I don’t know how much news coverage this is getting stateside, but this week municipal workers all across South Africa have been holding demonstrations and organizing strikes. Things in Cape Town are much less intense than other cities, and it hasn’t been very disruptive yet (in terms of our daily routines, we’ve only faced general precautions about staying out of the city center at certain hours of the day). I think things are more tense in a some of the township areas. Yesterday it was sort of interesting to hear people shouting and marching on the street outside our office and see police crowded on every street corner, and leaving work there was a big crowd of workers on the street hanging about with signs and sticks (the signless sticks were a bit disconcerting, but people weren’t paying the least bit of attention to us and it didn’t feel threatning in any way). Unfortunately in some scenarios the strikers aren’t acting very intelligently - dumping over trash cans and throwing garbage on people, destroying property, etc. is not the best way to get the public on your side.
I actually think it’s very good that people are starting to try and hold Zuma and the ANC accountable for change, as opposed to placidly standing by as elected officials make all these promises and then in the end just buy themselves new cars. Of course politics here are complicated by the fact that it is basically a one party system with everyone feeling they have to vote for the ANC for various reasons, not least of which revolves around them having been the liberating party. I read some depressing statistics in the Cape Times yesterday: 25% of Cape Town residents live in informal settlements, 22% are unemployed, and 15% are HIV positive. The weird thing is that you can still live in this city without ever knowing that – if you have money, isolating yourself in a comfortable bubble is more than feasible.
The most frustrating thing about all of this is that it is unbearably hard to find good news coverage on these issues – South African newspapers are consistently about a day behind, stories are never in depth, and our TV news mostly comes out of Joburg so you never know what applies to Cape Town. So if anyone in the U.S. knows more than I do, let me know...
Thursday, July 30, 2009
Tuesday, July 28, 2009
Driving and whatnot
Unfortunately, to get around Cape Town you need a car (minibuses and trains are only safe during daylight hours). Even more unfortunately for us: a) our car is stick shift, b) none of us know how to drive stick, c) Cape Town is akin to San Francisco in terms of having unimaginably steep hills which are no friend to the novel stick shift driver, d) we must remember to drive on the left side of the road, and e) Cape Town drivers are crazy. All of the above combined obviously make an interesting driving experience for us. Still, we are determined to learn (though not surprisingly, others are braver than I am at the moment). Byron has been an absolute trooper and has seemingly mastered manual shifting relatively well. Yes, we pull out of half of all stops with screeching tires, but it’s better than nothing having a car sit in our lot with no one driving it. With Wenli and I in the car to serve as annoying reminders for making sure we are in fact driving on the left side of the road and that we don’t actually drive too far on the left side of the road and take out everyone’s mirrors (its startlingly harder than you might think to get a feel for having a large part of the car be to the left of the wheel as opposed to the right), we make an okay team. Thank you, Byron, for being brave enough to drive and for putting up with our running commentary! Sunday Byron even drove us all the way from our house to downtown to meet a few Princeton in Africa alumni for lunch. It actually went very well, until we realized the road we were going up was very, very, very steep, at which point we decided to just keep driving past our restaurant until we could turn around so we could park going down hill. Someone told us to be sure and park with our wheels turned into the curb if we’re facing downhill, but we didn’t exactly have to worry about that because we pretty much parked on the curb (again, adjusting to spacing with the wheel on the left side of the car is way harder than it seems!). All in all, we survived. Wenli has since advanced to driving around our neighborhood and has even gotten up to 4th gear once. I, on the other hand, am really struggling. I’ve just been practicing getting into 1st smoothly in empty parking lots, and it hasn’t been going so well. Either the car does this horrible lurching/earthquaky thing or the tires squeal as we jolt to a start...and I’m not quite sure how to find a nice in between balance. Very frustrating. However, I did manage to drive the car from the parking lot back to our house (about 2 blocks) and park, which involved going to into reverse, so I think I’m getting braver. It’s the little victories that count.
What else is new...well, last Saturday Wenli, Julia, and I found a lovely little Saturday market to explore and eat our way through. The market was housed in an old biscuit factory in an up and coming neighborhood of Cape Town, with lots of little artsy shops and surrounding open air (but tent-covered) clothing booths and food galleries . The food booths ranged from Greek to French to Mexican to Indian to Thai, etc. and there were also lots of baked goods and specialty items to choose from. It was really nice to spend the morning there, but every time I go to something like that in Cape Town I can’t help but notice how everyone is white and trendy/well-off. Though the city is large, certain circles (i.e. wealthy, predominantly white ones) are not...we ran into people from work and Wenli’s friend at the market, and we constantly run into Byron’s friends all over the city, making for an odd small town feel. Today, however, I went into the absolutely packed Shoprite grocery store near the train station with Byron (and I think Shoprite is a cheaper grocery chain) and I was definitely the only white person in the entire store. In many ways this is still a very segregated society, in some sense of the word.
