Wednesday, August 31, 2005
What wonderful memories!
As you can see from the posts and pictures, we have wonderful memories from our visit to South Africa.
My memories include: worrying as to whether everyone would get to Logan Airport in time for the 6:10 AM flight(we did!); doing my "night nurse" routine and checking on members of the group during the flights (they were fine and I got my exercise to prevent DVT's); seeing Costa at the airport to greet us; going to dinner our first evening at Jenny and Costa's home to bid old friends and colleagues Kathy and Dotty farewell; seeing friends and colleagues at Highway Hospice,the Nursing School at UKZN, McCord Hospital, Church of Scotland Hospital where we also visited an orphanage and went on home visits, St. Mary's Hospital, Lamontville Township feeding program, Africa Center, Crompton Hospital,Inkosi Albert Luthuli Hospital, and the Doris Duke Research Center at the Nelson Mandela Medical School(UKZN)and much more.
People always make the difference in every trip. There are so many people who made our trip memorable and we're grateful to all of them. Many have been special friends for a number of years. Although I won't mention names I will make one exception with Costa and Jenny who were incredible hosts. They did far more than rent us rooms. Their thoughtfulness made for a wonderful trip for the group.
Culturally, we visited a flea/craft market, saw Durban and environs, had a picnic breakfast at Tala Private Game Reserve, attended the African Footprints production, had a weekend at the beach, saw the uShaka aquarium, St.Lucia Wetlands,and Hluhluwe Game Park among other activities.
A special treat for us was the presence of the President of the MGH Institute of Health Professions for the first few days of our stay. She came to be with us and to express her support of the international activities of the Institute. We were all sorry to see her leave.
We squeezed a lot of activities into a very brief period of time. It was special for me not only because of our South African colleagues, but also because of the composition of our group. They came on this very first educational venture abroad for us as an educational institution when not all of the details had been worked out because they were committed to learning more about international health care. They came and we were all conquered with the commitment to return.
My gratitude to all who helped make this possible- who supported us in large and small ways both in South Africa and in the U.S. Thank you also to those who have decided to support the work of our South African colleagues. Inge
My memories include: worrying as to whether everyone would get to Logan Airport in time for the 6:10 AM flight(we did!); doing my "night nurse" routine and checking on members of the group during the flights (they were fine and I got my exercise to prevent DVT's); seeing Costa at the airport to greet us; going to dinner our first evening at Jenny and Costa's home to bid old friends and colleagues Kathy and Dotty farewell; seeing friends and colleagues at Highway Hospice,the Nursing School at UKZN, McCord Hospital, Church of Scotland Hospital where we also visited an orphanage and went on home visits, St. Mary's Hospital, Lamontville Township feeding program, Africa Center, Crompton Hospital,Inkosi Albert Luthuli Hospital, and the Doris Duke Research Center at the Nelson Mandela Medical School(UKZN)and much more.
People always make the difference in every trip. There are so many people who made our trip memorable and we're grateful to all of them. Many have been special friends for a number of years. Although I won't mention names I will make one exception with Costa and Jenny who were incredible hosts. They did far more than rent us rooms. Their thoughtfulness made for a wonderful trip for the group.
Culturally, we visited a flea/craft market, saw Durban and environs, had a picnic breakfast at Tala Private Game Reserve, attended the African Footprints production, had a weekend at the beach, saw the uShaka aquarium, St.Lucia Wetlands,and Hluhluwe Game Park among other activities.
A special treat for us was the presence of the President of the MGH Institute of Health Professions for the first few days of our stay. She came to be with us and to express her support of the international activities of the Institute. We were all sorry to see her leave.
We squeezed a lot of activities into a very brief period of time. It was special for me not only because of our South African colleagues, but also because of the composition of our group. They came on this very first educational venture abroad for us as an educational institution when not all of the details had been worked out because they were committed to learning more about international health care. They came and we were all conquered with the commitment to return.
