaity, where you cannot cry because you cannot feel and all you can do is put yourself as far away as possible. Shame on me for comparing the loss of his father to my loss of a friend, but it is the closest I know to the anguish he is experiencing. I tried my best to pay attention to the service, but I kept looking back at Xolani, wanting to somehow show him something with a look that could convey my worthless sympathy.

There were other family members to threaten my teetering composure as well. A few aunts were having fits, and Cecil’s girlfriend, well, she could not stand; she could only scream. The pastors continued through it all (there were 3 of them) and the crowd continued to grow as time went by. Soon the casket was carried outside to sit in front of the crowd under an arch of fake flowers (I would imagine it is far more economical to reuse fake flowers at each service rather than to provide real ones). At this point, Chris and I had been hiding in the back with the crowd for some time. I was unwilling to cry like a baby at the front of the service when my pain was so marginal in comparison to most. But we were spotted again. And we were called up to the front once more. Everyone in the crowd parted and guided us to two chairs directly next to the female pastor and the casket. This time, we were not alone up front. Dr. McNally, the one doctor in attendance, and his wife sat next to me. Dr. McNally is the provincial doctor who is in charge at the ARV clinic. Of course, none of the doctors employed by the DTHV made room in their “busy” schedules to come out. Elizabeth also sat up front with us, the head counselor at the clinic, and together we comprised the representation of the clinic (plus Chris). I could not understand why I got that seat instead of any of the many counselors who mean so much more to this community, but in the end I reasoned that because I was a guest coming from far away to show my support, I was honored and thanked with such special accommodation.

Again, this seat turned out to be a bad thing for me. I had a terribly perfect view of Xolani, who sat in the family section directly in front of his father. For the rest of the service he did not cry. He just stared at the wood that enclosed a man that just a week earlier had been standing. He listened intently to the words of each speaker but did not rise and sing with most of the songs. Between each eulogy there were hymns, but none were as loud and forceful as they had been on Tuesday. Tuesday was the day of purging, as I said in my last post, but today’s songs were songs for goodbye. There was, however, a sermon given by one of the ministers that was extremely loud and strong. He weaved his way into the still growing crowd, yelling and waving his hands in meanings that I can only guess. He went into English briefly, and shared in everyone’s pain by offering the information that his own sister had been shot through the face - again, another shocking example of the violent deaths by which this community is victimized. I can only imagine was being said the other 99% of the time.

By around 10:30, people I knew began eulogizing Cecil. First, Elizabeth and Dr. McNally got up to say a few words. They were followed by Zingisa, the counselor who I mentioned earlier as being a part of the men’s support group. His speech was the most difficult of them all. I know Zingisa as an extremely shy man, who is playful with those he knows well, but usually silent around me, the strange American who was always asking him for an interview. I did actually attempt to interview him, but his English is not the best and my Xhosa is non-existent, so it did not go very far. Mostly, when I see Zingisa at the clinic, I see him with Cecil, talking with his close friend. And now, I was watching Zingisa say his final farewell to his friend in front of a sea of people. He made it only to “molweni” (good morning) before he had to back away and regroup while another hymn was sung. On his second attempt, he got out about a sentence before he collapsed in tears at my feet. We all put our hands on his shoulders in a futile attempt to show him that we understand, when really, I know that I will never understand. It was some time before he was able to get up and move the side, where he silently sobbed to himself while the next counselor spoke.

It was Ayanda who spoke next, the counselor who was both Cecil’s coworker and his counselor. Cecil was her client long before he began working with the Sizophila program, so she knew him and his experience better than most. She spoke more softly than I have ever known her to speak and she trembled all the way through. Ayanda is one of the tallest women I knew, easily 6 feet, but today she looked weak and small, just like Xolani. I was beginning to feel as if I was violating everyone’s privacy by being there as I witnessed what they were going through and I could not even understand the words they were speaking. But still, I could not take my eyes away to stop staring at Xolani.

The next group to speak was the crowd from the men’s support group, who picked up the mood a bit with a celebration of Cecil’s life and a promise to continue his work. They got the crowd shouting “Viva Sizophila, Viva!” and “Viva Khululeka, Viva!” and they ended with dancing and singing that was much more vibrant than the preceding hymns. Then they carried Cecil off to the hearse and everyone loaded into cars, minibus taxis, and even a full-sized bus that had been rented to transport people to the graveyard. It was not until this point that I realized just how many people were there. I would easily estimate that there were at least 300 people crowding the street and the neighboring yards to be there to say goodbye.

We got to the graveyard, which was pretty much a huge field that separated the informal from the formal housing settlements. By the time we got there (we rode in a van with Ayanda), Cecil’s casket was already set to be lowered to the ground. After a few more prayers and hymns, his body was lowered and the family took turns throwing dirt on his grave. But once that had finished, all of the men in yellow plus many more started dancing and singing and shoveling in the rest of the dirt. Even Chris was snatched up to take his turn, as it is a ritual that the men share in the burden of covering the dead. I kept watching to see if Xolani took a turn, because he stood leaning against a pillar for most of the service, but the crowd got too big and I lost sight of what was happening. When all was said and done, and tears were once again pouring down my face, I met Cecil’s brother, who told me not to be so emotional, that everything is okay. Ha. Right. Tell me not to be emotional. Good luck. I’m not used to any of this.

We walked off with his brother and Ayanda and got back in the car to return to Cecil’s home for a meal. The first thing you must do in this culture after a funeral is wash your hands because you cannot take the family’s business with you. So back at the house, there were tubs and tubs of water and towels in which all 300 or so of us washed our hands. The VIP treatment then continued as Ayanda lead us into the house to eat with the family and close friends. We sat with her and Elizabeth and were served heaping plates of food that threatened to break my vegetarianism. I tried to be mature about it and prepare myself for the inevitable, as I was unwilling to insult anyone by refusing to eat the food they had worked all morning to prepare. It looked as if it might have been lamb, but it was hard to identify because it was grizzly and covered in an oily gravy. So, naturally, I started with the vegetables. And I snagged a Sprite as drinks were going around. All the while women were circling with more bowls of unidentifiable food products, and all the while I was accepting. By the time they were through, my food almost could not fit on my plate. I learned quickly that the one dish was comprised of peas and carrots and was not bad at all, while the three other dishes (not counting the meat) were not exactly something I would have ordered in a restaurant. So, I mixed them all together and started shoveling it into my mouth. Too bad you can’t force your kids to do this at home by telling them they are insulting you if they don’t eat it. Mom, don’t even try. You’d have to get me into an extremely sensitive situation such as this one to get me to abandon my picky eating habits.

So anyway, here’s where I got lucky. Ayanda, who was on my left (and almost finished with her meat) suddenly turned around to speak to the person next to her. Also, I was given a screen by a large man in front of me for just long enough to toss a couple heaps of meat onto Chris’ plate. This is another reason why I am grateful he came with me. The meat had to be eaten by hand, and I knew Chris was not exactly enjoying it, but in all fairness, he was the one who told me to do it. He said he wouldn’t make me eat meat if I didn’t have to. And really, if this had been my first venture back into the world of carnivores, it probably would not have ended well. I’ve heard of vegetarians who have gotten sick on their first small bites of chicken. So I cannot imagine what this week would have been like after a pound of a lamb-type substance. Note: add Chris to my list of things I am grateful for this Thanksgiving.

