A Cultural Immersion

Sejal Shah, Public Health and Development in South Africa, Spring 2014

An African Elephant in Kruger National Park

For the past two weeks, we have been busy traveling around South Africa. We spent time in Johannesburg, Kruger National Park and Hamakuya. At Johannesburg, we visited several historical museums, such as the Apartheid Museum, Liliesleaf Farm, and Nelson Mandela’s House. At Kruger, which is a huge game reserve, we saw the big five animals on the first day: the lion, African elephant, leopard, Cape buffalo and rhinoceros. The natural beauty of the different terrains, as well as the majestic beauty of the animals, were breathtaking. However, the best part of the journey came with Hamakuya where we were split into groups to partake in home stays in the rural villages of South Africa.

I stayed in a village called Dotha with four other students from my program. Our host mother, Rachel, and her mother-in-law welcomed us. We greeted our host family with the traditional Tshivenda (the local language) greeting, which consists of the girls laying on the floor with their hands to the side of their face saying “Aah.” The one boy in our group knelt on one knee and greeted the family by saying “Nda.” Our host family is quite extensive with the grandmother, mother, father, three daughters, son and daughter-in-law, and three grandchildren living there. We could not have asked for a more welcoming and caring family to stay with for the three days and two nights in Dotha. The village’s children also welcomed us and spent the whole weekend playing with us and accompanying us everywhere we went. Since most of the villagers only spoke Tshivenda, we had a translator, Glenda, to help us communicate with the community.

Terri, Christine, myself, Emily, Braeden and our host mother wearing traditional clothes in front of our hut.

Our family, who is relatively wealthy, has three huts and a small house. One of the huts is used for cooking while the other two are for sleeping. On the property, there are several chickens, cows, goats and dogs roaming around. The family also owns a large garden which is not typical of families in the village. The garden consists of several vegetables including spinach, cabbage and sugar cane. Our group and all the children were given several sugar canes to chew on for our walk back to the village. That was the first time I ate sugar cane, and it was definitely a sweet experience! Another new experience occurred the second day in Dotha. Our host mother dressed us all in traditional clothing so that we would look presentable for church. Then, with our translator and one of the younger daughters, we walked for an hour and a half to a Born Again church. We spent three hours in church, experiencing the emotional part of the repentance and the high spirited part of the sermons. The church welcomed us, having us on stage dancing while the pastor and other members of the church greeted us.

We had a great time eating sugar cane, playing soccer with the kids and dressing up in traditional clothes. Yet these amazing times didn’t hide the hardships of everyday life in the rural village. Since the water taps in the area are all broken, the women of the village have to walk at least 15 minutes to fetch “clean” water and carry it back to their huts on their heads. I say “clean” because some villagers get water from the river where cattle and children wade in. Others gather water from springs that may contain a high E.coli content. Other activities, such as grocery shopping, children going to school, and men going to work also provide obstacles. With the virtually nonexistent transportation system, the commute to almost anywhere could take hours. Children must leave for school before dawn arrives, and many fathers leave for work in the coal mines at 3am every morning.

The cooking hut and outdoor fire pit where all the cooking is done.

When we said a hesitant goodbye to our family, the mother and grandmother said they will miss us and be bored without our company. The monotonous daily life of women in the village is something I could not deal with. Thus, I am amazed by the strength of the women in the village and their acceptance of their place in their society. Nonetheless, sorrow set in when I said goodbye to our warm host family and the peaceful lifestyle of Dotha. Although the people in these villages don’t have much in terms of money, services and material goods, they are always in high spirits and willing to provide a helping hand when needed.