My gratitude to all who helped make this possible- who supported us in large and small ways both in South Africa and in the U.S. Thank you also to those who have decided to support the work of our South African colleagues. Inge
Tuesday, August 23, 2005
Nation of contrasts
People love 80's music in South Africa; one can hear it all over: it's playing in the airport upon arrival to the country, in the public bathrooms, shopping areas, from homes. This begged the question: what does South Africa have about this music?
In retrospect, South Africa seems to be a nation of contrasts, the most striking being the division and distribution of wealth. Huge mansions with walls around their borders and caged doors sit next to (and sometimes even a block away from) miles and miles of "informal settlements," which is a very "nice" description for the millions of homes that have been build by the people (illegally) that grip to hillsides and areas just outside of major urban areas. The informal settlements do not have government-supplied sanitation or electricity, and people use plastic trash bags as roof-tops. It is rumored that the government has begun a housing project, where a sturdy home of wood or brick will be built for every family in a settlement; however, according to a South African I met, "it will take over 100 year at the rate they're going." I am not sure of the proportions of people living in informal settlements to those living in mansions, but I would suspect that it mirrors the ratio of those with health care to those with none: 5:1.
Another contrast: in the few settlements I observed and in other communities throughout the country, people were pulling together. South Africans are very proud of where they live, and they identify with and want to help others around them. Florence, a "retired" nurse and dear friend of Inge, works day and night for her community; she runs a soup kitchen that feeds hundrend of the sick and injured daily, and she is building a health center for AIDS and hospice patients. People love her, they trust her, people want her near them as a leader. Then, we have the counterpoint: crime rates are extremely high in South Africa. Theft and rape are major problems, and they are crimes diametrically opposed to the neighborhood trust I just described. It seems to me that the crime in South Africa is directly related to poverty and to the lingering sting of apartheid. Despite these problems, I never once felt threatened or scared, and if I did, I believe that a mere "yelp" would have garnered the help of many.
The next conrast has to do with racial tensions in the aftermath of aparthied, which ended only 11 years ago. I think that South Africa has come a long way, especially in terms of equality in politics and law (at least on the surface). In the cities especially, the populations seem to be more diverse and integrated than in smaller, more rural towns. That's not to say that the urban areas are completely intergrated: they aren't, but neither is Chicago, New York, LA, etc. However, there still exists extreme racsim along with major differences in income, academic and employment opportunities, and access to resources, like healthcare, between races and gender. Hopefully with time these discrepencies will diminish, as they are slowly doing in our country. Just talking to people elicited different responses about the situation in South Africa since Apartheid; several people I spoke with think that they have come a long way but still have a long way to come. On a good note, at the various healthcare settings we visited, from small clinics to large hospitals, the workers and patients - of many races - worked together and were treated side-by-side as equals.
Sub-sarahan Africa in general and South Africa in specific have been struck by the HIV and AIDS epidemic. Admist the pain, sorrow and difficulties that surround the impact of HIV, hope, altruism and love are clearly evident and seem to outweigh the hardships. And that gives me hope. I think that is why people love the 80s music in South Africa: to me it is a music (corny at times, yes) filled with compassion (remember "We are the world?") and messages of community, love, and hope for a better future.
Courtney
In retrospect, South Africa seems to be a nation of contrasts, the most striking being the division and distribution of wealth. Huge mansions with walls around their borders and caged doors sit next to (and sometimes even a block away from) miles and miles of "informal settlements," which is a very "nice" description for the millions of homes that have been build by the people (illegally) that grip to hillsides and areas just outside of major urban areas. The informal settlements do not have government-supplied sanitation or electricity, and people use plastic trash bags as roof-tops. It is rumored that the government has begun a housing project, where a sturdy home of wood or brick will be built for every family in a settlement; however, according to a South African I met, "it will take over 100 year at the rate they're going." I am not sure of the proportions of people living in informal settlements to those living in mansions, but I would suspect that it mirrors the ratio of those with health care to those with none: 5:1.