With that mission accomplished, I only had to worry about this mountain of funky white stuff that looked a little like ugali (a corn-based starch that is a staple in Tanzania) but tasted a little worse. I kept on mixing and kept on shoveling, until, by the graces of God, someone came and snatched my plate away from me. I had survived. Chris, not yet having finished the meat on his plate for some reason, did not have the same good fortune. He was allowed more time to savor his serving. But don’t worry, I’m sure karma will come back to me someday, and somewhere in my travels I am sure I will have to eat a nice plate of little lamb. When that happens, I will promptly call Chris and yell at him for not being there.

Well, the end of the meal was pretty much the end of the day. All 300 people were fed, the family, Xolani included, was rushing around collecting empty bottles and plates, and slowly the crowd dissipated. Nokwayiyo found us a ride to the taxi rank and we were abruptly torn away from Cecil’s house when I wasn’t really ready to leave. I had wanted to give my condolences to all of his family, especially his son, but I was only able to grab Xolani for a second, shake his hand, and tell him what I thought of his father and how very sorry I was. Then I was grabbed and hugged by countless men and women who wanted to thank me for coming and showing my support. Nokwayiyo had to pull me away and force me to the car, because I would have easily stayed there talking to people for another hour.

We got dropped off by the minibus taxis and taken straight to the Cape Town stop by Lucy, the cleaner at the clinic, and two other women. They walked us all the way there to make sure we found the right taxi and hugged us goodbye as if we were family. I couldn’t believe how warmly we were treated throughout the day. And then in a moment, we were gone. The funeral that we had attended from 9-2 was over and another book of tragedy was closed. Chris and I tried to talk about the day on the taxi, but as I am experiencing here, it was difficult to find words. I was so grateful that he was with me and he was glad he came, but it was strange to feel happy about attending a funeral at all. Many people had asked us while we were leaving if we “enjoyed” it, and I didn’t know what to say. I tried to say that it was very sad but very beautiful, and gave far more honor to the deceased than the services we have in America, but I again sensed that this question fit the mould of the desensitized paradigm. Who enjoys a funeral? I suppose in South Africa a funeral is a celebration of life. And as even all of you who didn’t know him should be able to tell by the 300 plus people in attendance, Cecil’s was a life to be celebrated.

Still, celebration or not, I can’t stop thinking about Xolani. He lost his mother when he was only two, and now, at 16, his father has been tragically murdered. How will he carry on?

Note: I haven't reread what I wrote here at all, so I apologize if it is at all hard to follow. I think I may end up writing even more about this at a later date when I have more time and energy...there is still so much more to say.

Cecil Sitela 1973-2007

This is a very sad occasion to write a blog entry. Somehow I am “too busy” to sit down and tell you guys what I’ve been doing here so long as my biggest problem is my research paper. But today, I was reminded that there are much larger problems in this world. Today I learned that Cecil Sitela, one of the Sizophila counselors with whom I worked, was murdered last Saturday night. He was only 34 years old – two children survive him who have no mother. He had a girlfriend in the area, a mother in the Eastern Cape and countless other relatives and friends whom I do not know.

Cecil was one of only three male counselors at the clinic in Gugs. He was one of the newest employees; he only started this job last March. I did not work with Cecil very closely, but I did interview him last week for my own research paper. He was a quiet but friendly man who gave everyone his undivided attention. I can remember being very excited by his level of concentration with each question I asked. Unfortunately our interview was more brief than usual, mostly because at the time I was unsure of whether my study would even include men, and partly because we were interrupted multiple times. In the time we did have, we spoke about his leadership role in the community, how he spearheads men’s counseling groups and organizes support groups. Prior to his work as a counselor, he had sporadic contract jobs as a painter, but he dreamt of going to school and becoming a carpenter. Cecil took great interest in learning more about HIV because he lost family members and friends to AIDS. He lived in Durban at the time he was diagnosed, but after finding no support there, he returned home to Cape Town. Cecil explained to me the problems of disclosure with men and the prospective reasons as to why they may be unwilling to share their status with their partners. He spoke of alcohol abuse as a common barrier to treatment adherence and shared with me his strategies to overcome these obstacles. One could tell in talking with Cecil that he viewed men as equal partners in the transmission of HIV and his crusade was to help men to escape their unhealthy cycles of sexual behavior and to demonstrate responsibility in their lives. His loss represents a greater loss in the community, not only in the fight against HIV, but also as a role model who provided guidance and leadership to support those in need.

Tomorrow I will be attending Cecil’s funeral at his home after work. I am guessing I won’t get to the internet, so I will probably write more about the funeral and then post this on Wednesday. Hopefully I will be able to share more details of what happened, but for now all I know is that he was murdered by a patient’s boyfriend around 2am on Saturday night/Sunday morning. Apparently he was called for help so he got out of bed and went to the patient’s house where he was stabbed to death by the boyfriend. I do not yet know why, but I could project many unappealing reasons. Perhaps the boyfriend was jealous or suspicious of the male counselor working with “his” woman, or maybe he was angry that Cecil brought the topic of HIV into the home. Maybe the woman called Cecil for help because she was disclosing her status to the boyfriend and he wasn’t reacting well, and when Cecil arrived, he pulled out a knife. I am not going to bother guessing any further because none of these reasons bring me any piece of mind. All I can picture is the kind and unassuming Cecil, coming to offer his help, and in the end sacrificing his life.

Cecil told me that he hoped to work for the Desmond Tutu HIV Foundation for just a few years, maybe three of four, so that he could go back to school and work to fulfill his dreams. He hadn’t yet been here a year. In this line of work, it is the women who are most afraid for their lives, fearing rape as they walk alone through squatter settlements where they are looking for unfamiliar houses in unfamiliar neighborhoods. The male counselors are supposed to be safe. I cannot stop thinking about how HIV killed Cecil. It did not physically take his life, but his status and his work did ultimately lead him to his premature death. I am struggling to digest the injustice of it all.

Before I get myself going and really get worked up, I want to share the reactions of the other counselors today to compare such loss in the States to this kind of loss here. First of all, I showed up at the clinic at around 10 am this morning after a meeting at the headquarters in Cape Town. I was immediately told of the events by Xoliswa (the x is pronounced as a clique and a k combined - tricky) and then I was invited to the service for tomorrow by the head counselor, Elizabeth. The day was unbearably long and lonely, as I was unsure of how much sadness I could or should feel and was unable to share in the feelings of the other counselors, whose loss was so much deeper than mine. None of them were very productive today, and fortunately the clinic was not very busy, so they pretty much spent the day sitting around and speaking of Cecil. They reminisced and joked about his mannerisms in Xhosa all afternoon while I sat wondering what they were saying and wondering what on Earth I could say. I had never felt as separate from the staff as I did today. Today I realized that I know nothing of their lives and the constant risks that they take in their work. I realized just how ignorant I am of their emotional trials and their own concepts of loss.

It was relayed to me that I had missed a morning meeting in which the counselors could cry and share their feelings on the situation, but I still expected these tears to be present throughout the workday. If an employee had been murdered while I was working at NJP&A last summer, I don’t think there would have been work on Monday morning. I think psychological support would have been provided and work would have been postponed or made optional. But an HIV clinic never closes. There are patients to be helped. Here, where death and murder are not quite as unusual as they are to me in the States, the sadness was palpable but the excuse to take some time off non-existent.

I won’t write anything else tonight; I want to just think about the day and I will save the rest for tomorrow.