Revelations in the Museum

Rebekah Williams, Public Health and Development in South Africa, Spring 2014

Hector Pieterson Memorial Museum

We’ve been quite busy here finishing up exams (yes those do in fact actually exist here). But before our exam season started we traveled to Johannesburg for a four-day trip before flying to Kruger. To be quite honest our time in JoBurg wasn’t filled with too many highlights…which isn’t at all the fault of the program. In the middle of one of our excursions to a historical church in Soweto our entire group was simultaneously attacked by travelers diarrhea. Despite this funky sickness, we were able to visit two museums in Johannesburg that took my breath away and remain in my mind still weeks after. The first visit was to the Hector Pieterson Museum in Orlando West, Soweto. It’s only two blocks away from where in 1976 a 13-year-old Hector Pieterson was shot and killed by the police when they opened fire on a group of protesting students. Soweto was alive with student protests to the use of Afrikaans in instruction in the classroom. It symbolized years of struggle and oppression and students wanted no part of it. The iconic photo of Hector’s lifeless body being carried away by his brother and his weeping sister running beside them sparked attention to the upheaval happening in Soweto. The world turned its gaze to South Africa as it exploded into bloody rioting. When we visited the museum we had the opportunity to hear from Hector’s sister, the same one in the image, about that day, the creation of the museum and the legacy her brother has for the South African people. Her moving words also described the symbolism behind the creation of the museum and how each element of the walkway, the stone layout and shrubbery locations were designed to be representative of the protest movement and the lives lost in it.

Probably one of my highlights on this entire trip was our visit to the Apartheid Museum. I was captivated by the museum’s use of symbolism throughout its design. From the point of entry guests are given passes which identified them as either black, colored or white; just as in the apartheid era. Guests pass through separate entrances through the museum based on these passes. They walk through a small hallway filled with real passbooks individuals carried. As they exit, “black passbooks” walk up stairs to reunite with the whole group while “white passbooks” walk up a ramp. Once reunited, the tour guide explains that the reason for this difference is to reiterate the fact of the struggle blacks and coloreds underwent compared to the privilege whites have historically been given. These types of small symbolic reminders were found throughout the entire museum. They pushed you to think a little bit more about the images and words you saw in the museum. It forced the museum to enthrall all your senses and moved it beyond simply a one-dimensional experience. Because of these tools, it’s probably why weeks later I still cannot get that experience out of my mind.

I’ve gotten so swept up into the idea of museum symbolism, I’ve begun to search for fellowships and internships about museum curating and historical investigation. Mind you I’m a sociology and global health student…entering my senior year. It’s a bit too late in the game to switch to an art history or history degree! But it’s as if like a light bulb just went off in my head that reminded me how I used to take piles of history books home from the library as an 8-year-old and read through them over night. But I digress! If I do, however, end up working in the Smithsonian one day I’ll only have beautiful South Africa to thank for teaching me yet another lesson.

 

Natural Power

Sejal Shah, Public Health and Development in South Africa, Spring 2014

Riding baby elephants on the Garden Route. When fully grown, they will be twice the size.

Riding baby elephants on the Garden Route. When fully grown, they will be twice the size.

The past week has been unreal. I jumped off a 216 meter high bridge, rode and fed an elephant, and saw some of the most beautiful scenery South Africa has to offer. Our group definitely enjoyed the week long excursion and all the activities it encompassed on the Garden Route. However, the week also gave us an insight to a different side of South African culture: traditional medicine.

At Knysna Hospice we witnessed the making of herbal medicine. The particular ointment being made contained vaseline, lavender, kooigoed, and comfrey. The bottle of this concoction reads “All Purpose Ointment.” According to the women making the ointment, this applies to cuts, bug bites, and any other skin irritations. As I watched the ingredients boil together in a large pot over a gas burner, I was surprised by the imprecision of the mixture. The women mixed the ingredients together in no special amounts, telling us that there is no right amount to put in. Thus, every pot they make is different due to the different amount of lavender or comfrey put into the mixture. This imprecision of measurement seems to contrast drastically with the western medicine way of extremely calculated and controlled pharmaceutical drugs. Despite my doubts about the effectiveness of this herbal medicine, I purchased a small bottle of this ointment in hopes to see the natural healing power of these plants.

Some of the plants used of the ointment.