Another contrast: in the few settlements I observed and in other communities throughout the country, people were pulling together. South Africans are very proud of where they live, and they identify with and want to help others around them. Florence, a "retired" nurse and dear friend of Inge, works day and night for her community; she runs a soup kitchen that feeds hundrend of the sick and injured daily, and she is building a health center for AIDS and hospice patients. People love her, they trust her, people want her near them as a leader. Then, we have the counterpoint: crime rates are extremely high in South Africa. Theft and rape are major problems, and they are crimes diametrically opposed to the neighborhood trust I just described. It seems to me that the crime in South Africa is directly related to poverty and to the lingering sting of apartheid. Despite these problems, I never once felt threatened or scared, and if I did, I believe that a mere "yelp" would have garnered the help of many.
The next conrast has to do with racial tensions in the aftermath of aparthied, which ended only 11 years ago. I think that South Africa has come a long way, especially in terms of equality in politics and law (at least on the surface). In the cities especially, the populations seem to be more diverse and integrated than in smaller, more rural towns. That's not to say that the urban areas are completely intergrated: they aren't, but neither is Chicago, New York, LA, etc. However, there still exists extreme racsim along with major differences in income, academic and employment opportunities, and access to resources, like healthcare, between races and gender. Hopefully with time these discrepencies will diminish, as they are slowly doing in our country. Just talking to people elicited different responses about the situation in South Africa since Apartheid; several people I spoke with think that they have come a long way but still have a long way to come. On a good note, at the various healthcare settings we visited, from small clinics to large hospitals, the workers and patients - of many races - worked together and were treated side-by-side as equals.
Sub-sarahan Africa in general and South Africa in specific have been struck by the HIV and AIDS epidemic. Admist the pain, sorrow and difficulties that surround the impact of HIV, hope, altruism and love are clearly evident and seem to outweigh the hardships. And that gives me hope. I think that is why people love the 80s music in South Africa: to me it is a music (corny at times, yes) filled with compassion (remember "We are the world?") and messages of community, love, and hope for a better future.
Courtney
Wednesday, August 17, 2005
Reflections on South Africa
Dear friends and readers,
I returned from South Africa approximately three days ago and I am just beginning to recover from the jet lag (although I do enjoy waking up and feeling awake at 5am). In any case, I will try to summarize my overall impressions of my experience in South Africa.
One of my first impressions of the country and the one that has remained with me throughout my travels was the incredible vibe that I felt there. There was a political vibe, a cultural vibe, and a spiritual vibe. Politically, the country continues to recover from the apartheid years and the effects of apartheid are still very prevalent; particularly the existence of townships. Culturally, the country is so incredibly diverse that it pulses with diversity and multiculturalism. South Africa has the largest Indian population outside of India and eleven national languages! Spiritually, South Africa is vibrant. We saw this spirit displayed in several ways, from protests to prayer ceremonies. On two separate occasions we witnessed protesters doing the characteristic toyi-toyi dance to demonstrate their cause. One protest was among workers at the local "Pick and Pay" supermarket. The other protest was in a rural area called Tugela Ferry. Protesters there were holding signs that read, "Away with Sex"; most likely because the rural areas have such high rates of HIV infection. Song and dance is used often in South Africa during prayer and other ceremonial acts and is very very effective.
A major focus of our international health experience was the issue of HIV/AIDS. We began to understand why HIV and AIDS are so rampant in South Africa and what is being done (or not being done) to curb the devastating effects of the disease. South Africa is more developed than most other African nations, yet the problem of HIV in South Africa is the worst. I can only explain this by considering that as a developed nation, South Africa has easier and faster modes of transportation. Men, in particular, will leave their homes to work in mines or other faraway destinations. People are undereducated and traditional belief systems are prevalent. Women are marginalized to a considerable degree and many men have multiple sexual partners. Condoms are not widely used. The idea of testing for HIV is nonexistent for many people because of the incredible stigma of being infected. The rollout of antiretroviral medications is extremely slow and only began last year. Traditional remedies of olive oil, potato, leeks, and garlic are still endorsed by the minister of health. Only those who can afford to pay the monthly fee for medications are priveleged enough to have it in most places. Programs implementing ARVs have strict protocols for teaching adherence and only those who will be adherent will qualify for medications.
