Clay Pots

I am at a bit of a loss for what to write about lately so I thought that I might share some photos with you. There is a theme to the pictures. Everyone who is photographed is a patient (or a patients family member) of the Home Based Care team. Additionally, they are recipients of food parcels provided by an organization called Claypotts. We distribute the food to our patients and their families during our home visits. The food consists of mealie meal (which is ground corn), peanuts, beans, salt, sugar, cooking oil and milk. It varies from patient to patient, who receives what but it is some combination of what is listed as well as corn soya from the World Food Program. All of this is provided by an anonymous donor through the Claypotts Trust.

The patients are always pleased to receive the food during our home visits. Often donated money from our (David and my) family and friends goes towards supplementing the food distributed by the HBC team. It never ceases to be heartbreaking to see so many people without enough food to feed themselves. So, I want to take this opportunity to thank the Claypotts Trust and all of the rest of you who have provided donations for food for our patients. Know that your donations are greatly appreciated and very much needed. I hope you enjoy the photos and captions.





This is a typical pot used by the Swazi's to cook in. Most cooking is done outdoors, either in the open or in a stick and stone structure. In the colder weather many people cook inside their huts to keep warm and yes it gets very smoky.















An elderly woman with mealie meal and corn soya sitting next to a water barrel.


















A young boys carrying his 2 liters of milk to his homestead in the back ground. The milk is most often consumed after it has spoiled. This is a personal preference and due to the lack of electricity to keep it cool.











A couple of chilren in front of their homestead. We were giving out Comfort Dolls this day as well.

















More children on their homestead. It was a rainy day a couple of months ago. As usual, the girls do most of the work (carrying the food here), while the boys are at play.













It was a cold day when we visited this gogo, that is why it is so smoky in her hut. Unfortunately, she died before our next visit to her community.













All the children are very cute but this young girl was one of the most adorable. She was a bit terrified of me so I had to keep a good distance from her although she did like getting her picture taken.
















This young patient is one of my favorites. He has the best smile and he is very affectionate. As you can see, he was very pleased about getting the lubise (milk).













This girl had a baby boy about 8 weeks ago. She asked me if I would like to be the baby's father. I thought it best to decline. We made a home visit to her homestead yesterday and so far the baby appears to be healthy.













Old mukhulu (grandfather) here has many wives. I could not get a clear answer about whether this woman is one of his wives or not but it appears that way from the way she cares for him.














This old gogo had quite a rash all over her body when I first saw her. I prescribed some medication that worked pretty well and now she is always excited to see me. She claps her hands and says hallelujah whenever we make a home visit.











This young man runs to greet the truck whenever we visit. Our visits are unplanned although about every month or so. Even so, he hears the HBC truck coming and is there to greet us at the gate of his family's homestead whenever we visit.













David photographed with a family and their supplies. The littlest child standing is holing soap that we distribute whenever it is available.











These children were living with their father who has active TB. They have now been relocated to live with another family member so I do not see them any longer. Their's is one of the poorest homesteads that I have seen, so I am pleased that they are living elsewhere.










Peace,
Scott

Keeping Warm This Winter?

Winter is certainly upon us here in Swaziland. We are weathering the very cool nights, windy afternoons and dusty days. While most of you are enjoying the warm spring and soon to be summer breeze of the Northern Hemisphere, much to our surprise and dismay, it does get quite cold here in the Lubumbo Mountain Range.










But we truly have nothing to complain about, short of intermittently having cold hands and noses. The vast majority of our patients do not have it so good. Most of their homesteads are made of stick, stone, mud and thatched roofs. Additionally, since so many families are no longer intact there isn't anyone to maintain their homesteads. Frequently we encounter crumbling walls and thatched roofs that no longer keep the wind and rain out. To say that it can get smoky in one of these little huts is an understatement. During the winter months, often the Swazis will cook inside their huts in order to benefit from heat generated from cooking. One has to part the smoke in order to find our patients and be able to tend to their needs.







It can be very challenging to make a home visit and have to leave knowing that your patients are going to have a long cold night ahead of them with no heat. Blankets are a luxury for many and more often than not the whole family sleeps in the same space (usually on a grass mat placed on the floor) in order to keep warm. No need to worry about hearing the baby crying from down the hall, or falling out of their crib when you are sleeping next to each other on the floor. There are benefits to leading a very simple life but being cold is not one of them.