Our next stop was at George Botanical Gardens where we met the traditional healer, Richard, who is also a registered physician. Richard took us around the botanical garden, pointing out certain plants and their healing abilities. The most surprising part of the trip was when he claimed that a plant can cure HIV. Richard said that a patient with a CD4 count in single digits (a sign of an extremely vulnerable immune system) was revived to health through his herbal medicine. Naturally, one would wonder why a known cure for HIV hasn’t been widely used to treat all those infected to save millions of lives. However, Richard states that the reason no one uses his method is because there is no scientific evidence to prove its effectiveness. The strong belief in the natural healing abilities of plants appeared to contrast greatly with western medicines reliance on processed drugs. As we went through the tour of the gardens, I wondered if the substance in the plants used to heal certain ailments were the same ingredients found in western medicine to treat the same illnesses.

Although I personally would need to see evidence to believe Richard’s claims to treatment for diseases such as HIV, cancer, and pneumonia, it was informative to learn about the cultural differences in medicine and public health. Learning about traditional healing in Africa provided a whole new approach to medicine. The natural power of plants and the variety of their healing abilities are surprising. Hopefully the success of traditional medicine will be combined with those of western medicine to find a cure for deadly diseases such as HIV.

One world, different views

Karolina Kielbania, Public Health and Development  in South Africa, Spring 2014

 

Hey all!

WOW, what an absolutely incredible week it has been on the Garden Route. I could spend hours talking about the various fun things we did such as BUNGEE JUMPING, canoeing, interacting with elephants and ostriches, zip-lining, cave exploring etc… but I’ll spare everyone the time/details and just include some pictures (below) instead:


Besides partaking in all of these wonderful activities, we did do some learning as well. We had the pleasure of spending a few days with Dr. Frank Muller who is a medical doctor as well as a pharmacologist. However, he is unlike any medical doctor that I have met in the States considering that he is particularly interested in herbal remedies. African herbal remedies are considered a part of traditional African medicine, which is a component of one of the five different worldviews in Africa. What I mean by “worldviews” is simply the views that form our underlying assumptions from which we act. In Africa, these five consist of Traditional African, Hindu, Islam, Christian, and Modern Western. We spent a good amount of time on the Traditional African worldview, which holds the belief that things in the world are made better through the intervention of a healer. This contrasts with the Modern Western view, typically seen in the US, which believes that certain problems in the world can be alleviated through technology or education.

To better understand this worldview, Dr. Frank took us to a hospice center in Knysna (a town on the Garden Route) at which we got to see and help the traditional healers make their natural remedies. They used various herbs such as lavender, which they cooked in a giant pot using vaseline and peanut oil. Such herbal remedies can be used to treat things such as infections, cuts, etc. Below I included a picture of some of the herbs, as well as a few of the students helping out the traditional healer. In addition to this experience, we also got a chance to meet and interact with Richard, who was educated as a medical doctor, among other things, and is now a traditional African healer. He showed us various plants and herbs in his botanical garden, and I found it very amazing that a simple plant has the potential of curing so many ailments. For example, I learned that geranium, when used in tea form, can help with menstrual pain. Overall, the entire experience was very eye opening; it allowed us to see a side of medicine that we most likely would not have seen in the States.

If interested in reading more about Dr. Frank and his journey, check out his blog! It’s really quite interesting: http://www.docfrank.com/

When two cultures meet…

Karolina Kielbania, Public Health and Development  in South Africa, Spring 2014

 

As week 4 is coming to an end, South Africa continues to surprise and amaze me in the best possible ways. I don’t think I’ll ever get sick of this country with its beautiful views, kind people, rich history, and so on. How will I ever leave? It’s interesting, because as much as I love it here, I do not think I could ever consider South Africa a home after living near Chicago the majority of my life. In Chicago, I am just like any other local with my supposed Chicago accent (I don’t hear it, but everyone keeps telling me I have one), my mannerisms, and even my style of dress. However, here, in Stellenbosch, I am an “American,” and, surprisingly, this is quite noticeable to all of the locals here. So, naturally, like with most study abroad experiences, I want to start feeling more like the locals and students here. Slowly, but surely, I have begun doing this in a few ways.