Tuberculosis is a common comorbidity of HIV/AIDS and more people will die from TB than HIV. People are typically treated for at least two weeks on TB medications before initiating antiretroviral medications. This is done to prevent an immune reconstitution syndrome whereby the latent TB bacteria surge do to a sudden resurgence of the immune system from the ARVs. This can actually kill people relatively fast so prevention with TB medication is necessary.
I am glad to have had the chance to visit such a phenomenal country and to have met so many outstanding people. People who work so hard despite the odds against them. It was an inspiring trip that truly changed my life. Thank you to Inge and everyone else at the IHP for making it happen. Thank you to Costas and Jenny for taking such good care of us while we were there. The group could not have been any better and it was a pleasure having Ann with us in the beginning.
Thank you again and Cheers, Lisa
I returned from South Africa approximately three days ago and I am just beginning to recover from the jet lag (although I do enjoy waking up and feeling awake at 5am). In any case, I will try to summarize my overall impressions of my experience in South Africa.
One of my first impressions of the country and the one that has remained with me throughout my travels was the incredible vibe that I felt there. There was a political vibe, a cultural vibe, and a spiritual vibe. Politically, the country continues to recover from the apartheid years and the effects of apartheid are still very prevalent; particularly the existence of townships. Culturally, the country is so incredibly diverse that it pulses with diversity and multiculturalism. South Africa has the largest Indian population outside of India and eleven national languages! Spiritually, South Africa is vibrant. We saw this spirit displayed in several ways, from protests to prayer ceremonies. On two separate occasions we witnessed protesters doing the characteristic toyi-toyi dance to demonstrate their cause. One protest was among workers at the local "Pick and Pay" supermarket. The other protest was in a rural area called Tugela Ferry. Protesters there were holding signs that read, "Away with Sex"; most likely because the rural areas have such high rates of HIV infection. Song and dance is used often in South Africa during prayer and other ceremonial acts and is very very effective.
A major focus of our international health experience was the issue of HIV/AIDS. We began to understand why HIV and AIDS are so rampant in South Africa and what is being done (or not being done) to curb the devastating effects of the disease. South Africa is more developed than most other African nations, yet the problem of HIV in South Africa is the worst. I can only explain this by considering that as a developed nation, South Africa has easier and faster modes of transportation. Men, in particular, will leave their homes to work in mines or other faraway destinations. People are undereducated and traditional belief systems are prevalent. Women are marginalized to a considerable degree and many men have multiple sexual partners. Condoms are not widely used. The idea of testing for HIV is nonexistent for many people because of the incredible stigma of being infected. The rollout of antiretroviral medications is extremely slow and only began last year. Traditional remedies of olive oil, potato, leeks, and garlic are still endorsed by the minister of health. Only those who can afford to pay the monthly fee for medications are priveleged enough to have it in most places. Programs implementing ARVs have strict protocols for teaching adherence and only those who will be adherent will qualify for medications.
Tuberculosis is a common comorbidity of HIV/AIDS and more people will die from TB than HIV. People are typically treated for at least two weeks on TB medications before initiating antiretroviral medications. This is done to prevent an immune reconstitution syndrome whereby the latent TB bacteria surge do to a sudden resurgence of the immune system from the ARVs. This can actually kill people relatively fast so prevention with TB medication is necessary.
I am glad to have had the chance to visit such a phenomenal country and to have met so many outstanding people. People who work so hard despite the odds against them. It was an inspiring trip that truly changed my life. Thank you to Inge and everyone else at the IHP for making it happen. Thank you to Costas and Jenny for taking such good care of us while we were there. The group could not have been any better and it was a pleasure having Ann with us in the beginning.