Last night I was able to connect with one of Alysha and Sepp’s friends, Alexia. She was incredibly kind to take me out to dinner. We managed to catch the sunset as we walked along the beach of Camp’s Bay (see pictures above) before having dinner in one of the restaurants on the beach. Camp’s Bay is so unbelievably beautiful! Of course it’s a very upscale neighborhood and I could never afford to rent there, or even go out to eat there that often, but it’s worth it every once in a while. Somehow in the middle of “winter,” we enjoyed an evening on the beach with very mild temperatures and warm breezes, and we were able to eat outside and I wasn’t even cold (no small thing, obviously)! Though the evening was truly wonderful, Alexia and I couldn’t help but discuss how Cape Town is such a land of contrast. It just isn’t possible to be driving through neighborhoods with multi-multi-million dollar homes without thinking of how so many others live in cramped, dirt floor, makeshift houses just down the road. The constant confrontation of wealth and poverty can be somewhat wearing. I don’t mean to sound entirely negative though – this place is very full of life and provides a very dynamic and enjoyable cultural experience, and I’m certainly happy to be here.
Sunday, July 26, 2009
IAS and Site Visit
Last week was a very busy week for the m2m office given the International AIDS Society meeting was taking place, with over 5,000 international AIDS researchers descending on the city. On top of sending people to the meeting to learn more about the latest on PMTCT research, the meeting also meant the office had a lot of networking and PR development to take advantage of while the spotlight was on Cape Town.
Wednesday morning I had the opportunity to tag along as m2m organized a site visit for around 15-20 international journalists. These particular journalists were mostly from other countries all over the African continent, and a few were from Europe and Pakistan. We took a bus out to a clinics in Khayelitsha, one of the largest townships outside of Cape Town. Townships are essentially slums where many (in this case roughly one million) black people live in informal settlements. As far as the eye can see, makeshift houses comprised of corrugated metal, boards, plastic sheeting, and cardboard are crowded against one another. In some areas there are government housing projects with real structures built, but in the backyard of almost every real house you still see makeshift shacks, as people can make some extra money by renting out their yards. Somewhere in the midst of this, we pulled up to a government run maternity clinic. It felt strange to step off a bus that was probably 4 times as big as many of the makeshift houses we drove past and parade into the clinic to “see how the other half lives,” but it at least made me feel better to realize these reporters were here to tell the important story of real women’s lives and m2m’s work.
Inside, we met with two mentor mothers and a few of their clients. One mentor mother and all of the clients spoke only Xhosa, so a few Xhosa women from the office had come along to translate. Needless to say, these women who were brave enough to stand in front of 20 intimidating outsiders and tell their stories demanded much admiration. The journalists asked numerous questions. Sometimes I felt uncomfortable with their probing nature, but I suppose that’s what they’re trained to do. I couldn’t help thinking that publicity of this nature is an incredibly fine line for an organization like m2m to walk – while they of course want to expose their work and demonstrate their success to outsiders, it’s hard not to do that without making spectacles of their clients, to some degree. Some women had been living with the virus for many years, some had just recently been diagnosed, some felt they could tell their families, some did not, some had successfully completed the program and had HIV- children, others were less fortunate.
(FYI, even if a mother follows all of the current recommendations for PMTCT there is still a 1 in 20 chance that her child will be HIV+. PMTCT involves taking ARVs (anti-retrovirals) while pregnant, taking extra ARVs during birth, continuing to take ARVs after birth and making sure the baby is on ARVs for a certain number of days after birth, and exclusively breastfeeding. While breast milk can contain the virus, studies have found that in developing countries babies are actually more at risk of becoming sick and dying when they are formula fed because many places aren’t equipped for mothers to have sterile bottles and the babies miss out on acquiring a number of important nutrients from breast milk when access to formula is pricey and inconsistent (resulting in fewer feedings). The worst scenario is when babies are mix fed because the formula is harder on their stomachs, so when they are exposed to breast milk which contains virus, the virus is more likely to gain access to the bloodstream as the stomach lining is compromised. In short, it’s often better to risk contracting the virus from breast milk than to risk getting sick from the lack of nutrients and exposure to germs that occurs with formula feeding in developing areas.)
Most of all, I just kept thinking about how hopeless I would feel in their situation, but when I saw these women standing in front of us speaking of how they wanted to live for their children, I was very moved by their strength. One of the mentor mothers told of how she participated in the m2m program a few years ago when she found out she was HIV+, and how she worked hard to follow all of the procedures to ensure her baby was HIV negative, only to come through it all with her baby testing HIV+. All that was running through my head was despair, but this mother went on to describe how her child has been on ARVs since then and is living a good life, and how with her next child she went back to m2m and he was HIV-, and then she went on to become a mentor mother herself. She was so upbeat about everything and so happy to talk to everyone about her story, it was a good reminder for me to get out of the mindset of everything involving HIV encompass absolute misery. That’s not fair to these women, I realized. At some point, you have to recognize their lives are still meaningful and focus on the positive strives that have been made instead of just writing them off. When we were back on the bus, a number of reporters commented on how the site visit had been the most interesting and inspiring part of their entire experience with the conference.
