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.

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.

Psychosocial Health in a South African Context

Chance Cim, Public Health and Development in South Africa, Spring 2013

Psychosocial aspects of health have been the most ingrained in me during these past few weeks.  For my Development Perspectives on Health class, I have been volunteering at Hesketh King, an inpatient drug rehabilitation center outside of Stellenbosch. The organization offers two programs for up to 60 men: an 8-week program for young men between the ages of 16 and 20 and a 12-week program for men 21 and older. Recently, crystal meth, or ‘tik,’ has become a problem of epidemic proportions in the Western Cape. A recent report by The Daily Voice claims that 1 in 5 Cape children are on ‘tik’ (

Hesketh King

Drug abuse is a propagator of poverty and can trap people in deprivation. A drug addict can think of little besides his or her next fix and this often means missing work or school. Many abusers sell their  belongings or their bodies in order to buy drugs. While all this insanity is occurring, they are breaking social ties with their families, getting in trouble with the law, and taking a toll on their physical health. Drug abuse can not only take an economic toll on a country, but also a psychosocial one within a community.

During one of our excursions for our Public Health class, we visited Hangberg in Hout’s Bay. The topic of the day was psychosocial rehabilitation. The community was overwhelmed with ‘tik’ controlled by The Numbers Gang and the Chinese mafia. However, we met some of the most inspiring community workers trying to reverse the trend of neglect and violence: addicts in recovery trying to encourage others to seek help, an elementary school principal who completely turned the school around and taught her students to take pride in themselves, and an actuary-turned-community worker who was putting her heart and soul in establishing a day care center. The work that these people do is not easy, for they often have to negotiate with gang leaders and drug lords (who act essentially as political entities) in the course of their efforts. I greatly admire their exemplary bravery and passion for fighting to save the community of Hangberg.

Learning about substance abuse in a South African context has been a defining experience during my time here. It has not only reaffirmed my desire to working in mental health and underserved populations, but given me a new appreciation for healthcare’s role in addressing social issues. I am very excited to bring this new perspective back to Chicago!

The Public Sector is a Public Affair

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

South Africa’s health care system is quite simple to explain but emotionally difficult to observe. To give some background information to our excursions, the healthcare system is two-tiered: the public sector is basic, state-funded health care that is free to those who qualify, while the private sector is specialized and caters to a middle-to-upper class population. Despite the private sector only serving 20% of the population, it receives 80% of the nation’s doctors, making the public sector—which serves the remaining 80% of the population—severely understaffed and underfunded. These ratios mean little until you see what operates on a grassroots level at South Africa’s public and private clinics.

During one of our public health excursions, we visited Macassar Community Health Center, a public sector primary level center serving a mainly coloured population. In an already crowded waiting room filled with mothers and the elderly sitting in plastic chairs, the twenty of us only exacerbated the bottleneck in the busy hallways. A high-pitched beep would sound every few minutes in the overhead speakers to signal for the next patient in line to be seen by one of the few nurses. Lining the walls were posters conveying information that would seem superfluous or unnecessary in the context of a typical American hospital.

A poster outlining home-made oral rehydration therapy procedures to counteract dehydration caused by diarrhea

Here, however, the simple messages transmitted through these posters are essential. Fetal alcohol syndrome (FAS), for example, is a very common developmental defect children are born with in South Africa. Within the beautiful grapevines and wine farms in Stellenbosch’s valleys, we learned that a few of the less ethical farms pay their workers in wine instead of money. Drinking is so normalized and ubiquitous within some townships that children as young as 7 start experimenting with alcohol. Apparently, it is a common phenomenon in some communities for expecting mothers to purposefully consume alcohol in order to increase the chances that their children will be born with FAS—all because the government will provide these families with more social grants along with food/clothing passes. Initially, these seemingly reckless actions would have been morally inexcusable for me to fathom. Now, I’ve come to understand more about the volatile environments these women live in that drive them to such acts of desperation. Absent fathers, a lack of male role models, poverty, and inequality are at the crux of why these acts occur.

Our tour of Macassar’s Center quickly elucidated just how literal the “public” in “public sector” is. The building’s infrastructure simply did not support or have room for individual check-up or treatment rooms. For more severe cases, patients would be separated from the others with a privacy drape. During our tour, our doctor guide disappeared behind a drape and came back out several seconds later telling us that he got the permission from a patient for us to observe his condition. When the drapes were pulled back, we were greeted with an unsettling sight of an extremely thin black man twitching and groaning in severe pain on a bed. This man was suffering from a supposed kidney stone. I say supposed because the clinic did not have available technologies—X-rays, lab tests—to properly diagnose him, so the doctors could only make educated guesses on his diagnosis. Treatment was also limited, as surgery was out of the question. Such is the high level of medical uncertainty in a field with limited resources.

