Return to East London

After getting back from Knysna late last Monday evening, I had just enough energy to unpack my bags and then repack them for my return to East London on Tuesday. This time I travelled alone, and Nzwaki picked me up at the airport. We wasted no time getting to work, and we spent the whole week at different clinics and hospitals trying to finish all the data collection for the East London area.

Once again, I stayed in a lovely B&B with very hospitable owners. B&Bs are so popular here! I’m not terribly used to the idea of eating breakfast and dinner with strangers and it feels somewhat funny just moving into someone’s home for a few days as opposed to the hotel culture in the States, but it’s also a nice change of pace. The hosts are really friendly, and the food is delicious. I’m even able to run outside around here, as long as I stay on the main road and go during daylight (and yes Mom, I promise I only did this after checking with the hosts about whether it was safe and where to go!). I’ve been going for morning runs, and it’s sort of interesting to be out on the road with all the commuters. By commuters, I mean people walking on their way to work or school. I pass people singing to themselves, or big groups of women gossiping, or teenage boys trying to look really cool with their hoodies and headphones, or little boys in uniforms heading to school, etc. I’m not sure if it’s because people aren’t used to seeing a white girl out running, but I will say that people definitely DO NOT move in the least and that it adds a whole other element to running when you have to dodge and weave in between people. Regardless, it makes for a much more dynamic sidewalk culture than we have at home!

My first night at the B&B I was a little taken aback when, during dinner, another guest named Thandi started reading me the riot act on what is being done about HIV/AIDS in this country. We were the only two at dinner that night, and it all started when she asked me why I was in East London. I barely had a chance to get in two sentences about what m2m does when she got really loud and animated complaining about why wasn’t our organization doing things that actually worked, why weren’t we working in the township clinics, etc. (She originally thought I was only here to be at Frere, the large maternity hospital in East London, which according to her isn’t where most “real” people go, though I was able to explain later that m2m actually operates out of a large range of clinics in different areas). She told me she grew up in the squatter camps in East London, and with a memorably intent tone she looked in the eye and told me it’s just terrifying how vastly spread the virus is and how it’s taboo to talk about it so nobody discloses and as a result how teenage girls are just “doomed,” in her words. Listening to her really put a damper on the positivity and productivity I usually feel as I work for m2m.

Anyway, it was an incredibly challenging conversation, trying to explain the reasoning for how our organization works, especially after hearing her perspective on the situation. I have to admit, it felt just wrong trying to explain to her why m2m’s operating model was in fact really productive, as I clearly am pretty much the opposite of someone who is black, poor, and HIV+. I also really found myself struggling about how to use the right words when she asked why I wanted to be here (here being Africa), when everyone here just wants to escape. How do you talk to someone about wanting to “help” them, as if they are completely helpless and wouldn’t make it without white do-gooders? To be completely honest, I felt really intimidated and was at a total loss for words as I tried to respect her position. It’s funny how much we dance around these types of conversations in the U.S. – I found myself trying to be so completely politically correct that I just could not get any words out of my mouth, I was so afraid of saying something offensive. In the end, Thandi softened up completely and concluded by saying that she was really touched that I was here and that someone is trying to do something about the state of things. In her words, spoken ever so seriously, “something has to be done.” Her desperation, stemming from her perspective growing up in a desolate squatter community, was a stark reminder of what HIV is actually doing to this country...or rather a certain population in this country. I hate to say this, but sometimes when you work in an office, numbers just become numbers, especially when they slide into incomprehensible magnitude, such as the fact that 20% of the entire country has HIV. I’m grateful to be humbled by people like Thandi and have a reality check every once in a while to remind me of why in fact I am so passionate about trying to “do something”... even if I haven’t quite figured out how best to go about it yet.

Talk about numbers just blending together. At the clinics, as Nzwaki and I go over the logbooks with the mentor mothers and try to collect the data on each and every person seen, it’s easy to get swept up in just getting the numbers down. But then as I sift through the logbook entries, sometimes it hits me that each line isn’t just a number to be entered into our database, but a real person with a real story. Yes, looking at the logbook entries, it’s hard to comprehend how different life could be...I can’t even imagine being pregnant at my age, let alone being HIV+, poor, and often not having the support of a partner.

I get really upset with myself for undeniably feeling somewhat guarded and uncomfortable whenever I’m in these clinics – for lack of a better word, it just doesn’t feel “clean.” Sometimes it reminds me of being somewhere like an airport restroom, where you just want to get out as fast as possible. We often sit in dirty, cramped offices or patient check-up rooms with raggedy posters and textbooks looking like they would date back to the 70s or 80s, going through obviously over-handled logbooks, all the while I try to find somewhere to set my bags so they don’t have to touch the floor and avoid using the bathroom whenever possible. Frankly, I’m terribly embarrassed by how the standards I’m used to affect me (I really debated about whether I should even publically admit this!), and I’m making a very conscious effort to stop caring. If someone offers me half a piece of (unwrapped) gum that they just dug out from the bottom of their purse, wiped off, and broke in half, then I suppose it’s not going to kill me, right? When I see someone walking around the halls with a mask on and looking as if they might have TB or swine flu (which has recently been taking South Africa by storm, at least psychologically so), then I just can’t waste any time worrying about it. It definitely takes a conscious effort on my part, but I’m really learning to just let go and go with the flow!

Hard to believe a few months ago I was going to work at a sterile, high-tech lab where money flowed ever so freely, and this month I’m half way across the world spending every day as very clearly the only white person amongst a struggling population whose only resort are these resource poor clinics. As I tag along behind Nzwaki wherever we go, I obviously stand out and consistently get stared at by the packed waiting room crowds as we walk by, but everyone is always very friendly and open. I wish I could have more meaningful conversations with people, but mostly I just try to smile and be pleasant. Still, I’m starting to learn that this culture is much more open to conversation than we often have been trained in the U.S. and that people really appreciate it when you just let go of formalities and be yourself. I’m really enjoying getting to know Nzwaki and have nothing but admiration for her, and I’m definitely excited that we get to spend all of this week together too! Spending time with her, I especially realize how stiff our culture is. She is always touching my arm, giving me hugs, or linking arms with me when we walk somewhere, and I’m embarrassed that I probably seem somewhat uncomfortable in these settings, not because I mind her openness but because it just feels so foreign to our standards of colleague interactions.

After we wrapped up our work for the week on Friday afternoon, I still had about 5 hours to kill before my flight, so I ended up going back to the B&B where the hosts were kind of enough to let me hang out. They even took me over to their friends’ house for cocktails before they gave me a ride to the airport – talk about feeling like you become part of the family when you stay at a B&B! They also had a really adorable 7 month old daughter who they had recently adopted. As Alexia mentioned to me, and as I’m beginning to see for myself as I open my eyes to observing mothers and children, a lot of white South Africans adopt black babies who were orphaned or given up for adoption by HIV+ parents. It’s heartening to see people crossing cultures and reaching across racial lines like that. Anyway, it was fun to spend a few hours with the B&B owners and their friends (who also ran a B&B) – I heard lots of stories about them taking care of Annie Lennox (who, by the way, is a big m2m supporter and visited some of our Cape Town sites last month), taking the President of Botswana on private safaris, etc. I guess being in the tourism business means you get to meet lots of interesting people!

All in all, I’m really enjoying the opportunity to be out of the office and spend time in the clinics with the mentor mothers. I certainly have a lot to learn, not just about combating HIV and managing M&E operations, but about fitting into other cultures and opening my eyes to my own shortcomings.