Whew, I’m actually feeling really frustrated right now as I’m really having trouble finding ways to express how I felt and describe what I saw in the townships, so I suppose these issues will have to wait for some other time…
Wednesday afternoon I was fortunate enough to be given one of the office passes to the IAS conference (registration for the meeting was 400 Euro, so the m2m didn’t have that many passes for everyone to share). It was really eye-opening to be there, even if only for an afternoon. I was amazed at how fancy and large the Cape Town Convention Center was, but I suppose it’s probably the best convention center on the entire continent. I haven’t been to that many scientific conferences for comparison, but this one felt absolutely huge. After listening to a number of talks and browsing through posters for the afternoon, I felt very grateful to have had that kind of exposure to the international AIDS research community – and it definitely made me more even more excited to be heading (eventually) into a research career. A number of pharmaceutical and biotech companies were there too, and their displays also amazed me – enormous flat screen TVs hanging from the ceiling, espresso stations, safari tents – definitely the most extravagant product show I’ve ever seen!
In the evening after the conference wrapped up, Byron, Wenli, Julia, and I found ourselves at a really nice gathering put on by Dr. van der Horst and other UNC researchers who had attended the conference. Once again, the restaurant was very fancy, the food was very delicious, and we were all very grateful for Dr. van der Horst’s kind invitation. We had a lovely time at the dinner, and I had the opportunity to meet a few UNC faculty and students. Witnessing first hand UNC’s relatively large presence at the conference and getting to talk to a few faculty members made me really happy about what I’ll be embarking on next year.
Seeing such contrast throughout the day, it made me think a lot about how money is spent – from pharmaceuticals putting on over-the-top three-day displays halfway across the world to researchers spending thousands of dollars to convene in a pristine, upscale convention center and brush shoulders at a posh restaurants – is that fair to the women I met that very same morning, the women this work is arguably for? Of course I don’t mean to imply that I don’t admire what these researchers have devoted themselves to, and I certainly have no easy answers for how the world should run. Anyway, apologies for rambling…but all in all in all, a very interesting day!
Wednesday morning I had the opportunity to tag along as m2m organized a site visit for around 15-20 international journalists. These particular journalists were mostly from other countries all over the African continent, and a few were from Europe and Pakistan. We took a bus out to a clinics in Khayelitsha, one of the largest townships outside of Cape Town. Townships are essentially slums where many (in this case roughly one million) black people live in informal settlements. As far as the eye can see, makeshift houses comprised of corrugated metal, boards, plastic sheeting, and cardboard are crowded against one another. In some areas there are government housing projects with real structures built, but in the backyard of almost every real house you still see makeshift shacks, as people can make some extra money by renting out their yards. Somewhere in the midst of this, we pulled up to a government run maternity clinic. It felt strange to step off a bus that was probably 4 times as big as many of the makeshift houses we drove past and parade into the clinic to “see how the other half lives,” but it at least made me feel better to realize these reporters were here to tell the important story of real women’s lives and m2m’s work.
Inside, we met with two mentor mothers and a few of their clients. One mentor mother and all of the clients spoke only Xhosa, so a few Xhosa women from the office had come along to translate. Needless to say, these women who were brave enough to stand in front of 20 intimidating outsiders and tell their stories demanded much admiration. The journalists asked numerous questions. Sometimes I felt uncomfortable with their probing nature, but I suppose that’s what they’re trained to do. I couldn’t help thinking that publicity of this nature is an incredibly fine line for an organization like m2m to walk – while they of course want to expose their work and demonstrate their success to outsiders, it’s hard not to do that without making spectacles of their clients, to some degree. Some women had been living with the virus for many years, some had just recently been diagnosed, some felt they could tell their families, some did not, some had successfully completed the program and had HIV- children, others were less fortunate.
(FYI, even if a mother follows all of the current recommendations for PMTCT there is still a 1 in 20 chance that her child will be HIV+. PMTCT involves taking ARVs (anti-retrovirals) while pregnant, taking extra ARVs during birth, continuing to take ARVs after birth and making sure the baby is on ARVs for a certain number of days after birth, and exclusively breastfeeding. While breast milk can contain the virus, studies have found that in developing countries babies are actually more at risk of becoming sick and dying when they are formula fed because many places aren’t equipped for mothers to have sterile bottles and the babies miss out on acquiring a number of important nutrients from breast milk when access to formula is pricey and inconsistent (resulting in fewer feedings). The worst scenario is when babies are mix fed because the formula is harder on their stomachs, so when they are exposed to breast milk which contains virus, the virus is more likely to gain access to the bloodstream as the stomach lining is compromised. In short, it’s often better to risk contracting the virus from breast milk than to risk getting sick from the lack of nutrients and exposure to germs that occurs with formula feeding in developing areas.)