While the conditions in the Macassar clinic weren’t ideal, they surpassed my expectations. The facilities seemed adequate and care was comprehensive, covering TB, HIV, maternal and child health, etc. It was only upon walking into the private hospital MediClinic that I became shocked at the heavy contrast between the two, both in facility quality and patient demographic. MediClinic—a ten minute drive from Macassar—was as well-off, if not more luxurious, than American hospitals I’ve visited: patient care was private, there were no visible waiting lines, and the hospital even seemed somewhat empty. Private rooms were equipped with comfortable electronically-adjustable beds and flat screen TVs. There were surgical rooms for heart and knee-cap surgery. Hallways weren’t filled with wrinkled posters outlining TB prevention or hygienic practices, but rather with aesthetic framed paintings of flowers and children. Never had I thought about potted plants, elevator music, and small coffee shops within a hospital as signifiers of privilege.

Privilege truly is defined by relativity and invisible to those who have it.

A Black and White Divide

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

“What are the stereotypes about Americans?” we asked our tour guide.

“You stereotype Africa as a homogeneous place,” he laughed, “you think it is a country.”

As embarrassing as this accusation was, it’s true in varying gradients. Some of my friends from home have asked me whether I see lions and hippos roaming around, and I chuckle as I’ve spent the majority of my time in South Africa at the Stellenbosch University campus:

No hippos here

Even though I recognize the fault in viewing the world through a lens of absolutes—in haves and have-nots—I was still surprised at how “Western” and less traditionally “African” Cape Town and Stellenbosch are. To put it simply, I was shocked at my lack of culture shock. Surrounded by beautiful scenic mountains, Stellenbosch is a European-esque town with heavy Dutch influences in its architecture, culture, and language. The university is about 70% white, 15% coloured (mixed), and 15% black. While I initially viewed these racial statistics as simple categories and numbers, I quickly began realizing the tragic legacy of racial discrimination and struggle in post-Apartheid South Africa.

Just fifteen minutes outside of the picturesque downtown Stellenbosch lies Kayamandi, a township built in the 1950s that was reserved for non-whites. Kayamandi is known in Stellenbosch as a “bad neighborhood”: its social conditions foster rampant alcoholism, crime, sexual assault, and drug abuse. The public health clinics are overcrowded, stray dogs bark at you every few minutes, housing is haphazardly constructed with tin sheets, and trash litters the street. Community members who manage to find work amidst the climate of alarmingly high unemployment usually do so in jobs considered menial: as waiters, construction workers, custodians, etc.

Our group of twenty American students awkwardly walked through the community while locals openly stared and children flocked to hold hands with the foreign tourists. Questions about the interplay between privilege, power, and the ethics behind poverty tourism buzzed through my mind as we observed the township’s conditions whilst documenting daily life with our cameras that likely cost more than an average worker’s annual salary.


After these tours, the majority of the students and I felt overwhelmingly dejected. Such a juxtaposition of first and third world conditions within mere minutes of one another made us wonder: are poverty and disparity normalized here? Historical injustices—like the forcible removal of blacks and coloureds to areas like Kayamandi—are a major root to the complex issues embedded within the social fabrics of these communities. Shouldn’t there be more of a collective responsibility to right the wrongs of the past?

Thankfully, there is. We’ve been able to visit and work at NGOs and public clinics that scatter Stellenbosch and the Western Cape. Whether these organizations counsel those suffering from HIV, treat children with tuberculosis, or aid in the recovery process of drug addicts, they all operate on the core principles of human dignity and equality. Despite the many parallels between South Africa and the United States when it comes to race relations, the dialogue about race in here is refreshingly straightforward and honest. There are few who naively state that this society is colorblind. Our program’s professors exude a passion for progressiveness. And, I’m surrounded by peers who are eager to travel, explore, and learn from this place so different yet similar to home.

While I can’t yet say with confidence what South Africa is in all its complexities, I can say that this past month has been exhilarating, heartbreaking, and beautiful—and has definitely left a mark on my consciousness.

Molo, Goeie dag, Hello from South Africa!

