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Archive for July, 2012

Not far from here, roughly 30 minutes from the thriving, bustling, cacophony of noise which is Durban’s city centre, lies a community called Tshelimnyama (the black stone). You take an off-ramp, just before Marianhill toll plaza, and suddenly find yourself in a world you had no idea existed, particularly if you are a white, middle class South African. The only reason I am here is because I am going on a home visit with Maud Mbambo, the clinical officer of a community care project run by an organisation called Zoë-Life. Maud trains community care givers (CCGs) who work for the municipality and the Department of Health. Maud trains the CCGs to work within the community setting at a household level, where they transfer the knowledge they have learnt during training, to household members regarding key family health practices. The concept of the project is to build capacity and strengthen comprehensive HIV services at a community level so that the burden, placed on congested clinics, is reduced.

Welcome Home

We are here to visit a family, which a CCG earmarked as being highly vulnerable and in dire need of assistance; we have come to drop off nappies and dried soup mix, and to determine the level of need within the household. To find this house we drive through the community of Tshelimnyama; a hilly region with only one main road, which winds its way into and out of the valley, eventually looping its way back to the main road. The hills are covered in various types of housing; rondavels, square structures made of sheet metal, wattle and daub creations, and newly built homes of brick and cement. Goats and chickens run riot across the road and road humps have long since lost their warning paint. It is a scene one would not expect to see so close to the city, but rather, out in the rural areas. The close proximity of this poverty, to the relative wealth of the city, makes it all the more grim.

Once we are through Tshelimnyama, we enter into Dassenhoek. We drive down into the valley on a particularly steep road; the further we descend, the colder it gets. Our household sits a little way up on a hill and we climb the dirt path to get to it. An elderly man greets us and leads us into the house where a 15 year old girls stands, a baby on her hip, a bawling 3 year old at her feet and a shivering 6 year old washing herself in a plastic basin of filthy, freezing water. The house is made of bare concrete and crumbling plaster work. Its tin roof is supported at the apex by a solitary wooden pole which balances precariously on a brick; one careless kick and the entire structure would probably fall in. It is a depressing scene. The teenager lost her mother to HIV about 3 months ago and has had to leave school to look after her young siblings; her 17 year old sister has a temporary job (she also has not completed her schooling) and her aunt, who supports the family, has a permanent low-income job. The elderly man is the partner of the aunt and he receives a pension.

As Maud chats with the young girl, I notice a number of things which will stay with me for a very long time: the baby, a little over a year, but so tiny she looks about 8 months old, is wearing a diaper fashioned out of an orange municipal recycling bin liner. Her little legs and bum must be freezing inside the shiny, plastic covering. The two youngest children are crying hot, fat tears and are inconsolable. On enquiring, Maud finds that they have yet to eat, and it is already 9.30am. The teenager puts a bottle of formula together for the baby but Maud is not convinced that it is of any nutritional value and the water looks decidedly unclean. She pulls out a loaf of bread and gives it to the girl who has the look of someone experiencing severe shell-shock. I’m not sure that she has processed the situation she now finds herself in: I imagine she is feeling lost and confused, missing her mother and away from her friends at school, her future narrowing to a pin-prick of light in which she becomes mother to three children, uneducated and unemployable.

Maud explaining the soup mix to the 15yr old

The CCG, now trained to think in a more holistic manner, has contacted the local social worker to make plans for the girl to return to school. The child-care grants, which the mother received, had ceased on her death and the family is receiving no assistance at this point. The aunt has applied for foster grants, on behalf on the children, but it will take some time for the money to come through.  There is some concern that the money will not be spent as it should as both the aunt and the partner are known to drink (this is confirmed when I go outside and find a tree with at least 100 empty beer bottles strewn around its trunk). With regular check ups by the CCG this situation will be monitored.

As we drive back up to the main road I am struck by the fact that of course there must be many more households in dire straights all over this community (and in communities all over our province). Many more young girls being pulled out of school to look after siblings, with the unfortunate result that they repeat the cycle of poverty, in which they have grown up. Without education, these girls have no hope. Aside from looking after children, they aren’t occupied during the day and find themselves, out of loneliness, hanging out with unemployed adults and young men far more experienced than them. They aren’t learning about HIV/AIDS during life orientation classes, and they aren’t improving their english language skills through reading and interaction with teachers. For now, the only hope they have, lies in CCGs who have been well-trained and encouraged to think critically.

One of the benefits of properly trained CCGs is that they have the ability to connect the community with the relevant structures and services which are in place. CCGs can speak on behalf of community members and ensure that something gets done, that someone knows what is going on. For this young girl, the opportunity to go back to school lies in the hands of the social worker and school principal – two people she would be unlikely to access – but with the help of the CCG, she now has a chance.

To learn more about Zoe-Life, visit their site (which is in the process of being updated).

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