Most of all, I just kept thinking about how hopeless I would feel in their situation, but when I saw these women standing in front of us speaking of how they wanted to live for their children, I was very moved by their strength. One of the mentor mothers told of how she participated in the m2m program a few years ago when she found out she was HIV+, and how she worked hard to follow all of the procedures to ensure her baby was HIV negative, only to come through it all with her baby testing HIV+. All that was running through my head was despair, but this mother went on to describe how her child has been on ARVs since then and is living a good life, and how with her next child she went back to m2m and he was HIV-, and then she went on to become a mentor mother herself. She was so upbeat about everything and so happy to talk to everyone about her story, it was a good reminder for me to get out of the mindset of everything involving HIV encompass absolute misery. That’s not fair to these women, I realized. At some point, you have to recognize their lives are still meaningful and focus on the positive strives that have been made instead of just writing them off. When we were back on the bus, a number of reporters commented on how the site visit had been the most interesting and inspiring part of their entire experience with the conference.
Whew, I’m actually feeling really frustrated right now as I’m really having trouble finding ways to express how I felt and describe what I saw in the townships, so I suppose these issues will have to wait for some other time…
Wednesday afternoon I was fortunate enough to be given one of the office passes to the IAS conference (registration for the meeting was 400 Euro, so the m2m didn’t have that many passes for everyone to share). It was really eye-opening to be there, even if only for an afternoon. I was amazed at how fancy and large the Cape Town Convention Center was, but I suppose it’s probably the best convention center on the entire continent. I haven’t been to that many scientific conferences for comparison, but this one felt absolutely huge. After listening to a number of talks and browsing through posters for the afternoon, I felt very grateful to have had that kind of exposure to the international AIDS research community – and it definitely made me more even more excited to be heading (eventually) into a research career. A number of pharmaceutical and biotech companies were there too, and their displays also amazed me – enormous flat screen TVs hanging from the ceiling, espresso stations, safari tents – definitely the most extravagant product show I’ve ever seen!
In the evening after the conference wrapped up, Byron, Wenli, Julia, and I found ourselves at a really nice gathering put on by Dr. van der Horst and other UNC researchers who had attended the conference. Once again, the restaurant was very fancy, the food was very delicious, and we were all very grateful for Dr. van der Horst’s kind invitation. We had a lovely time at the dinner, and I had the opportunity to meet a few UNC faculty and students. Witnessing first hand UNC’s relatively large presence at the conference and getting to talk to a few faculty members made me really happy about what I’ll be embarking on next year.
Seeing such contrast throughout the day, it made me think a lot about how money is spent – from pharmaceuticals putting on over-the-top three-day displays halfway across the world to researchers spending thousands of dollars to convene in a pristine, upscale convention center and brush shoulders at a posh restaurants – is that fair to the women I met that very same morning, the women this work is arguably for? Of course I don’t mean to imply that I don’t admire what these researchers have devoted themselves to, and I certainly have no easy answers for how the world should run. Anyway, apologies for rambling…but all in all in all, a very interesting day!
Thursday, July 23, 2009
Recent outings (mostly involving climbing Table Mountain)
I suppose it’s a good thing that I’m not finding it that difficult to occupy my time here. Of course Cape Town is too beautiful and full of life to just sit inside all day! Some highlights of the weekend:
Let’s see…Julia and I kicked off last weekend by going to a movie at the Waterfront as part of an international film festival. (Julia is another new m2m employee.) The movie was called Youssou N’Dour, and it was a documentary on…you guessed it, Youssou N’Dour. For those of you who don’t know (and I embarrassingly did not), Youssou N’Dour is an internationally known Senegalese musician. I definitely recommend the movie for people who live in big cities/have Netflix (otherwise I don’t know whether it will be available to you). It was really interesting, not only to learn about his life and how his beliefs influence his music, but it was also really interesting to gain some insight into the opposition he’s met as he’s tried to integrate his Muslim faith into his pop music.
Saturday night Byron, Wenli, and I tried to look presentable enough to attend a dinner party hosted by a UNC professor who is in Cape Town for the major International AIDS Society meeting taking place this week in the city. The professor, Dr. van der Horst, was nice enough to invite us after I got in touch with him through other UNC connections. Dinner was held at an extremely nice resort located not too far from us. It’s always interesting to see how the other half of Cape Town lives – it never ceases to amaze me just how upscale things can be here, considering the country and city as a whole simultaneously contain such extreme and widespread poverty. More thoughts on that later. Anyway, the dinner was being held for a number of researchers who were taking part in a mini AIDS/TB meeting prior to the IAS meeting. The three of us were unquestionably out of place both age- and career success-wise, but it was incredibly kind of Dr. van der Horst to invite us and it was fun to get my scientist fix for the time being (Hard to believe it’s been over a month since I set foot in a lab!).