Mariah Wood, Public Health and Development in South Africa, Spring 2013

Hiking in Stellenbosch

Our first month here in South Africa has been absolutely awesome. Stellenbosch is a beautiful town nestled in between mountains and in the heart of wine country. The rolling hills are covered in vineyards. We were at Stellenbosch University for two and a half weeks at the beginning of April. In that time we got to go hiking in the mountains, go to a rugby game, experience Cape Town, visit Robben Island where Nelson Mandela was imprisoned for over 20 years, visit the Cape of Good Hope (the most southwest point of South Africa), and much more. The students here are welcoming and South African culture in general feels very friendly and open.

Some of the most striking things about South Africa, however, would be invisible to us if we were only here doing tourist-type activities like the ones listed above. We have been able to visit different neighborhoods outside of the main university and downtown area, and these have a completely different feel to them. I am doing my service learning practicum in Kayamandi, a neighborhood 10 minutes from downtown and, unlike downtown Stellenbosch, inhabited almost entirely by black Africans. Many of the houses are little more than tin-roofed shacks. The community is very alive, and the kids at the crèche (daycare) at which I volunteer are rowdy and exuberant. The crèche, with 17 infants to four-year-olds under the care of one adult, is no more than a small room with some Legos for the kids to play with. It is facilitated by the NGO I work for to make sure young children are safe and off the streets while their parents are at work.

Kayamandi was a township during apartheid, which means the government mandated that Africans in the area could only live in this part of town. The results of mandated segregation are still very apparent, with inhabitants of Kayamandi facing higher levels of poverty, poor health, and violent crime than downtown Stellenbosch. I can explain this in word form, but it has been in seeing it for myself that I have begun to internalize and understand what inequality means. I feel convicted of the importance of working in a community different from one’s own, not to greatly impact that community so much as to learn from it and to prevent from forming the kind of prejudice that leads to division. This experience has made me think of my own community, Chicago, and the eerie similarities that exist between here and home. I want to take the service learning I am doing here and apply these lessons back home, to engage myself in my community of Evanston and not just in the bubble of Northwestern University.

This is just a snippet of all there is to learn from this beautiful, contradicting country. Soon I’ll update on our recent trip to Kruger National Park, Hamakuya, and Johannesburg.

Parliamentary Response to the State of the Nation Address- Debate or Debasement?

Matt Guerrieri, Global Healthcare Technologies, Winter 2013

Apologies for my lack of updates to this blog!  A couple weeks ago, an onslaught of project work usurped any free time I may once have had.  It still hasn’t relinquished its grip.  With the quarter coming to a close this weekend, however, I should have more time to send updates as I will be remaining in Cape Town for another 5 weeks.

This post actually comes from an entry in my journal dating back to February and a little bit of subsequent research.


February 19, 2013

The garbled chatter of people filing into the room, the uncomfortable rigidity of the mustard-yellow chairs, the vapid fluorescent lighting, the stale re-circulated air: the reality of being inside the South African House of Parliament erodes some of the majesty surrounding this epicenter of political authority. Nevertheless, the gallery buzzes with excitement. No radical changes are being made to the nation’s constitution, no new leaders have been sworn into office, and no controversial bills are reaching the floor for vote. Rather, today is an opportunity for the parties of the National Assembly, the powerful lower house of the South African legislature, to give each other a piece of their minds.

Last week, President Jacob Zuma delivered his annual State of the Nation address. In a typical display of political showmanship, the leader emphasized the past year’s achievements, professed the need for continued improvement, and navigated through contentious issues with grandiloquent generalizations and skillful evasion of details. Today’s response in the National Assembly, the powerful lower house of the South African legislature, provides the opposition parties a chance to criticize Zuma’s speech and the failings of his administration.

Almost inconspicuously, the chief executive slips into the room and takes a seat facing the chamber. Head bowed, lips curled imperceptibly upward into a haughty grin, he prepares to endure whatever political mud his adversaries are poised to sling at him.

The assorted Members of Parliament (MPs) retreat to their designated benches. Their colorful attire, ranging from three-piece suits to vibrant, billowy dresses and elaborately decorated batiks, enlivens the otherwise drab room. South Africa’s ruling party, the predominantly black African National Congress (ANC), sits to the left of the podium. On the right, the noticeably paler Democratic Alliance (DA) leads the opposition parties, which include the Inkatha Freedom Party (IFP) and former ANC subsidiary, the Congress of the People (COPE). The other eleven represented parties occupy the spaces in between. In sum, the room’s demography reflects enormous diversity in age, gender, race, and ethnicity.