The Service:

Today I felt more enmeshed in the Gugulethu community than I ever thought a study abroad program could make possible. I know that I wrote yesterday about feeling isolated and separate, but today was totally different. I came to the clinic in the morning and found everyone in a bit better spirits than the day before. I had a two-hour interview with Flora, the head counselor of the pediatric unit, and I visited with a little friend of mine, a hairdresser, if you will, who I met a week or two ago on an unproductive day. I spent about an hour on the curb with her and came out of the situation with more knots than my hair knew (even in the days of “magic brushes” and maple syrup). A little boy was a co-conspirator in this destruction, and his tactics were to straight up dreadlock my hair. It was exactly the fun I needed today. I kept wondering if I will see the little girl and her mother, the pair I’ve written so much about, but this was a nice alternative. The little girl I played with today doesn’t look as healthy as the two-year-old I met a while back. She is extremely thin and her baby teeth are rotting. She looks to be about 4 years old. I first met her in the waiting room of the clinic on a day that I was avoiding the pregnancy study and prowling for little kids to make mischief with. I spent much of that afternoon being fought over by two little girls who both had to have equal shares of my lap, and again, my hair. Today I found my little friend snoozing in the sun on the curb outside of the clinic. I again did not see her with her mother. I get the vibe she’s an independent 4-year-old. Anyway, she remembered me immediately and burst into laughter. Her laugh is so difficult to describe; it’s always brief, but extremely high-pitched and is accompanied by a glowing smile and dancing eyes. She found her way back onto my lap and proceeded to “deflate” my cheeks with her fingers as I blew them up with air. Each time it was like she didn’t know what to expect, and each time she cackled as I blew air in her face. From there we moved on to my weekly hairdo, and before I knew it I had a second hairdresser as well.

After my head was sufficiently knotty, I said my goodbyes and headed back inside. There I found all of the counselors had finished their meeting and were busy practicing hymns for Cecil’s service. We made our way over there at around 2:45, accompanied by a few doctors and nurses from the clinic as well. His house was not far from Hannan Crusade, and it was a formal home (not a shack, or informal house). The front yard was covered in a tent and packed full of chairs. The house had three rooms, a small bedroom, a kitchen, and an open living room. The front room, the living room, was also lined with chairs, so we filed in and took our seats to begin the service. This whole time, I was wondering where his family was sitting and what exactly was going to happen. And for the next 90 minutes, “we” sang and eulogized Cecil. I say “we” in quotations, because my contribution consisted of standing up and clapping and swaying with the best of them. Xhosa has never sounded so beautiful to me. Even though I could not understand any of the hymns, they were more powerful than any song sung in English in such a situation. Quite a few people I’ve known have died this past year, but funerals and memorial services have never held as much meaning as this service did today. Ironic, isn’t it, since I couldn’t understand a word that was spoken.

Mostly, my mind kept racing back to Kaity’s funeral, and while the level of pain is incomparable, I remember leaving the funeral home wanting more closure, wanting to believe all the words that were said, and that I had echoed, that urged everyone to let her go and not to stay sad for too long. In Cecil’s service, the singing was almost like a purging experience. I cannot think of a better way to explain it. People sang through their tears and got louder as they went. One of the counselor’s had a cushion that she pounded to the beat and everyone else clapped along. It was the most beautiful emotional expression I’ve ever experienced. In between each song, someone eulogized Cecil. Sister Lulu, one of the staff at the clinic, actually went in and out of English in her speech, so I was able to follow her words, which were about him having done everything he came here to do. She said that it was time for him to go home, that our home is not this Earth, and we must not be sad. Rather, we must say goodbye to a dear friend and let him go. Maybe it was because I did not know Cecil very well that I was more able to buy into that, or at least to find it soothing, because with Kaity, those same words would not have eased my pain. I wondered how in a death so tragic, a murder, people could find such peace and let go of their anger. Part of me believes there is something to be said that the people I work with are more “used” to death than we are in quaint Clinton or cozy Chapel Hill. And these counselors, more than anyone, are “used” to funerals. One counselor was not in attendance at Cecil’s service because she was at the funeral of a pediatric client of hers who defaulted her treatment, became resistant, and passed away. Death is far too common here for me to stomach. But the way in which it is dealt with is so refined and so therapeutic that I suppose it allows people to move forward. What other choice do they have?

I could easily keep writing about the feelings I had in that service as we all cried and shared each other’s sadness, but I really am running out of time to write. So I’ll fast-forward to the end of the service, when I finally met Cecil’s family. We presented his aunt with a collection of money we all compiled (I only had 35 rand with me, about five or six dollars – nowhere near the amount I would have liked to have given) and then his aunt thanked us and welcomed us to have soda and cornbread. We made our way into the bedroom to give our condolences to his relatives and his girlfriend, but his mother was not around. Cecil had told me she lived in the Eastern Cape, but Elizabeth told me that she had passed away. So I am not sure where his mother is, but just seeing his other relatives and his son was painful enough. His son is 16 and looks a lot like Cecil. He sat outside under the tent throughout the service, most the time with his head towards the ground. When the last song was sung, he kept himself busy distributing drinks and collecting empty bottles. In South Africa, it is the family of the deceased that provides food and drink when mourners come to say their goodbyes. I found it strange that they carry this burden on top of everything else, but what do I know about anything? Each day I spend in Gugulethu I realize more and more just how little I know of life outside of the “Western” world.

People started to leave after a few announcements about another memorial to be held on Thursday and the actual funeral (which I plan to attend) on Saturday. I had thought that today was this funeral, but as it was put to me by Elizabeth, today was just a day to be with his family and share in their pain. Elizabeth and a few others stuck around talking to Cecil’s father after the service; it sounded like they were getting the real account of just what happened last Saturday. But my ride back to Cape Town tore me away before I could get the translation, so I guess you’ll have to wait till my next post to get the full story. I rode back to Cape Town in silence, feeling like months of mourning had just been consolidated into under two hours and wondering how evolution has allowed such emotional adaptation in these people that I could never see taking place in myself. No matter how much death I may encounter, no matter how well I did or didn’t a person, I don’t think I will ever be desensitized. All I could feel was exhaustion from the day’s events and gratitude that I had been able to be a part of the experience. On Saturday, we will all bid our final farewells to Cecil, and then work will continue as it must.

Or maybe, I will wake up and this all will have been a dream. I will still be a borderline member of this community and I will still be spared of its most intimate traumas. Part of me hopes that will happen, because I fear that now I have become both more infuriated with the world for these injustices and more appreciative of this society for its strength. I am wrapped up in Gugulethu now as I am in St. Lucia. All I know is that leaving is going to be very, very difficult. And I will not forget Cecil.

PS – I just realized that one of my first posts was titled “Cecilia” and one of my last is “Cecil”. The first was about someone I feared might die, and the later was someone I never expected to lose. How strange.

I can't title this post anything other than "SPRINGBOKS RULE!"

It’s been quite a while since I last posted, so I am going to have to brush over a lot here for the sake of time. Since my last entry, I have been to Namibia and KwaZulu-Natal, a province on the other side of South Africa. But most importantly, since my last entry, South Africa defeated England in the Rugby World Cup to become the reigning World Champions. The Springbok pride is still going strong weeks later. I think the victory has made me a little more South African and a little less American. And I'm liking it...

Okay. Because there seems to be so much to cover, I think I’ll write this post a bit differently. I’ll just do a section on work at the clinic, a section on our travels, and one on random experiences. Finally, to force you to make it to the end of my painfully long entries, I am going to add a “Bendles” section for fun. Maybe this will have to become a tradition with the rest of my posts. The Bendles section will just include a few quality quotes from our beloved Dr. Bender from the week before. Let us begin.

