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Letter from Gonubie

July 13, 2008

It is hard to believe that I am in my fifth week of working and living in South Africa.  I am doing really well in acclimating to new work, new home, and new challenges.

I moved into a small place in a seaside town called Gonubie, just outside of East London.  It is a magical home; I open my curtains each morning to a breathtaking sunrise over the Indian Ocean, and an equally awesome sunset over the Gonubie River when I return at dusk.  In the night, the sky is so clear that millions of stars are above me on the small porch where I stand, as well as the growing moon.  I  smile and laugh each day that I am so fortunate to live for a moment in a land of such beauty;  even though it is winter, the land on the hills before me is a deep green, with dots of purples and oranges and reds from flowers and bushes.  Birds of all kinds provide the only noise that I awake to.  I have found a small haven of peace and nourishment for my body and soul, now decorated with my shawls, jewelry, candles and flowers.

And this Gonubie home is a much needed balance for what awaits me each day as I navigate my way to Cecilia Makawane Hospital or Frere Hospital, or the many clinics (like Needs Camp Clinic and Chris Hani Clinic).  Lines and lines of women with their babies tied onto their backs wait outside the clinics, all of which are clean though sparse.  Children’s bodies reflect the scourge of infections and often minimal access to clean water and good nutrition.  Walking down the outdoor corridors of the major hospital I constantly need to step to the brick walls to make way for gurneys carrying those who have just died.  And everywhere there is a desperate shortage of adequate staffing, especially nurses who are the backbone of this healthcare system.  Yet within this challenging context everyone I meet is friendly, dedicated, trying very hard to stretch and creatively provide services that would daunt any healthcare system globally.  At one clinic a pregnant woman had just entered and asked for the toilet.  A wise midwife took a moment to investigate and then minutes later a beautiful new baby had been born.  I got to hold the little girl for a while as the mother regrouped and proudly smiled at all of us!

I have my time divided between the two women who are provincial managers for mothers2mothers from Tuesday through Thursday.  Each one of them has deep roots in the communities she serves, and great respect and care for the mentor mothers that she trains, guides, and counsels.  We have visited about 20 sites, talking about the project I am involved in, asking and listening to what nurses and women articulate as their needs.  Each meeting that I get to attend with the mentor mothers and their support groups, or listening to one as she stands in an antenatal clinic and talks to women about the urgent need to test for HIV and disclose the status, I am in awe of the depth of their commitment and bravery.  It is a challenge for anyone who tests positive for HIV to disclose to one person in her family, for fear of stigma, abandonment, isolation.  To watch these mentor mothers stand before a crowded clinic and introduce themselves as a new mother who is HIV positive gives new definition to what courage involves.  I tell them so as often as I can, many times in one day.  It is perhaps a key to open a very jammed societal door.

On my first day driving alone to a distant hospital (my team is very cautious about letting me out of their sight), I received a call from my director in Capetown.  So I pulled to the side of the road and talked for about twenty minutes.  When I finally got to the hospital, quite past the expected time, both women I work with were nearly hysterical that something had happened to me and what would they tell Capetown!  So now I have to text message them when I am coming and going.  One day this week the mentor mothers served me a lunch of umvubo, thrilled that it was a ‘vegetarian dish.’  It is made of mealie meal (a staple from corn) and mixed with soured milk, called locally an ‘African salad’ because it is eaten room temperature.  Everyone watched with great amusement as I made my way through the bowl — it tasted quite fine, though the curdled milk was a bit of a challenge.

The bright spots on the news are the constant blurbs about preparations for Mandela’s 90th birthday, July 18th.  Recorded statements from all sectors of this society are repeated over and over — it is joyful and tearful at the same time.  One person’s message was that if the world could choose one person to be its father, it would be Nelson Mandela.

Other news continues to be worrisome.  On this past Wednesday there was a national strike against buying food or petrol for the day to protest the escalating prices.  Conditions at the refugee camps for survivors of the xenophobic attacks continue to be dire.  Steps are being taken towards legal action against the provincial governments in Gauteng and Western Cape.  In Soetwater (in Capetown), all 900 refugees refused to eat their main daily meal because they believed the food was rotten.  The government has declared July 23 to be the deadline for the closure of all camps, though where everyone will be forced to go remains unclear.  The Joint Refugee Leadership Committee (JRLC) of Western Cape, representing refugees from eight camps, issues a statement that said, in part:

“Since the day we arrived in South Africa we have endured the hatred of South Africans for their black brothers and sister from across Africa.  In May we lost our homes, our possessions, our businesses and our faith in our neighbourhoods.  We lost hope.  We don’t want to lose our lives. . . .  We have lost everything that we own, but more importantly, we’ve lost the love and friendship of the South Africans here.”

Some advocate for resettlement to a third country (not one of origin).  On Zimbabwe, the South African government continues to argue that the mediation process should be given time and space to continue, and that targeted sanctions will not help this process.  A despairing time.

The Sunday Times here has launched a campaign with Discovery Health called the Right to Know competition.  For the next year, one person every month will win R100,000 (about $14,000) from a lottery; to enter the person has to take an HIV test with counseling and collect his/her results.  The ‘incentive’ is to get everyone to know their status on a mass level and an effort to change lifestyles by breaking the barrier of silence.

Two books that are important reads for understanding the complexity of the HIV pandemic: Jonny Steinberg’s Sizwe’s Test and Nicole Itano’s No Place Left to Bury the Dead.

I will close and go for a walk to the ocean.  I have found a yoga class for Thursday nights, and even treated myself to an amazing Indian oil head massage last Friday.

I love hearing back from people; there is an enormous amount of time to myself, which I am embracing.  It is a great balance to get news from you and keeps me current.

My best,

Jennifer


Jennifer Dohrn, CNM, is Director of Midwifery Services at the Childbearing Center of Morris Heights, the Bronx, New York, the first birthing center in the United States to serve inner-city women of diverse backgrounds.  Jennifer also directs the midwifery education program at Columbia University School of Nursing.  She has been working in South Africa to expand health care in pregnancy, birthing and postpartum in the context of an AIDS health care crisis of epidemic proportions. 



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