A few of the other students and I had quite an interesting experience when attending one of the student Catholic masses at the university. It was a typical mass, nothing out of the ordinary, until it came time for the announcements towards the end. The priest mentioned that there were some American visitors in the crowd (one of us emailed him earlier that week to figure out transportation), and then he looked straight at us, “It’s you guys, right? I could tell.” We were so surprised, and somewhat entertained, by this. How could he tell so easily that we were all American? Sure, we typically travel in larger groups and talk in a funny accent, but we just couldn’t decide how our outward appearance makes us look “American.”

With this in mind, along with other things, some of us decided to join a few sports and activities on campus in order to get more of a student experience. I, including some of the other students, decided to try out social tennis, which was really fun with the first practice we went to. Unfortunately, since we are kept so busy, we have not been able to attend many of the other practices. A few days ago, we attended a braai (a South African Barbeque with LOTS of meat) at the dorm where we are staying. This was another great way to meet some of the other students and feel less like a foreigner.

It’s definitely hard to feel like an actual student when you’re in a foreign country for a short span of 11 weeks. So far, I have been feeling much like a tourist especially considering the fact that we go on many excursions and travel in large groups. However, some aspects of South African culture have been starting to rub off on me a bit, such as taking my time with things (dinner is at least a good two hours here). South African time is a lot more relaxed and chill than “American” time. All in all, as the weeks go by, I feel myself acquiring a so called “third culture” where certain aspects of my home culture intermingle with aspects of this new and foreign South African culture. I am sure this will strengthen even more throughout the program. But, now I must pack for our week long Garden Route trip which I am super excited for and will definitely post updates once I’m back!

P.S. My NGO placement is at House Horizon for the remainder of the program. It’s really an awesome organization and you can read more about it here: http://www.huishorison.org.za/home.h

Putting the “study” in study abroad

Karolina Kielbania, Public Health and Development  in South Africa, Spring 2014

 

Greetings from Stellenbosch!

This past week and a half has been absolutely incredible. South Africa has definitely managed to exceed my expectations and capture my heart in just this short timespan. Our first week here sort of felt like a second spring break; we got to walk the streets of Stellenbosch (which reminds me of a European town), eat amazing food, tour beautiful and historic places, etc. I have included some pictures with some of the highlights which include views of Stellenbosch mountain, as well as the view of Cape Town from the top of Table Mountain.

But, I want to focus this post on one of the aspects of study abroad that usually gets forgotten: the academics! Don’t get me wrong, the touring, the eating, the socializing, and the cultural immersion are all absolutely wonderful pluses of studying abroad. However, the academic aspect really allows us to put what we are seeing into perspective, as well as giving us the necessary background information. We just started classes this week, and I already feel like I have learned so much. Just to give some background, we are taking four Northwestern classes here at Stellenbosch University which include the following:

Development- We will all be working at various NGOs in the surrounding areas once a week, and the types of projects that students do will depend on the NGO that they are working at. I haven’t received my assigned area yet but I am super excited to find out where I’ll be working!

Public Health- This class consists of many excursions. The professor doesn’t believe in straight lectures, which I think is obviously great. So, throughout the quarter, we will be visiting various health areas such as clinics, hospitals, etc. We actually went on our first excursion this week which consisted of the community care clinic in Macassar (a free clinic), a private hospital (Mediclinic), and a district hospital. This experience was extremely eye opening and allowed us to see just how wide the disparities are within healthcare. Although there was a lot of information acquired throughout the day, one of the key takeaways for me was the fact that the private hospital only serves about 7% of the population. This was the most high tech, clean, and well staffed hospital out of the three; it reminded me of a typical hospital seen in the States (it may have even been better quality than some). The other percentage of the population is served through the public hospital, which was extremely crowded, understaffed, and noisy.

Politics- This course serves as a way for us to get familiar with the apartheid past and the transition to democracy in South Africa. From the first lecture, I can already tell that this course will be very information heavy, but extremely interesting.

Language, Culture, and Identity-  From my perception of this course so far, I can already tell that this one will be the most easy going out of the four. Our first lecture consisted of learning about the origins of the official languages in South Africa (there are 11), and then learning some phrases in Afrikaans and isiXhosa (which is actually the language that Mr. Mandela spoke) through a song.

