GEPN Clinical Rotation in Tugela Ferry, South Africa
(Jul 2007)
>In July of 2008 Kun Lu and I completed our Community Health Rotation in Tugela Ferry, South Africa. Thanks to the many outstanding individuals who dedicate their lives to providing quality healthcare through Philanjalo and Church of Scotland Hospital, we were allowed to step into the everyday life of the predominantly Zulu region called Msinga. The adjustments we had to make in our daily lives paralleled our adaptation to the healthcare system in a region with an HIV/AIDS epidemic, a devastating incidence of co-infection with tuberculosis and multi-drug-resistant TB. Of the countless experiences we had as student nurses within Msinga, there was a day that sticks with me in particular.
Kun and I made a home visit to a family located kilometers away in the hills of the community. The road to their home was rocky and was almost impassable by a 4-wheel drive bakkie (truck). Their home was in traditional Zulu style- a rondavel (a round hut with conical thatch roof), about the size of a large bedroom. There was a dirt floor & the walls encircling us were a mixture of mud & cement. A man, the patient we were there to visit, was covered in a blanket on a mat on the floor. Due to his emaciation the lines were blurred between his body and a slight elevation in the blanket. His wife held a child and another toddled around us.
The patient explained that he had been diagnosed with TB at the hospital outpatient clinic. He had been on medications now for 1 week. The home-based caregiver asked the next logical question, and he answered that he had not yet been tested for HIV. The home-based caregiver assisted the mother in the administration of her husband's TB medications, five pills I counted as she scooped each of them individually onto a spoon and then slipped them into his mouth. I was told they had no food. I was left to wonder: was this the literal translation from Zulu? No food? Or did they perhaps say: "little food"? It was hard to know in that instant if I was prepared to meet a family of 6 with no food. Immediately my mind raced: How many Rand might it cost to feed them right now, then tomorrow, and next week?
The poverty was palpable, & the reality of their situation was inescapable. There was very little in the home, a single bed, cot-like with wooden legs tied together at the corners, a small table which held 2 cardboard boxes, the contents of which seemed to encompass the few kitchen supplies they had. A dusty jug of water sat next to us on the floor. Their local water source was no longer available so the mother had to walk very far for water. They would normally grow food, but could not because of the drought. Much more discussion & education took place in the home before we began to leave. Mary, the leader of the home-based caregivers, gave the family some toys and food. She handed one of the children a loaf of bread and began packing large quantities of raisins into a plastic pitcher & a tin bowl brought from the family's home. Kun & I gave the children heaping handfuls of raisins, as the bowl & pitcher were filled beyond their limits. My mind raced: Are my hands clean enough to handle their raisins? How long will these raisins even last? Is this all they will eat today? How can I give them more? How far will a loaf of bread go in a family of 6? We said our goodbyes, as I wished I had so much more to give. I imagined the aisles at Target & things the family might get there: diapers, baby wipes, big family size boxes of cereal, and shorts with tags that read, "size T3" and "wash with like colors." We said our goodbyes, my mind raced, and my hands remained sticky from the raisins.
Regina Longinotti, YSN Class of 2010