Sunday couldn’t have brought more perfect weather for our trek up Table Mountain. (Table Mountain is the giant, flat-topped mountain that serves as a backdrop for the city of Cape Town.) I know I was complaining about the weather earlier, but if it can reach 70ºF in the middle of winter, I’m no longer going to whine too much about missing out on summer back home. Though I’ve done this hike before, it’s not exactly something you tire of. We started from Kirstenbosch botanical gardens and basically hiked up a gorge on the backside of the mountain, and then trekked our way across the flat top to the cable car on the opposite side to hitch a ride down. I’ve certainly done my fair share of hikes, but this one can be pretty steep and challenging at times – mostly because there’s no gradual climb, you just have to go straight up. I normally wouldn’t mourn the absence of switchbacks, but when forced to use ladders instead, I don’t know…Anyway, it felt great to get outside and I really enjoyed the day. Going up the gorge you are essentially just clambering your way up a (not always dry) creek bed, so everything is very green and moist. Once you reach the top, there are no longer trees but little stubby bushes everywhere and much drier ground. And of course the view is like none other. You can see everything, from the mountains near Stellenbosch, to the city bowl of Cape Town, to the tip of the Cape of Good Hope. The trail across the top of the mountain on the way to the cable car doesn’t leave much room for error, as it pretty much follows the cliff’s edge, give or take a few feet. Not easy for the faint of heart (me), but an incredible feeling none the less. After hours of climbing and trekking and enjoying the view, we finally made it over to the cable car area where tons of chipper and clean tourists kept giving us sweaty folk questioning looks. I suppose if you were short on time the cable car would be worth it, but I think it’s infinitely better to experience the entire climb. Of course taking the cable car down is the only option…at least for those of us who don’t want to destroy our knees!
As for the pictures posted above, they were all taken on top of Table Mountain. In order: a view of the Twelve Apostles mountains, below which sit some of the most beautiful and exculsive Cape Town suburbs; Robben Island (where Nelson Mandela and others were imprisoned) seen in the distance; Lion's head, another signature Cape Town city backdrop; and the view looking down from the trail on the edge of the mountain.
Friday, July 17, 2009
Working at mothers2mothers
Most of you probably know why I’m in Cape Town in the first place, but for those of you who don’t, I am spending this year as a Princeton in Africa Fellow working at an international NGO called mothers2mothers (check it out at www.m2m.org!) while I defer from my MD/PhD program. Even after my first few days of work, I quickly realized this is going to be an exciting year and an incredible organization to work for...and that I have a lot to learn!
mothers2mothers is a South Africa based NGO that was founded in 2001. It’s hard to believe, but in South Africa 1 in 5 adults has HIV and 1 in 3 pregnant women is HIV positive. In the fight against HIV spread, m2m works to educate pregnant women and new mothers who are HIV+ to ensure that they are knowledgeable of their disease and have assistance in accessing clinics and medications, to train them about feeding and medication options to prevent mother to child transmission of HIV (PMTCT), and to empower them to live healthy lifestyles and be proud members of their community. m2m has developed an incredibly innovative and successful way to reach their target population: by training mothers who are themselves HIV+ (and at one time completed the m2m program) to be “mentor mothers” to other women in the community. The way this works, practically speaking, is that m2m partners with numerous clinics that offer HIV care services (ranging from antenatal clinics to maternity wards to postnatal clinics), stationing their mentor mothers at these clinics. Women visiting the clinics are referred to the mentor mothers, who meet with each client and counsel them on HIV testing and the basics of what to do during and after pregnancy for PMTCT. Mentor mothers offer one-on-one sessions, lead group support meetings, give talks in waiting rooms, and share their own experiences about PMTCT services. I could go into a lot more detail, but that will probably suffice for now.
My new work life could not be more different from everything I’m used to (i.e. driving to work in residential Hamilton), though it’s interesting to see finally experience what a lot of the working world goes through every day. It certainly feels funny to be part of the commuter working world! Every day we take the train from Rondebosch to Cape Town Station (only about a 15 minute ride, luckily) and then have another 10 minute walk to the m2m office, which is in downtown Cape Town. Walking the streets of Cape Town you find the never-ending extreme mix of upper class mostly white people on their way to work and numerous mostly black poor people selling things at stands along the sidewalks, milling around corners, shuffling people into minibuses, etc. There is no such thing as passive walking here – you have to constantly be on your toes to not only dodge everyone/everything on the sidewalk, but to make sure the crazy city drivers don’t mow you over even when the green “walk” light is flashing. This could not be more opposite than the culture of letting the pedestrian have the right of way. To make things more difficult, everything is backwards in terms of driving on the opposite side of the road and the directions the cars come from. You don’t often realize how ingrained it is in your system to look left, right, left before crossing the street, nor how dangerous it is to do so when the traffic comes from the opposite direction...hopefully I’ll adjust before the end of the year!
On the first day of work, I had a quick tour of the office and then a nice personal debriefing meeting about the organization’s infrastructure and mission, and where I would be falling into place (I missed the official orientation that the other Fellows had). I am going to be working in the “Department of Strategic Information and Technical Support” (DSITS) and I will be part of a relatively new “Monitoring and Evaluation” (M & E) team. (And yes, acronyms are big here!) m2m is growing like crazy right now, and as they suddenly become awarded more and more grants from major funding sources and have a much bigger budget to operate and many more people to report to, they need to have a well established monitoring system which allows them to better track their numerous sites and measure their impact. Even after Day 1, I felt like I had already gained a lot of perspective on the difficulties of actually operating a successful, large scale aid organization. And the employees here are going to amazing resources to work with – everyone has very, very impressive resumes and endless experience in international non-profit work, and there really aren’t that many people in t he office so everyone from every level interacts with everyone else. Many of the senior people left extremely successful careers in finance and entertainment to work for something they actually cared about – very refreshing!