Hannan Crusade: Take Two

It seems my last post was heavily focused on an encounter with a mother and child, so I think it’s only fair that I give you all un update on their situation. Exactly one week after I first met that little girl and her mother, they returned to the clinic for more pre-treatment counseling. I was able to discover that both mother and daughter are in fact HIV-positive, but fortunately the little girl still has a very high CD4 count and does not yet need to begin treatment. In addition, the reason her mother was crying the week before was because she was afraid to tell her husband of her status. The only reason she had even been tested in the first place was because her daughter was sick and when she took her to the doctor it was encouraged that she have the child tested for HIV. Once the little girl’s test came back positive, the doctor persuaded the mother to test as well. When all of the counselors were gathering around to reassure the mother that everything would be okay that first week, they were actually offering their support to be there with her when she discloses to her husband and to provide encouragement for him to get tested as well.

I have spent a lot of time trying to understand this woman’s fear, trying to imagine being so afraid to tell your partner of your status when, in all likelihood, he was the one who infected you in the first place. I cannot wrap my head around that fear because to me it is implausible. If the husband was not loyal, my thought is that he is the one who should be afraid and begging forgiveness. There is so much talk of women’s empowerment issues and the need for women to stand equal next to men in the workplace and in greater society, but they cannot even stand as equals next to their husbands who have infected them and their babies in their own homes. I know that is a vast generalization, and certainly not all infection at home comes from men, but a very large portion of it here does. And if women have to fear being left by their already adulterous husbands, on top of the fears of their infection, how are they to be empowered? Where does one begin to help them? Certainly a lot of attention must be focused on the husbands and their roles in this mess, but in terms of HIV, families infected do not have time to wait for empowerment or equality. Treatment must be pursued, so empowerment may be forgotten.

People cannot be discussed as mere vectors or victims of disease; they need to be looked at as the still living, not the dying. With antiretroviral treatment made available to this mother, she and her child can live. Luckier than some (but still nowhere near as privileged as others), this little girl can have the opportunity to draw pictures for her mother as I did for years to come if her mother stays strong on antiretroviral therapy. But now that she has the drugs, where does that leave her as a woman? I’ve realized that ARVs will treat the illness, but not the inequality, and now this mother is putting it all in context. What if her husband does not accept her? What if he leaves? What if she has no way to support herself or her child? What good are ARVs if she cannot eat? It’s so very depressing to acknowledge that science can only go so far and society has to take on the rest. Statistics can be used to measure access to treatment, but access to the greater issue of survival cannot be measured quantitatively. So back to my original struggle to understand this mother’s fear, I suppose I will never fully understand it, because I have been born into a place where my rights and, what’s more, my value, are seen as equal to that of any man. There are no laws preventing a man from leaving his wife in my country or here, but the implications of such an event are incomparable for a woman of the States and a woman of South Africa.

Look at me go again. Sorry. There is actually a reason why I am going off about women’s empowerment. Even though I have never found myself to be an ardent feminist, I have seen in this clinic the inordinate impact of HIV on women and I’ve witnessed how the virus thrives on the structure of this society. It’s a symbiotic relationship, the union of HIV and inequality requires more than medicine to combat. Poverty permeates all of these issues, but functional inequality promotes poverty, and thus this is where I want to focus my energy. I have developed a certain interest in empowerment, if only for the sake of supplementing the struggle against HIV/AIDS. I have decided to twist my research paper to focus more heavily on the ways that the Sizophila counselors have turned their own illness into economic opportunity and - here’s that hazy word once more – empowerment. I look at that mother and wonder what she would do if her husband did leave her. For all I know she could be the breadwinner in the family, but if not, would she find work? People wonder why women turn to prostitution in the face of AIDS in Africa, but what would you do if you had a hungry little mouth to feed at home and no options other than to sell yourself on the street? Would you let your child starve?

The Sizophila Counselors are finding a new niche for themselves in a world that has yet to understand the obstacles that inhibit every step that some women take. In a community where unemployment hovers above 70% across both genders, what are the primary caretakers, the mothers, to do? Add AIDS into the equation, remove a generation of mothers, and reform the question: What are grandmothers to do? I still can’t believe how much this one little girl and her mother have made me think. It’s almost nerdy how much I have pondered their situation at night. I don’t have a single answer for that mother. I can’t even help her when she does tell her husband her status because she does not speak English and I do not speak Xhosa (aside from a few miserable attempts at clicks). All I can do, worthless as it seems, is to continue to think of her and her child and hope that the answers will come. But I do know this much: odds are it will be the Sizophila Counselors, the people who know the problems best, who will finally find solutions for the women of Gugulethu. WHO documents, UNDP reports and international prescriptions and recipes can try to be culturally sensitive, but the authors of those proposals will not be with this young mother when she sits down to discuss HIV with her husband, and they won’t be there in the days that follow. I take comfort in the existence of the counselors and I am desperately pouring hope into their ability to change their own corner of the world. I’ve recognized that they can do a damn good job of it, certainly much better than I ever could.

The week after I saw this little girl and her mother for the second time, I threw myself into interviews with the Sizophila counselors to explore the empowerment issue a little further. I had finally finished collecting phone numbers and data from the thousands of files and there was a lull in my workload as I waited for an upcoming meeting about the pregnancy study. I thought that maybe Nokwayiyo would find the time to sit and talk with me, and maybe even Elizabeth, the head counselor, but within 2 days I had six interviews completed. Nokwayiyo was extremely helpful in explaining to everyone what kind of research I was doing and asking if they would be willing to speak with me. We went to an empty room, and one by one, these women told me their stories. I did not yet interview any of the three male counselors, but in light of my favorite patient pair at the clinic, I was more interested in talking to the women anyway. I couldn’t believe the stories I heard. In everyday work, these women are like superheroes, impenetrable to HIV-related stigma. But in talking to them, rather than just stalking them in the counseling room, I learned that they too have been left, they too have been hurt, and they too have infected children whom they worry about. One counselor has a 7-year-old daughter who is also HIV positive, but despite her own open lifestyle, she is unable to tell her daughter that she passed on the virus to her at birth. These women are independent and lonely, experts and ill-educated, and leaders and learners, all at once. Most of them are back in school now, either finishing matric (senior year of high school) or going on for certificates in social work and peer education. Women who never thought they’d be in school again are both teaching their community and taking classes on how to better it. I am convinced that there must be more than 24 hours in their days. That or they never sleep.

I could keep going about the counselors forever. I had better just cut myself off before I start coming across like I have a crush on Nokwayiyo, because that is probably what is about to happen. She has just been so incredibly warm to me and so willing to help me in my studies that I really wish she could be a mentor to me forever. She leaves next week for a two week internship for her social work certificate, and then she will be back just as I am getting ready to go back to Tanzania. I am going to attend the annual staff party with her and then give her a pair of tickets to visit Robben Island with her daughter. She’s never been and has always wanted to go, and her daughter should be able to enjoy it with her. Plus she says she’s too afraid to ride on a boat alone. But I think South Africans deserve to see the prison more than any visiting American, so if I’ve seen it, she should too. I hope it will serve as a good thank you for all she has taught me, but if I am not disciplined, I might end up buying her a plane ticket instead so that she can come back to the States with me and you all can see why I’ve been so lucky to work with her. We’ll see what happens.