Ceremoniously, a black-robed usher brings forth the symbol of the National Assembly, a golden mace with a black, boxwood shaft and places it upright in front of the podium.  The Speaker of the National Assembly requests a moment of silence before calling the meeting to order.  The ruling party bows, the opposition bows, and the first orator, Mathole Motshekga of the ANC, begins his remarks:

“We meet today, heavy in the heart at the horrific and brutal loss of life of innocent babies, children and women through domestic and sexual violence. The scourge of this disease has taken hold in our communities and as much as we develop interventions… to stem this tide, we can all agree that the roots of this violence and the notion that life is cheap, can be traced all the way back to our dark and unjust past.”

This solemn introduction continues with a several minute discourse into the abominations of apartheid and the oppressive system’s agenda to “enslave black people through dispossession and make them dependent on their white employers for survival.”  The oft-repeated exegesis concludes by reminding the South African people that it was the leadership of the ANC that finally ushered the divided country into its young democracy.

In the second chapter of his speech, Mosthekga parrots last week’s national address, peppering endorsement of Zuma’s priorities with lofty words like energize, grow, build, enhance, and promote.  Clichéd platitudes and inspirational quotes by Nelson Mandela are greeted with boisterous cheers from the ruling side of the chambers. Across the aisle, you can almost hear the eyes rolling.  Mosthekga’s adulation boils to its pinnacle with this confirmation of his party’s dedication to fighting South Africa’s blights:

“We will not turn away and fold our arms. We will rise to these challenges and know that when we do so, we are building this country brick by brick.”

Suddenly, Mosthekga changes direction.  His tone intensifies.  At last, he procures the meat of this afternoon’s monologue – disparagement of his opposition:

“By selling their soul and surrendering their autonomy to the DA … [the IFP, COPE, and other allied opposition parties] can no longer claim to represent the views and aspirations of [their] constituencies. They can no longer claim to enjoy freedom of thought and freedom of opinionIt is an antithesis of a multiparty democracy system… to have the throng of political leaders from diverse ideological persuasions dancing to a tune of the neo liberal and conservative agenda of their political master.”

Mosthekga’s accusations of spinelessness among the smaller parties and his obvious contempt for the DA are met with vigorous applause and unabashed jeers.  His lament over the dissolution of the multiparty system portends some irony given South Africa’s history as a one party democracy. Since 1994, the ANC has never held fewer than 63% of the National Assembly, has maintained at least two thirds of the provincially elected upper house of Parliament, and accordingly, has retained absolute control of the executive.

By the time Mosthekga returns to his seat, the crowd is fired up.  Thirty-two-year-old DA Parliamentary Leader Lindiwe Mazibuko is next to the podium.  Forgoing lamentation of the past for criticism of the present, the rising political starlet begins her denunciation:

“The South African people have lost confidence in President Jacob Zuma and his State of the Nation address showed why.”  She pauses, turns her head, and casts a pointed look at the ample man seated on the dais behind her: “He offered a reheated version of last year’s broken promises based on spin and lip service… Ours is a president who says one thing to appease South Africa, and then does another to please himself and his inner circle.”

With calculated but not dispassionate dictation, the young MP portrays the president as self-serving and out of touch.  She mourns the nearly half a million jobs lost since Zuma first assumed office.  In an appeal to young voters, Mazibuko employs a histrionic anecdote about a struggling new mother, conjecturing that Zuma does not “feel for the five million South Africans under the age of thirty-four who are unable to find work.” In this vein, she criticizes his administration for failing to adopt a youth wage subsidy that promised tax breaks to employers who hire young people:

“The worst betrayal of all was the President’s abandonment of the Youth Wage Subsidy.  This would benefit hundreds of thousands of-“

Of white people,” interjects a cracked, grumbling voice behind me.  The outburst – an inevitable reminder of the country’s enduring racial tensions – comes from a leather-skinned, older man whose faded black, green, and yellow tee shirt boasts a dedicated allegiance to the ANC

“-Of young people,” continues the parliamentarian, undeterred, “by absorbing them into the formal economy and providing them with real opportunities.”

After disparaging the President’s economic policies, Mazibuko denounces his intimate relationship with political bigwigs in the Congress of South African Trade Unions (CONSATU) who play a major role in education policy.  She declares, “As repayment for the re-election debt he owes to COSATU, the President endorsed teachers’ unconditional right to strike,” which could potentially leave children without teachers for weeks at a time.