As for my first project (a bit intimidating for Day 2), I was assigned to make the posters that the two Executive Directors and organization founders will be presenting at next week’s International AIDS Society (IAS) meeting, a huge international biannual conference that is being held in Cape Town this year. Just to share a few statistics I put on one poster: “Each year 1.3 million HIV-positive women become pregnant in sub-Saharan Africa. 1 in 3 will transmit HIV to her baby without preventive interventions. 1,400 children are newly infected with HIV each day worldwide; most will die before the age of 5. Prophylaxis to prevent MTCT is highly effective if mothers receive the proper education, treatment, and support. However, nurses and lay counselors are understaffed and health care facilities often lack time, training and resources to fully educate clients about critical aspects of PMTCT care.” And on a more inspiring note: “The NGO mothers2mothers (m2m) was founded in South Africa in 2001. Now, it employs over 1500 HIV-positive mothers as professionalized health care providers who assist more than 20,000 new HIV-positive mothers each month, in 546 sites in 7 countries.”
Of course, I have a lot of learning to do before things will get going in terms of my projects (and unfortunately the women who will be my direct boss is on maternity leave until September – bad timing!) but I really am very excited to be here. As I said, I’ve already picked up many things about how a public health NGO operates and the many obstacles it faces. There is obviously a lot more to say, but this is hopefully a good beginning.
Just one last thing to share for now…Something really struck me the other day as we fought our way through the bustling Cape Town Station at peak commuter hours, trying to make our way onto a train home. It was one of those typically unpleasant scenarios where too many people bunched together are subsequently trying to funnel themselves through a revolving gate one at a time to get onto the platform. Passing the ticket counter woman, who was shifting between marking individual tickets and sort of generally holding a conversation with the crowd, I heard her say in a jovially mocking tone, “You can look serious if you want to…but why?!” A good example of the unique spirit many Africans possess, which no longer prevails in the fast moving culture of our American cities – and something nice to keep in mind, I think.
mothers2mothers is a South Africa based NGO that was founded in 2001. It’s hard to believe, but in South Africa 1 in 5 adults has HIV and 1 in 3 pregnant women is HIV positive. In the fight against HIV spread, m2m works to educate pregnant women and new mothers who are HIV+ to ensure that they are knowledgeable of their disease and have assistance in accessing clinics and medications, to train them about feeding and medication options to prevent mother to child transmission of HIV (PMTCT), and to empower them to live healthy lifestyles and be proud members of their community. m2m has developed an incredibly innovative and successful way to reach their target population: by training mothers who are themselves HIV+ (and at one time completed the m2m program) to be “mentor mothers” to other women in the community. The way this works, practically speaking, is that m2m partners with numerous clinics that offer HIV care services (ranging from antenatal clinics to maternity wards to postnatal clinics), stationing their mentor mothers at these clinics. Women visiting the clinics are referred to the mentor mothers, who meet with each client and counsel them on HIV testing and the basics of what to do during and after pregnancy for PMTCT. Mentor mothers offer one-on-one sessions, lead group support meetings, give talks in waiting rooms, and share their own experiences about PMTCT services. I could go into a lot more detail, but that will probably suffice for now.
My new work life could not be more different from everything I’m used to (i.e. driving to work in residential Hamilton), though it’s interesting to see finally experience what a lot of the working world goes through every day. It certainly feels funny to be part of the commuter working world! Every day we take the train from Rondebosch to Cape Town Station (only about a 15 minute ride, luckily) and then have another 10 minute walk to the m2m office, which is in downtown Cape Town. Walking the streets of Cape Town you find the never-ending extreme mix of upper class mostly white people on their way to work and numerous mostly black poor people selling things at stands along the sidewalks, milling around corners, shuffling people into minibuses, etc. There is no such thing as passive walking here – you have to constantly be on your toes to not only dodge everyone/everything on the sidewalk, but to make sure the crazy city drivers don’t mow you over even when the green “walk” light is flashing. This could not be more opposite than the culture of letting the pedestrian have the right of way. To make things more difficult, everything is backwards in terms of driving on the opposite side of the road and the directions the cars come from. You don’t often realize how ingrained it is in your system to look left, right, left before crossing the street, nor how dangerous it is to do so when the traffic comes from the opposite direction...hopefully I’ll adjust before the end of the year!
