This blog post is made possible by the lack of scheduled time here in South Africa! As I sit here in Plett Aid's office in Kwanokuthula I am unaware of when the care givers will come pick me up and also of what our daily work will involve. I was told that today I would be able to administer the regular tests to patients (blood pressure and sugar) after I nervously asked yesterday and got the impression that I should've asked sooner!
Plett Aid is a non-profit organization that monitors patients social and physical well being in the greater Plettenberg Bay area. They administer to patients that have been referred from local clinics as being stable to live at home, but needing assistance in some regard. As I've shadowed the two carers for another township, New Horizons, I've concluded that their main concern is that the patients make it through every night. The carers mainly take blood pressure and blood sugar and talk to the patient and family about the living conditions and how they are receiving food and water. They will also draw blood or swab for spit to take into the clinics to test for more serious diseases such as HIV and TB. But if something is out of the ordinary with a patient, the carers must consult the professional nurse, who must visit the patient in the home or refer the patient to the clinic, which can take an unimaginable amount of time and energy from the patient's days.
Time, like I said earlier, does not exist here. It bothers me very much not to have my day planned out with my calendar, but it seems to work for the people here. I see the lack of time management as inefficient. There would be time to squeeze in another patient if we didn't stop to talk to the neighbor or go the store to buy bread, but I'm learning to understand and accept this way of life. It seems selfish that the carers are not spending every second tending to the patients needs, but from the patients view they might not want to be poked and prodded and talked to for longer than they already are. The culture here is very social, but not always directed at the topic or issue at hand. Although I cannot understand the Afrikaans language that is spoken between carers and patients, after the carers translate or when they speak english to include me, the conversation has usually shifted to a tangential topic.
The apparent inefficiency stems from the lack of trained health care providers. The carers have a very limited knowledge of medicine and can administer just a few basic tests, that they are willing to let me do without any previous experience. They know the issues effecting the communities (HIV, TB, cancer etc.) but they lack the medical background and terminology to understand fully how to prevent the outbreaks from occurring in the future. The professional nurses are a step up from care giver and they can diagnose and prescribe medication, as well as do check up's in the clinics. These women are also referred to as Sisters. Then there are doctors who only come to the clinics once a week. They are mainly white women who live in Plett. The clinics do not offer 24 hour services, the hours are similar to an office building, 7am - 4 or 5 pm. If you need emergency care in the middle of the night you can call an ambulance to drive you to George, which is 30 minutes away (I think). This whole system is considered 'public health care' which is entirely free to patients. The private care system is very expensive and I'm unsure about it's complete services.
I finally, and successfully, administered the regulatory tests to a patient on Friday. All of the anticipation was slightly exaggerated for the actual moments, but I was proud of myself for accurately measuring the woman's blood pressure and sugar, and maybe more relieved that her data was in a healthy range, despite the fact that she had one leg amputated at the knee about a month ago.
I'm learning a lot about the system from just observing, but I long to do more hands-on work. It's easy to disregard small details of day-to-day life in South Africa, but thinking about sights and sounds and interactions after they happen have led to the most interesting analysis. I'm still investigating the core reasons South Africa is so rampaged with non-communicable diseases such as HIV/AIDS, TB, and diabetes, but I think it has to do with the relaxed lifestyle. The history of Africa - Colonial rule that led to inefficient infrastructure after independence was won for many countries in the 1950's and 60's, has never allowed African countries to gain stability in their governing systems. Private sector initiatives were the main priority during the time of huge aid initiates in the 1970's-90's, which has caused public sector organizations to struggle to gain footing in the current day. The public health system is alive and well in South Africa's townships, but there are obvious inefficiencies that continue to cause problems.
I will continue to learn about the care giver's role in the public health system this week and then next week I will be working in a local primary school assisting grade four teachers as they attempt to teach the children in English (A dramatic shift from the first 3 years of primary school that are taught in Mother Tongue, Xhosa).
I'm learning so much everyday and with limited internet access it's hard to capture my ideas all at once. There are so many people I want to contact and catch up with, but snail mail seems to be quite snail-esque. Feel free to email me or just catch up on my periodic blog posts! I promise to update about the other aspects of my new life in South Africa soon!
Peace out from Plett!!
An attempt to document my journey through 5 countries, 3 global issues and billions of people