Ebb and Flow

I walked into a house where a young woman named Philiswag sat on a couch. She looked weak and wore a hat, even though the sun was scorching outside. “Moloweni!” she greeted us with a bright smile. She was very thin, but her stomach was distended and her left ankle was swollen—symptoms of an HIV infection. From her purse, she withdrew her ARVs and other pills and set them on the table to show us. She has to take them all at scheduled times throughout each and every day. If she misses a dose, everything could go wrong.

On Monday, our South Africa routine began.

In the morning, work starts when our taxi driver, Percy, drops us off at the medical clinic in Kwanokuthula at 8 o’ clock. We then set out on foot for the next five hours as we follow Priscilla from house to house for her patient check ups. Arriving at each house, we’re greeted with smiles and cries of “Moloweni!” (which is hello in Xhosa.) We visit patients with varying degrees of illness and living conditions. About half of our patients are HIV positive; of those, many have Tuberculosis additionally. Philiswag was the first patient I saw. She was also the first person that I think I’ve ever been face-to-face with who has had HIV. Maybe I’ve been sheltered, but HIV and AIDS have just never been real-life issues in and around my community and life at home. But sitting feet away from Philiswag as she held her ARVs provided a jolt of reality for me. Everything I’ve learned, heard, read, and watched about HIV/AIDS crashed down on me with full force. Seeing the epidemic in person really illuminated the immensity of the issue and true necessity for a solution. We’ve seen patients with other ailments as well. I was surprised to note that, after HIV, the second-most prevalent condition afflicting the patients I’ve seen is diabetes. The case of one man sticks out to me most poignantly. We entered his room to find him sitting with his legs in a bucket of water. Withdrawing them allowed us to see the raw sores running up the sides of his calves and ankles. We wrapped the sores with wet gauze and a cloth bandage, but that’s just a temporary fix. If these sores get worse, he could lose the ability to walk. If they get too bad, he might have to have his legs amputated. We’ve seen other patients with arthritis, high blood pressure, and strokes, too. Priscilla is teaching us to take insulin finger sticks and use the blood pressure monitor in a very “learn-by-doing” way, meaning that she hands us the tools and tells us to use them on the patient. Lauren and I were both confused and lost at first, but we’ve got it down now.

On our walks between houses, we have time to talk with and get to know Priscilla. Home caregivers like her spend their whole days—rain or shine-- walking from house to house. Since they don’t have scheduled visit time, sometimes patients won’t even be home. So they continue walking to the next house and check back later. I just want to buy all of the caregivers bikes. Sometimes Priscilla will take us to one of her friends’ houses for tea or juice or for her to get some lunch. And at one, Percy picks us up and drops us back in Plett. But Priscilla keeps doing her rounds until four.

After lunchtime, we head down to the beach for seminars. Yes, our seminar room is above a restaurant that is right on the sand. We hear the waves crashing and can watch the lifesaving team (there are like 100 little kids in speedos that are on some sort of lifeguard training team that come to the beach for hours every single day.)

While our days are filled with some pretty heavy stuff in the townships, things lighten up back in Plett. On Thursday, I met the local running club for their weekly time trial. It was neat to see so many people of all ages. I had a good time, but was not expecting for it to actually be a time trial with timing and everything! I also went bungee jumping! I conquered the Bloukrans bridge, which at 216 meters, is the highest point you can bungee jump from in the world! It was awesome. And there’s more: a chartered catamaran sail around the bay. We even got to see a pod of dolphins and TONS of seals. Bruce cooked us our first braai, a South African barbecue, too.

Don’t be too jealous, though. Unfortunately, all of our activities in the sun have given me some pretty funky tanlines…. :)