PS – One of the counselors is into fashion design and is really good with a sewing machine. She told me to bring in my ripped jeans tomorrow and she is going to mend them for me since I don’t have anything with me to do it myself. I am way too spoiled by these women.

Travels

I’ll try to take this in chronological order. We had a day off from class a few weeks ago so Robin, Alison, Liz and I rented a car and drove up through the Northern Cape all the way to Namibia. We wanted to go far enough into the country to see the largest sand dunes in the world, but we HAD to be back in South Africa in time to watch the World Cup on Saturday night, so we settled for canoeing on the Orange River that separates South Africa from Namibia instead. Poor us. We got free canoes and got to spend the afternoon waving to South Africa on our right and Namibia on our left. The only expense Namibia showed us at all was in gas and the car fee to drive across the border. We didn’t even need visas as Americans, and as attractive young women, we hardly needed our passports. I am pretty confident we could have said “Oops, we left them in Cape Town” and made it across anyway.

So after exhausting our arms from rowing, we risked the reptiles in the water (hoping there were no crocs!) and went for a swim. The running joke is that I now will probably get schistosomiasis from snails in the water, but we’ll have to wait and see for that one. We made it back with all of our limbs and hopped back in the car to go watch the game. Somewhere along the way we also attempted to climb our own version of the largest sand dunes, but they were burning our feet so badly that we couldn’t even make it to the top in sandals. The dessert is A LOT hotter that I expected.

So, the Springboks. Wouldn’t it be cool to watch the Springboks play from the town of Springbok, South Africa? Yeah, that’s what we thought. We were so terribly wrong. Springbok was pretty much the only main town between the Western Cape and Namibia. In between were miles and miles of desert, sprinkled with small villages that do not even have access to a hospital. You don’t want to know how expensive gas was out there. But anyway, back to Springbok. We arrived there late Friday afternoon and I immediately pulled the hotel bandit routine, getting a room for one so we could sneak everyone else in without being charged per head. We soon realized though that there would be nothing to do in Springbok for the night, so we pushed on to an even smaller town on the coast to watch the sunset. We were able to save the room in Springbok for the next night and our lying Lonely Planets told us that there would be plenty of accommodation in Port Nolloth, the coastal town. To make a long story short, my lone wanderer housing hunt kept failing left and right; for some reason every tourist in South Africa must have booked up Port Nolloth for the night. We were forced to go to the Emerald City-esque Country Club, a place that was entirely mint green, where even the lights in the grass shone green on the already green plants and trees. It was intense. Fortunately, we got a room there where we only had to pay for two of us instead of all four and we simply pushed the beds together to form a “Spoon Castle”, which has become a regular event for us here, and we all could finally rest our heads after spending the entire day in the car. Unfortunately, none of us could shower because the water was more like milk than H2O, and none of us could eat because there wasn’t one inviting restaurant in town. Port Nolloth probably will not make the list of places to which I must return.

So I was supposed to be talking about Springbok, not Port Nolloth. We got back into town from Namibia with enough time to grab dinner before the game on Saturday, but again, eating would pose a problem. We went to the busiest restaurant we could find (which isn’t saying much) and found ourselves a table. It took at least 10 minutes before any waiter would so much as look in our direction, meanwhile the rest of the establishment was openly mocking us and laughing. I guess that Americans are not as inherently popular outside of Cape Town. This was really my worst experience with the stereotype that all Afrikaners are cold and unwelcoming. I’ve heard this said a lot, but the sociology major in me always resisted believing it. Regardless of the truth, these particular Afrikaners sure were doing a good job of playing the part. I don’t know what the common regard for Americans is in this part of the country, and I don’t know if we were being stereotyped as well, but I do know that the atmosphere was awkward and uncomfortable. We ended up wasting too much money on nasty food and getting out of there as quickly as we could to find somewhere else to watch the game. At one point, someone had actually talked to me when I got up to see the TV screens, but she spoke to me in Afrikaans. When I apologized and told her I was American, the conversation ended. So watching the game there was clearly going to be about as much fun as watching it from England. Instead, we found the Inferno Sports Bar, a quieter place, and we all grabbed seats without opening our mouths to give away our nationality. Fortunately, no one at the Inferno seemed to care that we were American, in fact someone even offered to buy us drinks. And most people just ignored us all together because they were so focused on the game. The one thing I wish could have been different would have been to be in Cape Town again by Saturday night (which wouldn’t have been possible) so that we could rush Long Street with the rest of the South Africans, just as if it was UNC beating Dook and we were rushing Franklin. The celebration in Springbok paled in comparison Cape Town, where people were jumping on cars and singing in the streets. I guess it makes for a funny story, but we’re all still a little bitter that we were stuck in Springbok when our “home town” was going wild.

After the hugging and screaming died down we went back to our room to watch the news anchors travel to each major city showing the mayhem that ensued. Feeling a little left out, we just went to bed so we could get up early the next morning to sneak everyone out of the room before I checked out. Things continued to go downhill, as I killed my first ever animal on the road driving through the desert in the morning. It was a dassie, a little groundhog-like creature that clearly doesn’t value life at all. There were HUNDREDS of them in and around the road, just asking to be hit. I even gave the stupid creature the entire lane as it looked like he was on his way to the edge, but he turned and ran under my tire at the last moment. Just as I’ve mentioned in previous posts about my shrieking and insanity, I again started up my yelping and yelling at every furry animal we passed, futilely ordering them to stay out of my way. It finally got to the point that I was swerving and slamming on the breaks so much because of the plethora of dassies that everyone else in the car told me I had to choose between their lives of the dassies’. I guess I chose their’s, but I hesitated for a minute at the thought of hitting another animal. I knew Trevor would be mad at me.

I drove for a few more hours while everyone slept, the dassies finally cleared the road, and it was by far the most amazing drive I’ve ever taken. I am not going to say how fast I was going for my parents’ sake, but between the scenery and the dry wind and the endless open road, I felt more free (and drove faster) than I ever have before. I can’t put it into words, but I was probably happier driving in that desert than I was when I first got my license and could take my very first drive alone.

Okay, I am going to skip ahead to talk about our next trip to KwaZulu-Natal. This was a trip with the entire program in which all travel expenses were covered by tuition. SWEET. We left on a Saturday morning and flew to Durban. Then we drove for a few hours to the Drakensburg Mountains where we stayed in beautiful chalets that sat in the slopes of the mountains. The meals there were amazing, which of course would be the first thing I mention. There was mac and cheese at dinner, something I have been deprived of for far too long. Furthermore, the view from my chalet, which I shared with Kavita, was to die for. It was nothing but mountains all around us and I could see them from the comfort of my queen-sized bed (the only times in my life I’ve ever had bigger than a twin bed is on vacations, so excuse the excitement) when looking out the floor-to-ceiling windows that surrounded me. I would have been happy spending the rest of the week in that room alone if I had to. But I didn’t have to. We all had the opportunity to take a guided hike up one of mountains, which was, of course, amazing. We stopped at a waterfall along the way and about half of us braved the freeeeezing cold water to go for a swim and sing the Carolina alma mater in the water. Being the hopeless klutz that I am, I actually took a pretty nasty spill when trying to climb behind the waterfall and scrapped up my feet pretty badly. But it didn’t make any difference. Everything was so beautiful that I didn’t want to stop hiking. Brendan and Kristen, the whole hike made me think of you guys and Ithaca. There were no 60-foot waterfalls to jump from, but there was a lot of baboon poop, which you guys love just as much.