Finally, Mazibuko, like Mosthekga before her, reaches the apogee of her litany – allegations of Zuma’s corruption: “Most presidents’ characters are revealed over time.  This president was compromised from the beginning.”

Her evidence includes Zuma’s refusal to publicize incriminating documents despite court orders. Without this information, the National Prosecuting Authority eventually dropped over 700 charges of fraud against him in a seemingly suspicious maneuver.  Mazibuko additionally condemns his use of the “hard-pressed public’s” tax dollars to fund the R200 million ($22 million) upgrades to his personal compound.  Finally, she urges the President to forgo reelection, charging that “South Africa is a great country being let down by a weak President” and concludes:

“There will be a day; a day when the voices of young South Africans everywhere will finally be heard; A day when our country’s confidence in its own greatness will be restored… There will be a day; a day when South Africa soars under the leadership of a new president and a government led by the Democratic Alliance.”

With that, the opposition parties explode into emphatic applause.  A supercilious roar of laughter erupts from the ruling party. As the afternoon lurches forward, the room becomes more and more unruly.  In a particularly exuberant address, impassioned COPE leader Mosiuoa Lekota foments utter indignation in ANC devotees by comparing the construction of Zuma’s private mansion to the expansion of Hitler’s personal palace during the Nazi regime.  The animated Inkatha Freedom Party (IFP) leader, Mangosuthu Buthelezi, expounds upon the reasons why his party has aligned with the opposition:

The ANC believes the state is there to be pillaged…. The rest of us believe the state is an instrument to serve the people of South Africa, to meet the needs, wants and aspirations of our people.

Conversely, ANC representatives like Public Enterprises Minister Malusi Gigaba rush to defend Zuma. Gigaba argues that the President’s address was a report on the progress made since his 2012 speech and a plan of action for 2013:

It would have been total folly to present a new vision again in 2013 on top of the vision the president presented in 2012, which has only just begun to be implemented. But, of course, the opposition wants us to be stuck on endless visions so that they turn around and ask the question, ‘where is implementation!’ When you implement the vision, they turn around again and ask, ‘why is there no new vision?”

The cycle of criticism and defense continues.

Finally, after nearly three hours in the contentious gallery, the time has come for our small group of university students to head home.  As the heavy wooden door swings shut behind us, the debate inside rages on. Like that of the United States, the South African government is highly polarized. In contrast to the US, however, a single party has exerted uncontested political dominance in South Africa for the past twenty years. Now, it appears that loyalty to the once exalted African National Congress has begun to wane. Crippling allegations of corruption, venality, and overall poor leadership have led to the rapid growth of the opposition movement.

High tensions and emotional investment in the issues at stake incite some leaders to make aggressive, cutting comments and even launch personal attacks on the floor of Parliament. While thoughtful argumentation and intellectual debate are healthy components of an effective government, stubborn animosity and immutable contempt stagnate progress like a virulent, debilitating plague. Today’s dramaturgy serves as a vivid reminder that the line between the two can be extraordinarily fine. The danger of crossing it may be dire.

It’s Hip to be Squ[hair]e

By Matt Guerrieri, Global Healthcare Technologies, Winter 2013

Street in Obs

Dreads, afros, bangs, bobs, corn rows, crew cuts, mohawks, fauxhawks, rattails, mop tops, mullets, braids: if hair means anything- and trust me, it does- Cape Town’s hair says that this city is trendy.  In a country desperately grasping at national unity, Capetonians proudly express their individuality on the tops of their heads.  Style and dress, too, make loud statements about attitudes and beliefs.  Here, they seem to seem to say, “come one, come all.”

Take Munya- tall, thin, dark-skinned with wide-set eyes and an easy smile.  His long dreads bounce up and down on his back as he saunters casually down Lower Main.  A bumbling group of foreigners trails awkwardly behind him.  Obs’ main drag is littered with faded exteriors and dusty windows masking beatnik bars and hip cafes.  Record shops, liquor stores, and small boutiques line the haphazard street, decorated with colorfully dressed locals who loiter outside.

“Which direction are we facing,” I ask, “north?”

Munya’s tight, neat dreads twirl as he shakes his head. “I don’t know, man,” he laughs with a shrug. “I only know towards the Mountain and away from the Mountain.”

