Hout Bay’s Hangberg

Lily Zhou, Public Health and Development in South Africa, Spring 2013

Hey guys! I’m back in the states and will write my final blog post very soon, but before that I wanted to tell you a bit about one of my favorite public health excursions there. We learned about psychosocial rehabilitation, which is a socially driven process of an individual’s recovery in terms of well-being and community functioning. As many townships in South Africa have an astonishingly high percentage of its population using tik (meth), alcohol, or exposed to/involved in sexual and gang violence, psychosocial rehabilitation is imperative and has been emerging. We visited the Hangberg Community Centre, where our group was able to better understand the organization C.A.R.E.S.’s approach to psychosocial rehabilitation.

Hangberg residents moving an informal settlement’s walls that were taken down by city law enforcement. Photo: Peter Luhanga/WCN

C.A.R.E.S. painted a comprehensive picture of common challenges that the Hangberg community faces: 60% of the population is on or addicted to tik, an average of 15-17 people live in a shack, and women often prostitute their bodies to men at the harbor in order to make extra money. I was especially shocked to hear that it is a common phenomenon for women to drink alcohol to increase the chances that their children will be born with fetal alcohol syndrome, as families with children who have FAS are eligible to receive more social grants and food/clothing passes. Now that I’ve been increasingly exposed to the volatile social scenes that drive members to such drastic measures, I have come to understand more and more the effects of one’s environment on their behavior and beliefs.

Interestingly, we learned that the organization places heavy values and sensitivity on the connotations behind words. For example, rather than calling C.A.R.E.S. clients “drug addicts” or “alcoholics,” they referred to them simply individuals going through recovery. Many of the workers at C.A.R.E.S. were themselves past drug users, and the reason they didn’t use these labels was because the use of them tends to conjure images of stereotypes. These stereotypes relay a shallow surface representation of individuals with complex personal histories and individualism. The actual recovery process that C.A.R.E.S. guides its clients through is one that examines the spiritual, emotional, and physical needs of clients. They test their clients every week for drugs—whether it be tik, cocaine, alcohol, heroine, etc. Because many drug users have gotten around urine tests by buying other people’s urine or other means, they now require these tests to be done with an eyewitness so as to hold users accountable for their actions.

Despite obstacles in the recovery process, the organization has an extremely high success rate: 78.2% of their clients lead drug free lives after psychosocial rehabilitation. Hangberg’s C.A.R.E.S. is just one example of a community based organization helping others reach their potentials amidst some of South Africa’s challenges.