So, with that in mind, I shall say “Lekker dag” and will update with more in the coming weeks!

 

 

There is more than a 30 second recap

by Keyra Ogden, Public Health in South Africa 2013

Exactly one year ago today I was on a plane to Cape Town, South Africa. The next three months in South Africa would change my perspective about the world and stay with me forever. It seems surreal that this incredible experience was so long ago. Sometimes I can’t even believe that it happened. As soon as I stepped back on campus, life returned to its normal routine and aside from the initial interest in my experiences abroad, the topic of South Africa and my time there rarely comes up in conversation. Luckily I have a group of 19 other Northwestern students to reminisce with and to help keep my experiences alive. Without them, I think I would feel an overwhelming sense of frustration.

Many people I talk to about my time in South Africa only want to hear about the safari or the bungee jumping (WHICH WERE BOTH AMAZING), but my experience there was SO much more than that. It’s hard to convey exactly what you learned and how things affected you to those who did not experience them with you. The frustration sets in when you start to feel like no one else truly understands what you have to say and they just want the 30 second recap – which is honestly impossible to come up with. Generally, you get the question “How was South Africa?” To which you mentally respond, “How on earth am I supposed to answer that question? I was there for three whole months and saw social segregation, health disparities, townships full of thousands of people living in spaces no bigger than my bathroom at home with no plumbing or electricity, cultures vastly different from my own, new traditions, new foods, different currency, new languages, traditional medicine men, children with no shoes, lots of mullets, beautiful beaches, contrasting living conditions, rugby games, and the list goes on. And that’s only what I saw, not what I learned or what I felt or who I met or how my perspective changed!” However, you verbally respond, “It was fantastic, I had the time of my life,” because that’s the short and socially appropriate response (and all anyone usually wants to hear).

But salvation comes when you remember that you have a network of friends on campus that lived every moment with you. These friends have been my support network and have helped me continue to incorporate my experiences in South Africa into my everyday life. In addition, as an IPD ambassador, I have gotten to relive my experiences and share them with new groups of people – most notably, those who are on their way to South Africa right now to participate in my program. The ability to share my experience with them and to get them excited about going abroad has honestly led to a sense of personal fulfillment. My efforts as an ambassador have helped me feel as though my experiences matter and always will. Many people don’t realize that it can be tough to adjust back to the normal routine after returning from being abroad. The key is finding ways to keep your experiences a part of you each day – whether it be writing about it in papers for class, reminiscing with friends from abroad, going to international events related to your country, keeping in touch with friends you made in-country, or even becoming an ambassador for your program. Keep your experiences a part of you and don’t let them fade away because they are worth sharing and only help you continue to grow!

Hammocks and Sweet Tea

Rebekah Williams, Public Health and Development in South Africa, Spring 2014

Hiiiii ya’ll, I’m Rebekah and for the past week and half my days have been consumed by hammock lounging in my backyard and eating copious amounts of my mom’s mac-and-cheese. Also…lots of sweet tea…sweet tea from dawn ‘til dusk. While this sedentary (perhaps slightly-worrisome-for-my-health) lifestyle has been the perfect break after the Polar Vortex Quarter…all good things must come to an end. This week has given me the chance to reflect on the quarter and think about what will begin tomorrow. Having the time to simply stop, pause and think is unheard of the quarter system and this break gave me nothing but time to do this.

Spring quarter of junior year isn’t supposed to be filled with new experiences. Instead heading back to Evanston, you’re a seasoned upperclassman familiar with the coffee of Finals Week, annoyed by the freshman and planning out your stress level while waiting to hear back about internships for the summer. It’s the same-old-same-old.

My spring will be absolutely nothing like that. Every single experience I will have tomorrow and for the next 3 months will be brand new starting with the a 12+ hour plane ride that I hope I have enough movies to get me through. The fact that only the unfamiliar awaits me is thrilling in every possible way. I’m drawn to the familiar and the comfortable and it was about time I shake it up. The Northwestern bubble I built around me for the past three years is going to burst and I for one cannot wait.

Until then I shall be waiting in limbo for 5:44pm tomorrow when my plane will leave the runway. Let the countdown begin.