On the first day of work, I had a quick tour of the office and then a nice personal debriefing meeting about the organization’s infrastructure and mission, and where I would be falling into place (I missed the official orientation that the other Fellows had). I am going to be working in the “Department of Strategic Information and Technical Support” (DSITS) and I will be part of a relatively new “Monitoring and Evaluation” (M & E) team. (And yes, acronyms are big here!) m2m is growing like crazy right now, and as they suddenly become awarded more and more grants from major funding sources and have a much bigger budget to operate and many more people to report to, they need to have a well established monitoring system which allows them to better track their numerous sites and measure their impact. Even after Day 1, I felt like I had already gained a lot of perspective on the difficulties of actually operating a successful, large scale aid organization. And the employees here are going to amazing resources to work with – everyone has very, very impressive resumes and endless experience in international non-profit work, and there really aren’t that many people in t he office so everyone from every level interacts with everyone else. Many of the senior people left extremely successful careers in finance and entertainment to work for something they actually cared about – very refreshing!
As for my first project (a bit intimidating for Day 2), I was assigned to make the posters that the two Executive Directors and organization founders will be presenting at next week’s International AIDS Society (IAS) meeting, a huge international biannual conference that is being held in Cape Town this year. Just to share a few statistics I put on one poster: “Each year 1.3 million HIV-positive women become pregnant in sub-Saharan Africa. 1 in 3 will transmit HIV to her baby without preventive interventions. 1,400 children are newly infected with HIV each day worldwide; most will die before the age of 5. Prophylaxis to prevent MTCT is highly effective if mothers receive the proper education, treatment, and support. However, nurses and lay counselors are understaffed and health care facilities often lack time, training and resources to fully educate clients about critical aspects of PMTCT care.” And on a more inspiring note: “The NGO mothers2mothers (m2m) was founded in South Africa in 2001. Now, it employs over 1500 HIV-positive mothers as professionalized health care providers who assist more than 20,000 new HIV-positive mothers each month, in 546 sites in 7 countries.”
Of course, I have a lot of learning to do before things will get going in terms of my projects (and unfortunately the women who will be my direct boss is on maternity leave until September – bad timing!) but I really am very excited to be here. As I said, I’ve already picked up many things about how a public health NGO operates and the many obstacles it faces. There is obviously a lot more to say, but this is hopefully a good beginning.
Just one last thing to share for now…Something really struck me the other day as we fought our way through the bustling Cape Town Station at peak commuter hours, trying to make our way onto a train home. It was one of those typically unpleasant scenarios where too many people bunched together are subsequently trying to funnel themselves through a revolving gate one at a time to get onto the platform. Passing the ticket counter woman, who was shifting between marking individual tickets and sort of generally holding a conversation with the crowd, I heard her say in a jovially mocking tone, “You can look serious if you want to…but why?!” A good example of the unique spirit many Africans possess, which no longer prevails in the fast moving culture of our American cities – and something nice to keep in mind, I think.
Tuesday, July 14, 2009
First few days back in South Africa
Well, it’s been almost 3 years exactly since I last took up residence in Cape Town, and it’s good to be back! After arriving late last Thursday night and enduring a somewhat worrisome lost luggage mishap (unfortunately I don’t have a huge amount of confidence in the return of lost items in South Africa) everything worked out fine and I had the chance to wear clean clothes while enjoying the weekend before starting my fellowship on Monday.
Byron and Wenli (also Princeton in Africa Fellows working at mothers2mothers) and I share an apartment in Rondebosch, sort of the University neighborhood of Cape Town. Though it’s a commute from city center, it’s at least a very safe place to live with lots of shops and restaurants and people out and about. We live right next to the train station, which is of course nice for the commute into work but also a bit loud (or at least louder than Little Willow Creek…).
My previous Cape Town knowledge is coming back to me pretty well, which is a pleasant surprise. Even if I can’t remember the names of places I can usually remember how to get there, and everything seems very familiar so I definitely feel very comfortable here. However, one thing that will always take my breath away no matter how many times I see it are the mountain views this city offers. (For someone raised in the Bitterroot Valley, it means a lot when I say the mountains here are like none other!)
The one bad news upon my arrival was discovering that the lovely car the three of us invested in (1993 Toyota Conquest anyone?) does not want to start for some reason. The previous m2m PiAf fellows swore this was a good car, but I’m obviously having my doubts. (Of course none of us know how to drive stick and Cape Town drivers are an extremely intimidating force to reckon with, but we’ll worry about that later…) Hopefully we can get this taken care of soon because having a car will be essential to exploring the city and surrounds on the weekends. Without it you’re essentially limited to crazy minibuses or expensive taxis. The trains are only safe to take during commuter hours on weekdays and minibuses are off-limits after dark. Cape Town can really seem like a European city until you step onto a minibus (essentially a large van fit for 12 people but often stuffed with more like 18 people) and are suddenly crammed next to strangers, watching the change-counter (minibuses are usually operated in a team with a driver and a “cashier” of sorts) hanging out the window calling to passengers as the driver crazily manipulates the roads. All this with rap music usually blaring so loud you can barely hear. All in all a very cheap and acceptable mode of occasional transport but not my first choice for the long term.
