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.