Thank you again and Cheers, Lisa
Thursday, August 11, 2005
The African Centre
Friday. July 29th: The last Friday of our trip we drove to the region of Hluhluwe (shoosh-louie) located North of Durban. Our first stop was to the African Centre near the town of
The centre takes pride in its environmental friendly approach of management, and to being a source of employment to the town of
There is a lot more of information about the centre but in the interest of time I should finish here. However, if you want more information abut the center, and about their research studies you can visit their website at www.africacentre.org.za
Enjoy,
Carmen
Monday, August 08, 2005
St. Mary's Hospital, July 27, 2005
Hello Blog readers!
Well, it has been almost a week since our return and we still have so much to share from our International Health Experience :)
The last Wednesday we were in Durban, we spent the morning with Sr. Regina at St. Mary's Hospital just outside of Durban. St. Mary's is a 200 bed community hospital which services the Inner/Outer Ethekwini Community (750,000 people!).
One program at St. Mary's is the Ithemba ARV Program which is funded by PEPFAR. The clinic was founded in 2003 as a collaboration between St. Mary's, Harvard University Partners AIDS Research Center and Pangea San Francisco AIDS Foundation.
The Mission of this clinic:
"To give life and improve quality of living to the community we serve by delivering holistic care to patients and families with HIV/AIDS by returning hope and delivering ARV's"
Quite a powerful mission...and Sr. Regina is a phenomenal Nurse! She walked us around the different units of the hospital as well as the outpatient antenatal clinic (I think we all liked this one a lot because of the cute babies there with their mothers for check-ups etc.). Everyone we met was not only welcoming and willing to talk more about what they do, but also quite motivated to work hard because they are making such a difference in the lives of their patients.
It was exciting to talk to one of the research assistants who explained one research study being done to test out ARV's on AIDS-infected infants...the thought is that since the babys' immune systems are immature, perhaps the use of ARV's initially followed by periods of no ARV's may allow the infant's developing immune system to begin to fight off the virus. It is quite hopeful that some of this research may lead to less infants dying from AIDS.
Spending time at St. Mary's, with Sr. Regina, was truly inspiring...to see all the good work being done in the fight against AIDS was hopeful...
Well, it has been almost a week since our return and we still have so much to share from our International Health Experience :)
The last Wednesday we were in Durban, we spent the morning with Sr. Regina at St. Mary's Hospital just outside of Durban. St. Mary's is a 200 bed community hospital which services the Inner/Outer Ethekwini Community (750,000 people!).
One program at St. Mary's is the Ithemba ARV Program which is funded by PEPFAR. The clinic was founded in 2003 as a collaboration between St. Mary's, Harvard University Partners AIDS Research Center and Pangea San Francisco AIDS Foundation.
The Mission of this clinic:
"To give life and improve quality of living to the community we serve by delivering holistic care to patients and families with HIV/AIDS by returning hope and delivering ARV's"
Quite a powerful mission...and Sr. Regina is a phenomenal Nurse! She walked us around the different units of the hospital as well as the outpatient antenatal clinic (I think we all liked this one a lot because of the cute babies there with their mothers for check-ups etc.). Everyone we met was not only welcoming and willing to talk more about what they do, but also quite motivated to work hard because they are making such a difference in the lives of their patients.
It was exciting to talk to one of the research assistants who explained one research study being done to test out ARV's on AIDS-infected infants...the thought is that since the babys' immune systems are immature, perhaps the use of ARV's initially followed by periods of no ARV's may allow the infant's developing immune system to begin to fight off the virus. It is quite hopeful that some of this research may lead to less infants dying from AIDS.
Spending time at St. Mary's, with Sr. Regina, was truly inspiring...to see all the good work being done in the fight against AIDS was hopeful...
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