This past weekend unfortunately brought endless rain, which made it a little bit difficult to take advantage of the usual Cape Town attractions. (And when I say rain, I mean RAIN – like the kind that literally creates rushing rivers in the streets.) On Saturday, Byron, Wenli, and I spent the day downtown at the V & A Waterfront, which is essentially a very touristy mall filled with extremely high-end shops and good restaurants, with a beautiful location right on the water’s edge overlooking Table Mountain. It was so cloudy, it was a little difficult to tell that Table Mountain even existed, but it was still a very pretty area. Of course it’s not that fun to spend the day in a mall that looks exactly like anything you could find in the U.S. or Europe, and frankly, it’s sort of the epitome of the sickening reminder of how sharp the class divide is here. But anyway, on a rainy day, I suppose it’s not a bad place to at least check out. Saturday night we had dinner on Long Street (perhaps akin to New Orleans’ Bourbon Street?) but didn’t stay out long as jet lag was still getting to us all.
Sunday brought even heavier rain and a trip to another mall just one suburb away from us. (No I don’t have a love for malls, but yes, I needed to buy some essential living supplies!) Byron and I had a heavy debate about whether to join the Virgin Active gym (same company as the airline, and definitely the fanciest gym I have EVER seen) which was more expensive and would require a short minibus commute, or whether to join the local Rondebosch gym which was incredibly cheap but also pretty poorly equipped. In the end, convenience and price beat out the dreams of a luxury workout.
So, now I’m officially past jet lag, have settled into my new apartment and returned to my old Rondebosch routines, and am looking forward to the year ahead! Yesterday was the first day of work, which I’ll describe soon enough, but enough for tonight!
Byron and Wenli (also Princeton in Africa Fellows working at mothers2mothers) and I share an apartment in Rondebosch, sort of the University neighborhood of Cape Town. Though it’s a commute from city center, it’s at least a very safe place to live with lots of shops and restaurants and people out and about. We live right next to the train station, which is of course nice for the commute into work but also a bit loud (or at least louder than Little Willow Creek…).
My previous Cape Town knowledge is coming back to me pretty well, which is a pleasant surprise. Even if I can’t remember the names of places I can usually remember how to get there, and everything seems very familiar so I definitely feel very comfortable here. However, one thing that will always take my breath away no matter how many times I see it are the mountain views this city offers. (For someone raised in the Bitterroot Valley, it means a lot when I say the mountains here are like none other!)
The one bad news upon my arrival was discovering that the lovely car the three of us invested in (1993 Toyota Conquest anyone?) does not want to start for some reason. The previous m2m PiAf fellows swore this was a good car, but I’m obviously having my doubts. (Of course none of us know how to drive stick and Cape Town drivers are an extremely intimidating force to reckon with, but we’ll worry about that later…) Hopefully we can get this taken care of soon because having a car will be essential to exploring the city and surrounds on the weekends. Without it you’re essentially limited to crazy minibuses or expensive taxis. The trains are only safe to take during commuter hours on weekdays and minibuses are off-limits after dark. Cape Town can really seem like a European city until you step onto a minibus (essentially a large van fit for 12 people but often stuffed with more like 18 people) and are suddenly crammed next to strangers, watching the change-counter (minibuses are usually operated in a team with a driver and a “cashier” of sorts) hanging out the window calling to passengers as the driver crazily manipulates the roads. All this with rap music usually blaring so loud you can barely hear. All in all a very cheap and acceptable mode of occasional transport but not my first choice for the long term.
This past weekend unfortunately brought endless rain, which made it a little bit difficult to take advantage of the usual Cape Town attractions. (And when I say rain, I mean RAIN – like the kind that literally creates rushing rivers in the streets.) On Saturday, Byron, Wenli, and I spent the day downtown at the V & A Waterfront, which is essentially a very touristy mall filled with extremely high-end shops and good restaurants, with a beautiful location right on the water’s edge overlooking Table Mountain. It was so cloudy, it was a little difficult to tell that Table Mountain even existed, but it was still a very pretty area. Of course it’s not that fun to spend the day in a mall that looks exactly like anything you could find in the U.S. or Europe, and frankly, it’s sort of the epitome of the sickening reminder of how sharp the class divide is here. But anyway, on a rainy day, I suppose it’s not a bad place to at least check out. Saturday night we had dinner on Long Street (perhaps akin to New Orleans’ Bourbon Street?) but didn’t stay out long as jet lag was still getting to us all.
Sunday brought even heavier rain and a trip to another mall just one suburb away from us. (No I don’t have a love for malls, but yes, I needed to buy some essential living supplies!) Byron and I had a heavy debate about whether to join the Virgin Active gym (same company as the airline, and definitely the fanciest gym I have EVER seen) which was more expensive and would require a short minibus commute, or whether to join the local Rondebosch gym which was incredibly cheap but also pretty poorly equipped. In the end, convenience and price beat out the dreams of a luxury workout.
So, now I’m officially past jet lag, have settled into my new apartment and returned to my old Rondebosch routines, and am looking forward to the year ahead! Yesterday was the first day of work, which I’ll describe soon enough, but enough for tonight!
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