Fortunately, members of the Mission Team from Highland Park Presbyterian Church in Dallas, Texas took it upon themselves to donate blankets. Over the last week we have distributed them to our Home Based Care patients. It has been very gratifying to hand out the blankets over the last week since everyone was so pleased to receive them. Nothing like being a good will ambassador from America and in turn being the recipient of so much gratitude and good will.







I want to personally thank all of you who donated the money for the blankets. Our patients were very touched and incredibly happy to have a new warm blanket during this cold and windy season. Your generosity is acknowledged and appreciated. The attached photos show some the people who received the blankets but it does not fully capture how grateful they were. Be assured that the blankets are in the hands of those in need. Attached are photos of some the people who received the blankets, I hope that you enjoy being able to put a face to those you are helping.












The three children pictured here are siblings. Both of their parents are very ill, hopefully they will not be orphans soon but that is unlikely.

















Siphesihle, always with a great smile. Her birthday is July 25th, she will be turning 7 years old.

















This young patient was more concerned with getting his sweetie than having his photo taken.
















Pictured is a Gogo with her mentally disabled granddaughter along side her. Another grandchild, who is our patient is on her back. Gogo is the sole caregiver for the family.

















A young woman photographed with her new blanket and food parcels from Clay Pots.























Thabiso keeping warm and with a big grin. He was on his way to his homestead from school when he received his blanket.


















Make Maphosa with one of our patients, he is able to wheel himself up and down the hill behind him with just one functioning arm. He is incredibly strong for having such limited use of his arms and legs.















This is a young man, from a community called Magugu, which is very close to Good Shepherd Hospital. He is a double orphan and patient of ours. He raises vegetables in his garden and then he sells in town to support himself. Only 14 years old and already such a hard worker and quite the gentleman.











This old Gogo is wearing a black piece of cloth tied around her neck. This generally denotes the death of a child or family member, usually within the last six months. Most likely the fabric is marking the death of a daughter. If she were all in black it would represent her husband and the loss of a son would be signified by a black shirt as well.













This woman make quick use of her new blanket to secure her child to her back. In Swaziland, children are carried on the backs of their mothers or caregivers.










Peace,
Scott

Lax, yes but not relaxed.