Unfortunately, we only had one day in the mountains before we left on a six hour drive to Hluhluwe, where we spent the rest of the week. We went on a game drive one morning, did a tour of a village another, and painted a 1^st grade classroom on another. The game drive was beautiful, but definitely would have been better had I not gotten stuck next to Dr. Bender. I’ll come back to that in the Bendles section. The village visit was awful, the worst part of the whole excursion, but of course Bendles loved it. We walked around people’s homes, feeling extremely uncomfortable and exploitative, and the whole way Dr. Bender was getting in people’s faces and snapping photos of them. This from in PhD in anthropology. I don’t get it. Jennifer was the only smart one in the group; she chose that day to get sick and stay back at the lodge. Actually, about half the group got sick after her as well. Apparently it was food poisoning. Miraculously, my immune system stood by me and I was spared, for once. I think being a vegetarian was what saved me. But I don’t want to dwell on sickness or the village visit. The day we painted the school made up for any bad times in the village tour. I spent about as much time playing and dancing with the kids as I did painting, but I think by now I have resigned myself to limited productivity when there are kids around. We took turns teaching each other dance moves and games and then when I had to return to work they cluttered around the windows to ask us questions and watch us paint. The principal had the whole school sing a song for us and greet us, and in turn we thanked them for having us and encouraged them to finish school so they could come and paint our school on a visit to America. By the end of the day, the painted room felt much less important than the exchange we had with the students. I think we have mandated that this program return to the school each year to paint another room or help in some way.

To wrap things up, we spent our last night in Durban, most people at a hotel, but a few of us (the cheap ones) at a hostel. Three students and I took out our driver, Tabiso, for dinner and learned all about his life and his interests, the main one being to win the upcoming election ad be the next President of South Africa. I really admired his optimism, but as a man who refuses to get on a plane or a boat, I am not sure how successfully he could campaign, let alone run the country. And his political party, Wake Up Africa, has yet to be registered, so I doubt that he can take down the army of the ANC. But I guess there’s always a chance. I wish him the best of luck.

Finally, on Saturday we flew back home to Cape Town. Everyone was exhausted after two flights and we were all very happy to be back at the house. It’s so bazaar to realize that this house has become home because none of you reading this will ever see it, but after a week away, we all realized that it really was more than just a vacation house. We actually live here. How strange.

Random Experiences

I want to mention a few of the things that don’t normally make my blog posts because I am so busy writing about work or travel. First of all, I have to share that I attended my first South African theatrical production about 2 weeks ago with Dan, his roommate, Andrew, Kavita and Robin. We saw A Christmas Carol. Well, we saw a very unusual version of it. I have to say, I definitely liked it better than anyone else in our group. The story was very South African, with Scrooge being a businesswoman who ran a mine and Tiny Tim being “Tiny Tambisa”, the daughter of a miner. HIV had killed Scrooge’s sister and Scrooge then had to support her orphaned niece. The show had some cool dancing and some creative elements, but there were also a lot of comical and cheesy lines. For example, the Ghost of Christmas Present said she gave birth to Santa Clause randomly and also claimed to birth 2000 other people. That was never explained. There were many other instances like that, but my personal favorite was the way that Tiny Tambisa limped with crutches on stage but resumed her normal walk as soon as she was at the edge of the stage (and sometimes even earlier). I guess no one ever told her that the audience could still see her.

Enough about the show, it really isn’t that important. I want to tell you all about the most uncomfortable part of my days here in Cape Town. Brendan, this is about recycling, so you should keep reading. In South Africa, it is almost impossible to find any form of recycling bin anywhere. Everything is just thrown away. At first, I couldn’t handle it and I would hold onto my recyclables in a futile attempt to find an appropriate bin. But after walking to my bus stop for work early on Wednesday mornings, I have discovered that there is a recycling service in Cape Town. It is run by poor black South Africans, who only enter Tamboerskloof for the purpose of tearing through trash cans on garbage day to pick out all of the plastics and cans. In my first few weeks here, I thought they were searching for food, and I could hardly walk by them without wanting to dig a hole fifty feet down and tunnel past. But eventually, I realized that they are actually collecting recycling because they can make money in giving it to the province. One of the wealthiest parts of this city does not have any recycling services other than the poverty that encourages certain black South Africans to dig through trash cans every Wednesday. And while I feel better knowing that they are not searching for food, I still cannot get used to the site of someone going through my trash to find items that the city is too lazy to collect. At least it is a source of income, but the racial segregation that still exists in many areas here is highlighted by the Wednesday morning “infiltration” of citizens who will never know Tamboerskloof for anything other than its recyclables. It is little things like this that demonstrate the remnants of Apartheid, and it is the lack of services such as recycling that reminds me that this still is a developing country.

Bendles

Ah yes, finally, I can get back to Dr. Bender. I would like to share a few quotes from our excursion, the first two being from our game drive and the last from our night in Durban.

1.) “You know, there’s something to be said about zoos. You don’t have to be there at 6 o’clock in the morning.” (This was said to me around 7am when we were driving through the park.)

2.) “They should just tag the animals and call us when they locate them so that we don’t have to drive around aimlessly looking for them. When is this going to end?” (This was about 3 hours into the drive, after she had been sleeping for most of it.)

3.) “I see a lot of Indians, but where are all the chiefs?” (I actually did not have the pleasure of hearing this quote because I didn’t stay with her in the hotel in Durban. But Durban is a town with a large Indian population, and even though Bendles studied in India as an undergrad, she still isn’t comfortable around people who are not white.)

There were many more fantastic quotes. These are just a taste. But probably the most offensive thing to me was the way she spoke to our drivers the entire time we were traveling. She was so patronizing and condescending to them, openly behaving as if they were beneath her. I won’t go into more detail here because I will get too worked up and I will go on forever. I’ll save some for the next Bendles section.

Time to write a paper, folks. Hopefully it won’t be another few weeks before I can write again.

The Hannan Crusade HIV Clinic

Hello again. It’s Sunday afternoon here, finally a day with a little down time to write. I am not sure when I’ll actually get to the internet to post this, but I have some free time before our movie for class and I thought I should get some stuff down. Where should I even begin this time? I want to discuss the environment at Hannan Crusade, but even just tackling one clinic seems it could take hours.

I suppose I can set the stage by sharing that the Hannan Crusade Clinic is pretty much how most people would envision an HIV/AIDS clinic in sub-Saharan Africa. It is overcrowded, understaffed and LOUD. Upon entering you find yourself in the waiting room; a church-like aisle against the wall is the only space to maneuver past the pews of people waiting their turn to be seen by a doctor, counseled or given medication. A TV plays to keep the many children quiet for the long hours that they may wait. At the front of the room is the pharmacy, which is what brings in most of the patients on any given day. Then to your left is a hallway that leads to the classroom and the counseling room, which is where I spend most of my time. To the opposite side there are doctor’s offices and examination rooms. Finally, outside, you’ll find where the unofficial TB clinic makes its home, in a trailer. There is a wooden shack next to it that was constructed solely for the collection of sputum samples. A nurse wears a mask and accompanies the patients into the shack to show them how to induce the sputum for testing. With doctors and pharmacists, counselors and patients, and above all, children, you can begin to imagine the constant bustle that pushes you through the workday.