Munya has lived in Cape Town for eight years and knows the city like the back of his hand. Originally from Zimbabwe, he came with his family to escape the political and economic turmoil of his home country. As we stare across the Cape Flats toward mainland Africa, Munya smiles and pulls something out of his wallet.

“It’s kind of sad,” he says softly, “we used to tease the Zambians- a million Zambian dollars can’t buy you a loaf of bread- but now, things have gone the other way.”

He shows us the Zim fifty billion dollar bill from his pocket.

“What can you get with that?” one of us inquires.

“Nothing,” replies Munya, “just a laugh.”

When asked if he would like to go back after finishing his masters, Munya answers, “Maybe someday- if it gets better.  But now, Cape Town is home.”

As we wander through the vibrant city, we can’t go more than a few blocks without running into someone Munya knows. Handshakes, hugs, and friendly greetings are exchanged as we pass a medley of different colored skin, hair, and eyes.  The kaleidoscopic crowd moves slowly, flowing aimlessly across streets, through alleys, and in and out of buildings. Our parade slithers and winds around pedestrians, outpacing them, often outpacing our gentle guide.  Nevertheless, during the day we manage to miss both a bus and a train. Munya is unfazed. Time, like direction, is a relative thing.  Some buses are early; some trains are late. People never hurry; everything gets done on Africa time.

Long passed sunset, we arrive back home and wave goodbye to Munya with promises of seeing each other again soon. Before going to bed, I take a refreshing, cool shower. A big glob of shampoo oozes out of the bottle and plops onto my head.  While massaging the viscous solution into my scalp, I begin to wonder, “What does my hair say to people?” (Aside from, perfection of course.)

In truth, the way a person looks can only disclose a superficial insight into his or her personality. However, this mode of self-expression undoubtedly evokes a distinct culture in Cape Town. The city’s youth emanate a bohemian vibe that celebrates diversity, acceptance, and freedom. As everywhere, but particularly here, South Africa’s young people hold the key to a brighter future. Known as the “born-frees,” the first generation of South Africans to have lived without subjection to the oppressive apartheid government has just turned eighteen. The country hopes that from this generation, a new South Africa, unshackled by the bounds of racism, will emerge- that the longstanding animosities of apartheid can at last be replaced by earnest collaborations to alleviate poverty and proliferate justice. It is up to these young Samsons to mend and germinate their wounded country- and to do it in style.

Worth Waking Up For

By Kathryn Jaruseski, Public Health in South Africa, Spring 2012

Handmade crafts arranged on tables in a manner that is pleasing to the eye.  Delicious-looking cupcakes and cheesecake slices begging to be enjoyed.  The comfortable aroma of fresh coffee on a crisp autumn morning.  Local music adding a nice touch to its surroundings.

For some reason, South Africa seems to love weekend markets.  When our group spent a weekend in Cape Town, one of the highlights of the trip was a Saturday morning spent at Old Biscuit Mill, a marketplace that sold handmade crafts, clothing, and artwork, and had a section called the Neighbourgoods Market, which had many amazing food and drink options.

Stellenbosch has adapted this idea in their own way, creating the Stellenbosch Fresh Goods Market which takes place each Saturday at a site in the center of the town.  This morning, several friends and I returned for our second time.  Despite getting up at 9:00 AM for the forty-minute (but rather picturesque) walk to the market, we just couldn’t resist another chance at inexpensive, freshly-made foods.  In this sense, the walk may have been just what we needed to feel a bit better after eating so much deliciousness!  We also wanted to check out the items that were being sold, since we are still on the hunt for a few souvenirs to bring home to our families and friends.

As visitors enter the market, there are many little stalls set up, where local artists peddle their creations, among them crafts, jewelry, accessories, and clothing.  Then, the best part of the market starts: the food area.  Local businesses vend just about any delicacy imaginable: bakery goods, chocolate, Chinese, Indian, and Mediterranean cuisine, and many other tasty choices.  Most of them also offer samples of their goods, allowing shoppers to try just about everything.  Purchases of mine have included snacks from chow mein to popcorn to macarons to lemonade to sparkling wine, all sold by local businesses that specialize in these respective types of food.  A good number of Stellenbosch locals are also present at the market, a place that has been bustling on both occasions that we visited.

Although I hope to fit in one more trip to the market next Saturday (the day before we head home,) I am thrilled to have had a cultural experience in this form, and I would very much encourage future Public Health and Development in South Africa students to take advantage of weekend markets in Cape Town and Stellenbosch!