 

Projects that matter

Sarah Uttal, Global Healthcare Technologies, Spring 2014

As our time in Cape Town draws to a close, we are all working hard to finish up our design projects we have worked on all quarter. This quarter has given each of us the opportunity to design a medical device to be used in South Africa, dealing specifically with South African health problems. Our classes here also taught us how to correctly think about these devices in a broader setting of health technology management and their potential cultural impact.

I got to work on a redesign of the current respirators used to protect against tuberculosis (TB) infection. We first came across these respirators during our time in KwaZulu-Natal when we had to wear them before entering a TB ward. Since TB is one of the top five causes of death in South Africa these respirators are used all over the country, but that does not mean they are the ideal way to protect oneself from the disease. We actually found them almost unbearable and decided there had to be a more comfortable solution to this problem. It was great to experience a problem first hand, hear the impact a better solution would have, and then begin to work on it in the setting where it would be implemented. We were able to speak to so many professionals around Cape Town and even around the country who gave us insights into why these respirators are not functional and how we could work to make them better. This is exactly what I was excited about doing before coming to Cape Town, working on a project that matters where it matters most.

Our entire group also worked on a waiting time study at the primary care facilities around Cape Town. People here wait for hours before being seen by a doctor and the government called us in to figure out why. We spent long days in clinics tagging patients and tracking clinic flow to determine where the system was failing. This meant hours of patient contact every day as people approached us telling us their problems with their healthcare system and letting us know how we could help fix it. This was another design project where we could really make a difference immediately. It is hard as an outsider to come into a South African community health clinic without much previous knowledge and try to change the system, which is why these patient anecdotes were so valuable. After multiple full days with 5:45am starts we began to get the hang of the clinic flow and figured out how to tag all the patients coming to clinic. We also began to observe some problematic trends and best practices we are now able to pass on to administration. We learned so much about the primary health care system’s successes and failures by being a part of this unique experience. It was definitely hard work but hopefully we made an impact and will have made those wait times a bit shorter for a frustrated patient population. It is great to know we are leaving having helped a country that has given so much to us these last few months.

What is “best” is not always “best”

Sarah Uttal, Global Healthcare Technologies, Spring 2014

We spent an eye-opening 10 days in Kwa-Zulu Natal to begin our South African immersion. Our time was spent traveling around the province visiting different clinics and learning about the healthcare system here. We had amazing guides, including one of the best biomedical engineers in this part of the world, who showed us around and introduced us to healthcare professionals. There is no comparison to seeing the environments where patients are treated and talking with those who treat them to discover the strengths and failures within a healthcare system.

There are definite problems with the healthcare system that were exposed during our visits. One that shocked me most was the waiting time at some of the hospitals, like Grey’s Hospital in Pietermaritzburg. We saw patients waiting outside for hours in the heat not knowing if they would even be treated.

At another hospital visit we were able to observe a couple surgeries including a cataract removal. This was an amazing experience for those pre-meds among us, as getting to scrub into surgeries in the US is uncommon. The operating rooms did not have all the amenities of those I have seen in the US, but the surgeons were resourceful. When one of the vents in an operating room kept blowing hot air on a surgeon they simply patched it with a piece of cardboard and kept operating. It was impressive to see they did not let anything get in their way of caring for the patients.

We also saw examples of technology we would never expect to see in use in the US. We saw a bed that looked to be at least 70 years old still being used in an operating room. This bed clearly stood the test of time, was still functional, and was sturdy enough to last for years to come.

This was just one example of many technologies we saw that exemplified the concept of “appropriate technology.” What is appropriate is not always the most modern technology available, but is what will be most effective in the environment it is needed. This does not mean people in South Africa or anywhere else deserve substandard equipment, because everyone deserves quality healthcare. Instead it means redefining that word “best” to mean what will best serve the community where that care is being provided. What is best is what will work and last in the environment where it is needed. I think this concept is lacking from our biomedical engineering education and has sparked many discussions in our group during and after these hospital visits. We are learning what it means to be biomedical engineers and how to make the best technology for the community we aim to serve.