I know, it has been a very long time since my previous entry. There are a million and one excuses, but that would only help me to feel better (about my lack of communication) and no one else would care or possibly believe the ones that I chose. What I have really wanted to do was to rant, and who wants to hear me complain? Well the answer was many of you, so here it goes.
November 24th, 2008 was our departure date from New York. David and I have completed six months of our one year volunteer commitment. Unfortunately, I have to report that I have not been able to change Africa (and in particular Swaziland), to my liking in that time. It feels as if the more work that I do, the less some others around me do. No matter how subtly I push and prod, the results remain about the same. There is a very slow and yet chaotic pace here, especially to the outsider. That pace, I have not been able to penetrate. I am having to accept that I am not going to change this world. This vast land with all of its rich, strange, exotic, foreign and lively traditions, cultures and experiences that has made it what it is today. This little country called Swaziland has existed a hell of a lot longer than I have. Many Kings (and their numerous Queens) have come and gone, procreated and ruled such a small country from afar without leaving its borders. No matter how noble my intentions are, no matter how pensive or frustrated or angry and inpatient I get, nothing changes.
I like to tell myself that it shouldn't matter. I am a foreigner in a foreign land. Volunteering to help others and myself as well. Maybe I am trying to right some racist tendencies of my own, or just trying to live up to the ideals of the Sisters of Saint Joseph who so deeply formed and molded who I am today. Possibly just trying to change up my life a little and do some distant traveling and meet people that would never have crossed my path on West 23rd Street. It is highly unlikely that I would have met any Swazi's while having dinner at Tre D'ici or working out at the gym or even while making home visits with the VNSNY Hospice Care. So why I am so deeply pained by what I am seeing here and cannot change?
I miss the efficiency of New York. The New York minute and all that it entails. The ability to make a request to have labs drawn for a patient at 10:59am, one minute before the cut off time for same day lab service and know that it would happen. It didn't matter why the labs were being drawn or even if they were necessary, it was about customer service and getting results. If the customer service representative on the receiving end of the phone call did not want to process the request then you would just talk with their supervisor and again you would have results. The list could go on and on. Here on the other hand, life is quite different.
A response to a request made here can be quite interesting, here are some of the responses that you may get:
"That is humanly impossible."
Or how about, "The CD4 machine is broken come back next week."
Or "Let me see if I can get to that by next week sometime."
Or try this on for size, "I am at tea, come back in a half and hour."
Or maybe, "The Outpatient department is closed for lunch, have the patient wait outside."
Or one of my favorites, "The chemistry machine is broken, come back in a month and a half."
We could go on to play the matching game, matching the request to the response but I do not think that I have the energy to relive it all. OK then, just a couple. The questions may consider some paraphrasing.
Number one: I need to start my ARV's and to do so I have to get these labs drawn. I am a 29 year old man, I weigh only about 90 pounds, my CD4 count is 6 (yes that is a single digit), I have traveled 25 kilometers on my own, I had to borrow the money for the transportation, I have not eaten yet today and I need to know where the labs are drawn. Do you give up? The correct answer would be "The chemistry machine is broken, come back in a month and a half."
Number two: Could you please photocopy these four sheets of paper for me?
I know that is an easy one but here it is anyways. The correct answer would be "That is humanly impossible."
Number three: This is the answer to anyone who wants to get their CD4 count drawn on a Thursday afternoon or anytime on Friday. "The CD4 machine is broken, come back next week."
For over two months the chemistry machine at the hospital was broken. Time and time again patients were sent home and told to check back later, that the initiation of their ARV's would be delayed. Not exactly the right answer for me. There was consideration given to drawing the labs anyways and sending them to another hospital to have them 'run' on their machine but it was too difficult to determine which of the six full time drivers at the hospital would be required to take them and in turn get the results. Yes, I ranted and raved, one of my favorite responses from a physician was, "Well we shouldn't be starting ARV's on anyone with a CD4 count of less than 100, they are going to die anyways, in my country we don't bother." Or, "The protocol calls for liver function tests and if the machine is broken there is nothing we can do." Yes, I am taking several deep breaths because reliving it is nearly as painful as the first time.
Now where was I? I get rather forgetful when I am all worked-up. Another part of my discontent is the immense suffering that I see. I really cannot begin to tell you how many young women and men I have made home visits to that have since died. With a life expectancy of 32 years, that is the reality of life here. It is not my reality and I want people to react. To say, this is enough, I am not going to let another child of mine die. I am not going to see my grandchildren orphaned. I am not going to bury another husband, brother, sister, child, parent, friend or countryman. HIV/AIDS and TB are literally killing this beautiful, peaceful, unemployed, uneducated, poor, male dominated, polygamist, Christian, land locked kingdom.
I keep asking, "Aren't you angry?", "What is going to happen to this country?", "Doesn't something have to change?" The common response is that "this is Swaziland, nothing will change, you just have to live with it" or more common than not, die with it. Here is a question to ponder. How can a hospital that has 225 beds and services 350,000 people continue to have so many empty beds? I digress.
All of this said, I still think that we are making a positive impact here. How else can I make sense of it all? This positive influence has been on a very individual basis. Not grand like my dreams and hopes. Many more children have had their school fees paid. Dozens more patients have been seen by a physician that didn't have the money to do so on their own. We have heard many voices tell their story and shared their grief, sorrow and joy. Many medications have been administered and patients have been seen the following month to find that the medication suggested did in fact help to alleviate their symptoms and enrich their lives. Some orphans are finding their way to a safe haven, with food, shelter, education and emotional support provided free of charge. Thabiso is home safe again with his aunt and uncle and their children. This evening after running away again last night and spending the night in the bush. It took a lot of searching and chasing and talking, talking, talking but he his home safe and now I can sleep.
I just want a better life for many of the people I encounter on our home visits and in the community at large. That does not mean that I want them to have a TV, running water or electricity. Although I do want them to grow up with their own parents, to go to sleep at night with their siblings, have food to eat and who knows, live until forty. There is a lot that has to change. Traditions, ancient belief systems and cultures alike. Realistically, that is not going to happen overnight. HIV/AIDS and TB has pushed this continent much faster than it is able to react and because of that I too suffer. Timing, location, education and access to adequate health care are what is needed. I am not sure if there is enough time to help this country and her people.






Siphesihle, she is still waiting to start ARV's. We are hoping to get this accomplished by her seventh birthday on July 25th.














Siphesihle and her mother in front of their home. We are going to try and raise money for a new permanent home for the family.















Make (mother or Mrs.) Matsenjwa's attempt at building a new home for her children. She continues to collect the wood and stones but cannot even afford the nails to continue construction.




Peace,
Scott