And Hannan Crusade is not a free-standing establishment. It shares a plaza (I can’t think of anything better to call it) with the Green Clinic, from which most of Hannan Crusade’s patients are collected. The Crusade does not actually do any HIV testing; that is done across the way at the Green Clinic. Once a person has tested positive, he/she is referred to the Crusade for counseling and treatment. Now that Dr. Dave is conducting the TB study, patients are also referred to him if they present with symptoms of TB, though there is an official TB clinic somewhere in the area where most people receive treatment. Actually, any patient who is HIV positive and has yet to begin ART can participate in David’s study, because he is also interested in uncovering the incidence rates of TB in the patients he sees, rather than only examining those who show up with classic symptoms. At the Hannan Crusade I have only seen one masked patient with TB, but I am still hoping to get to visit the official TB clinic with David at some point to get a better picture of how this disease is really affecting the Guguletu community.

I was about to refrain myself, but I think I should actually include a tangent about Guguletu to give you a little background of its history. Guguletu, or Gugs, is one of four black townships created throughout the 20^th century by the Apartheid government to cleanse the city bowl of “impure” races. Langa was the first township constructed, I believe in the 1920’s or 30’s. Then there is also Nyanga, Gugs and Khayalitsha (I think I just slaughtered that spelling). So for an entire race to be removed froma city and forced into 4 townships, you can imagine these townships would have to either be extremely large or extremely overcrowded. If you guessed the latter, you would be correct. In actuality, the townships are indeed very large, but not when you consider populations of hundreds of thousands, and even to millions of people who reside there. Knowing all of this, I hope you can better appreciate the strain on this clinic and the sheer exhaustion of staff and resources that must be combated. I do not even think that I, after working there, have fully realized the organizational nightmares that this Crusade has overcome in order to function in a community so under-served.

But organization could certainly be improved, and this segways nicely into the amusing woman-hunt that is my job. Now that I am no longer really assisting David with his study, I spend most of my time tracking down women who are currently or have been patients at the clinic. I work with Nokwayiyo, one of the Sizophila counselors, to collect the names and numbers of these women in order to interview them about HIV and pregnancy. Nokwayiyo is incredible. I think back to my few days with Nosee in September and I thank Heaven that I am now working with Nokwayiyo. When first assigned to this research project, I was apprehensive about how I could step into it without stepping on Nokwayiyo. A few months ago there was an American med student working on the study, but since he left Nokwayiyo has been saddled with the work. For a counselor who already has between 50-100 patients for whom she is responsible, this study can be nothing more to her than an afterthought that she can work on in her downtime, if she even has any at all. Thus far, she has simply looked at the list of patients each morning to see if any of them also appear on her list of women whom she needs to interview. If luck strikes, she interviews 2 or 3 women a day. At this snails pace, the study could be done in a few years. So here I was, feeling more bashful than usual, approaching Nokwayiyo and offering my labor. Fortunately, she was thrilled to have an extra set of hands and she welcomed me warmly. We decided together that it would be more efficient for her to try and call these women and conduct interviews over the phone. Since most of these interviews take place in Xhosa, my ability to be of any use in the actual data collection was immediately eliminated. But boy can I be useful in tearing through a room of files, hunting down names and numbers. With no computer access and not even a desk to sit at, I started drawing my own spread sheets of names and numbers, alternative numbers if friends or family members are disclosed of the patients status, and ages if no numbers are available so that we can just rule out the 60-year-olds all together in considering recent pregnancies. All the years of practicing my awful handwriting have really paid off in this area. I seem to have mastered the art of making charts that could be trumped by a 2-year-old, and one might even say they were on Wednesday. But I will come back to that.

Things started to work like clockwork; I’d come in the morning and assume my position on the floor with the files, passing off sheets to Nokwayiyo as I finished for her to make the calls. We’ve already interviewed 10 times the number of women last week than she would normally have been able to reach. The only real obstacle is finding all of the files. Obviously there are going to be women with no contact information, though most have been able to at least list a neighbor or a friend if they do not have their own phone. But after finishing the entire room of cabinets on Wednesday, I looked back to see that not even half of our list was found inside these drawers. The rest of the files will be found (hopefully) in the green clinic, but I suspect that many of them will never be found at all. It’s frustrations like these that make me appreciate computers.

Anyway, once we have found all the numbers and made all the calls, we will analyze the data to see what therapies are most effective for pregnant women. We will unite our data with the data of the South African Department of Public Health to publish a study, hopefully all by the time I leave in December. I just look forward to the interviews that will take place in the clinic, because Nokwayiyo has such an authority when she speaks, such a convincing presence, and I am anxious to hear the translations of what she is saying in these women. I’ve watched her at work in her counseling; I’ve listened as her voice rises to stifle the tears of a newly diagnosed patient. I’ve studied how her body language adapts to the person in front of her; whether a mother needs comforting or a young man needs his pride restored, she can find the right demeanor in a heartbeat.

I guess it has been studying Nokwayiyo that has finally inspired a feasible topic for my research paper this semester. I can no longer do a study on the vaccine trials, partly because I am no longer at the trial center, but mainly because the Merck vaccine that the DTHF was testing has just been proven ineffective and pulled from trials all together. Additionally, I am finally resigning myself to the restrictions placed on my research by the confidentiality agreements I must uphold. I will not be able to center my paper on patient studies because I would have to first be approved by the IRB. So, Nokwayiyo is who I want to study. I again have to apologize if I am repeating myself from my last post, but you should all be used to me repeating myself by now. I don’t know if I already wrote much about the Sizophila counselors, so I am going to write about them again. Sizophila means “We Will Survive” in Xhosa. It is the mantra of these counselors as they carry patients through the stage of acceptance and then through a month of education and preparation for treatment, and finally through anti-retroviral therapy itself. All of these counselors exude pride and emanate human beauty. At some point, some of them were on their last legs, but due to ART, they look no different than any other South African you may encounter. A few of them, like Nokwayiyo, do have lesions and rashes that may tip off their positive status, but somehow it makes no difference because their confidence conceals their illness. In fact, their frailty seems appreciated by the patients who can see that despite their illness, they are still thriving. I love that I can sit in their workroom as I gather up numbers because I feel I am getting to know their personalities as I watch them counsel their patients. I’ve even sat in on a weekly review meeting, in which one of the counselors was discussing the dilemma of how to get medication to an HIV-positive child whose parents were gone. The child lives with her grandmother, who is too weak to make the monthly journey to the clinic to pick up her grandchild’s meds. This counselor had visited the woman’s home, counseled her on the importance of the medication, and tried to find a neighbor or friend who could bring the child to the clinic. Until the issue is sorted out, the counselor herself will continue to make the journey to supply the child with her medication. Somehow I suspect that this is not a unique occurrence, and somehow I doubt that these counselors are just going home after work. It seems their work continues around the clock, as they are living in and caring for the same community. There are no hour-long commutes to a hospital or clinic in another town like we would see in the States. These women are caring for their neighbors, their fellow community members, and, in this way, they are also contesting stigma and encouraging acceptance of those who are HIV positive.

Enough about my research paper. That’s boring. I want to write about my favorite pastime at Hannan Crusade – the kids. Since Wednesday was pediatric day at the clinic, the entire education room was transformed into a playground. I kept sneaking away from my files to teach the girls paddy-cake or chase the boys around the room. Most of the kids were too young to have yet picked up any English, so our only verbal communication was through laughter. It made me miss St. Lucia so much. And it made me realize just how unexpectedly you can be hit with your own unfair perceptions of poverty. I would usually make the argument that the kids in Tanzania have far less than any of the children I’ve met in South Africa. There are fewer resources, less education, and there is certainly less medication available in TZ. I know that that is an ignorant and over-generalized statement, but it is one I would still go with if asked, “who has more?” But playing with these Xhosa-speaking children reminded me that I am STILL defining poverty by my own Western indicators. Subconsciously, I was thinking that these kids had less because they knew no English. The kids at St. Lucia are surrounded by so many English-speaking volunteers that even the littlest ones, the Three Musketeers (as my Mom and I like to call them) can understand a few basic conversational phrases. I was still translating English into wealth, and wealth into wellbeing. But if I were at home, I would probably choose the kid with the loving family over the kid with the trust fund as the one who had it best. I don’t know if this is because it is so incriminating of our fixation with money that dissuades me from making the “shallow” choice, or if it is because in America, even if you do not have money, you stand a better chance of finding yourself in some form of safety net than you would in South Africa or Tanzania, or any other nation with a lesser developed infrastructure for essentials such as health and education. If the Xhosa-speaking children were still fortunate enough to have their parents, while the St. Lucia children are all orphans, than by the same indicators one should find that the South African kids as better off. I know that I am just thinking on paper right now and that none of this is worth your time, but I just have to remind myself of my own double-standards sometimes so that I do not define problems of poverty by American ideals such as lack of English literacy. I also need not even answer the question of “who has more,” because I am not now, and will never be, in the position to have the correct answer. My values have been shaped by my home, my comforts and my perceived needs. The children at St. Lucia do not want for food, but, as Cecilia reminded me, they certainly do want for mothers and for love. As for the kids who come with their mothers to Hannan Crusade, who am I to know what they want or need? Who am I to judge that because they are not learning English, they are not receiving an education? I have to keep asking myself these questions so as to avoid addressing problems as I perceive them and to continue to concentrate my efforts on the obstacles for which the community asks my help. And I have to remember that my limited knowledge of the world outside the US is not always sufficient for comparison. There are endless factors, such as political climates, to name just one, that impact quality of life for a child in any country. I cannot draw up lists of pros and cons, and I cannot try to form linear relationships between countries in which I have only been a guest for short periods of time. It’s kind of like that saying that the older you get, the more you realize how little you know. Well, the more I travel, the more I realize my own biases and preoccupations, and the more I surrender to my ignorance and strive to free my mind from its trained patterns of thought.

Wasn’t I supposed to be talking about kids? Right. Back to that. I think I’ve completely forgotten how to paragraph or use grammar (not that I ever knew grammar). I don’t know how any of you are still reading this. If I weren’t so lazy I’d go back and edit, but sorry, no time. I believe that some pages back I mentioned that my handwriting was trumped by a toddler. This particular toddler and her mother were actually the catalyst that sparked my interest in writing my paper on the Sizophila counselors. It was mid-morning on Wednesday, and I was hidden behind a mountain of file folders on the floor in the counseling room. In walked a mother of about 30, two-year-old daughter in tow. At first I did rather well, I kept to my work and did my best to ignore the adorable little girl that was now stalking me from behind. But inevitably she won my attention. She began nuzzling her head into my side to get my attention and imitating my motions as I tore through files. I surrendered to her and we started making faces at each other, each taking turns puffing up our cheeks with air and squeezing the air out of the other’s cheeks with our fingertips. She loved to make the Xhosa clicks, and she loved even more to laugh at my attempts to copy her. After some time, I felt a little guilty though and thought that I should get back to work. I discovered an empty chair and snagged it to get to work on an actual counter, from which the adorable two-year-old would be out of view, and thus, out of temptation. However, my little friend then countered my discovery with one of her own – my chair had wheels. Just as I set my pen to paper, I was whisked back and away by this toddler, now roaring with laughter at her ability to maneuver me around the room (I have to admit, I helped a little with my feet, can you blame me?). At this point, we were just obtrusive. Counselors were all around, files were sprawled across the floor, and I was just bumping into and irritating people left and right for the amusement of a little girl. I finally learned some respect and scooped up the child into my lap, fed her a pen and paper, and let her color along side of me as I did my work. She tried to chart lines as I made my tables, and had she been writing numbers too, I can guarantee that Nokwayiyo would have had a better time reading hers than mine. It was not a rare occurrence that Nokwayiyo would struggle to decipher a nine from a four, and if I had written a name that I could not even pronounce, then you could be sure the spelling was probably off. I seriously considered taking on this two-year-old as my scribe for the rest of the study.

After all of these games and distractions, I finally started to realize that it had been a long time since this child and her mother had entered the room. A normal counseling session didn’t run this long. I looked over at the mother to find that she was crying, and all of a sudden I was awakened from the infantile mental state in which I often reside and thrown back into the reality of the HIV clinic in which I was presently located. I looked back to the little girl, not knowing whether the mother was here for her own health, or, since it was pediatric day, if she was here for her daughter. And in all likelihood, she could have been there for both. I don’t know whether this mother was afraid for her life, afraid for her child, embarrassed, ashamed or simply just overwhelmed, but whatever she was feeling at that moment, it was worlds away from where I had just been with her daughter. I started paying more attention as the counselor assigned to her listened and responded to the mother’s concerns. Soon I saw Nokwayiyo, my own mentor, leaving (regrettable, I’m sure) her own disheveled pile of phone numbers to stand by a mother in need. Before I knew it, four counselors had surrounded the woman and four voices were affirming her feelings and dismantling her fears. Voices were rising as you would hear in a church, and the passion radiating from the counselors was tangible even to the non-Xhosa-speaking audience, namely, me. I turned my attention again to the little girl (because she was again trying to drive me around the room in my chair), and I sat her down on my lap to draw a picture for her mom. As she drew, I thought about the many years in school in which I had been given the opportunity to make various arts and crafts for my own mother and I wondered whether this little girl would be afforded the same opportunity. Not only may she not even be able to attend a school with art supplies, but she may not have a mother for whom she could draw a picture at all. Suddenly her happiness seemed so fragile and finite. Suddenly I felt heavier as she pushed me around the room. And suddenly I wanted, more than anything, to just be left alone to cry.

This moment reminded me of the loss of so many children across the world, of the loss of the kids at St. Lucia, who, because I never knew their mothers, I often forget have suffered such a deep loss at all. I watched the young mother walk out with her daughter, face still splotchy, but head high and eyes dry (two-year-old still clicking her tongue all the way), and I hoped that that little girl would be able to draw her mother pictures for years to come. I looked back at the room I was left in and felt an intense rush of pride to be able to work alongside these women. The Sizophila counselors had picked up a mother in despair and turned her away with confidence. I can never know the full impact they have had on that mother, on her readiness to take her medication, and ultimately, on her ability to survive, but I can imagine that without that humanitarian link, of HIV positive person-to-HIV positive person, one might feel a lot more alone. If the Doctor had been the only available resource for this mother to air her concerns, would she have been comfortable asking the difficult questions? Would she have left feeling more isolated and ill than united and empowered to impact her own health? I immediately knew that these counselors would be the focus of my paper, if only for the excuse to interview them and get to know them more intimately as local heroes and community leaders. Maybe I’ll even get to see one of their follow-up visits with the mother I saw that day, and maybe I’ll get to know what it was they said to her that got her on her feet again. And maybe I’ll get to step back into childhood once more with her daughter.

It’s movie time, ladies and gents. I guess I’ll post this when I’m on campus on Friday. Hopefully I’ll get to write more soon.