Day 13 - Marianhill

Day 13
Wednesday
4/15/09

I feel like I witnessed so much today… I don’t think my writing can do it justice. A few of us went to the Marianhill Health Clinic, a small rural clinic on the outskirts of Durban. Marianhill is a run-down township, composed primarily of single room homes made of either sheet metal or bricks. The clinic consists of 5 rooms – a waiting area, two exam rooms, pharmaceutical storage, and the counseling room. Vusi, the clinic’s counselor/community health worker, is a small man with a huge smile. He is technically in charge of pre and post HIV test counseling but serves as the community’s advisor on any and all issues related to health. People come to Vusi seeking help for drug and alcohol abuse, family violence, STIs, and, overwhelmingly, help securing government aid for food. Vusi can sometimes offer little insofar as resources but always offers a listening ear and a kind, encouraging word.

Before we left for home visits, two patients came through Vusi’s office. The first woman blotted tears from her eyes as she explained to us in broken English that she had been drinking ”too, too much” and her life had fallen apart. She came to Vusi for help and it has been one month, 15 days since she has drank and she has found employment once again. The second woman, a younger one with a baby squirming on her lap, came to Vusi with hopes he could somehow help her obtain food. She is HIV+, but unable to take ARVs as she has no food at home and no money or work since being sick. This really means NO food – not like when I think I have no food at home. She has two children, the baby (who is also HIV+) and a school age son. She wept as she told us that she wants nothing more than for her son to finish school but he often has to come home midday and go to bed as he is just too weak from hunger – they sometimes go weeks without food.

After those sobering conversations, we readied ourselves for the home visits. I think we were all a little surprised when Vusi pulled himself out of his chair using only his arms and asked if one of us could get his wheelchair out of the closet. Marionhill’s roads are not paved and many of the homes are only accessible by a narrow, uneven path. How could a man in a wheelchair successfully live here, let alone make home visits to patients?

At first Vusi insisted on wheeling himself uphill, insuring us that it was his exercise. On our way into downhill, I’m sure we were quite a sight – five Americans struggling to maneuver Vusi’s chair on the uneven dirt road, Vusi cracking jokes that people were going to think he was being kidnapped.

Sure enough we had to leave Vusi parked in the road for our first home visit as his chair was far too wide for the narrow path. As we went to get the information he needed, I wondered how he had the energy and the enthusiasm to do this every week tirelessly. We followed the path to a two room home, made of sheet metal and other scraps, housing 12 people. Babies swaddled in towel scraps and toddlers with bare feet piled out of the doors, some playing cheerfully in the dirt, some just sitting in the shade, swatting at flies. An old woman sat outside on a blanket – after my eyes adjusted to the glare of the sun I realized she had no legs. Two other women live there, the other nine are children of various ages. Not all of these children were born to these women; it is common here for women to take in the children of friends or family members who pass away or otherwise abandon them. Their main problem, never mind the cramped and unsanitary living conditions, is no food. They only receive government grants (aid) for two of the children; the others are ineligible because they do not have birth certificates for them. The older woman is ineligible because she doesn’t have an ID and the trip to the police station to obtain one is nearly impossible for someone with no transportation, no money, and no legs. It was so hard to be able to do nothing besides listen and nod. These people are living in conditions we can’t imagine and have absolutely nothing. A bag of cornmeal or rice would be sufficient to get them through the week but they don’t even have that.

Our next home visit was equally difficult. An older woman welcomed us into her living room, where we found babies perched on every surface. She explained that three of the babies belong to her daughter who was off looking for work. The other three belong to her granddaughter who only comes home when her “belly is big,” a few days after giving birth she disappears. The woman hasn’t seen her for over six months and just assumes she is sick somewhere, maybe dead. She lists the health problems of each child while she cradles a tiny two year old who has yet to walk. The woman has taken her to the doctor many times but no one can tell her why her legs don’t work and they basically just wish her luck and shoo her out the door. Same as the last home, there is not nearly enough food. They haven’t had electricity for a few months so the woman cooks up what little porridge they have on an open flame in the front yard to split between the children, usually taking none for herself. She doesn’t seem to feel sorry for herself in the least, but finally admits she is very, very tired.

The third home is a woman living alone, a neighbor comes by daily to take care of her. She is on ARVs but hasn’t taken them for over a month as she too has no food. She’s been through TB treatment twice already and is on it again. Vusi hands her a towel to blot her eyes as she explains to us that a little over a year ago her baby died and no one could tell her why. She has no family and cannot find work as most days she can’t leave bed. If her friends stopped coming by, she would just die in there alone. Once again, I felt helpless as I just listened and nodded.

The last home we stopped at housed an old woman and her 16 year old grandson. From what I could understand her grandson has severe asthma but, judging from his frail appearance, I would imagine that’s not his only ailment. He has no medication and has had to drop out of school. Now he has no friends and his life is “wake up, maybe eat, sit all day, go to bed.” The boy’s eyes barely left the ground the whole time we were there.

On our way to the preschool we are greeted by a man who limps out of his home after spotting Vusi, an old friend. They both poke fun at each other, patting their bellies and saying the other has been eating “too much putui” (a traditional starchy dish made of cornmeal). The man tells us that he got laid off of his job after his leg stopped working a couple months ago, the doctor thinks it was a stroke. He has a wife and four small children at home, all dependent on him. They have enough food for now but are almost out of money. His wife has been looking for work but has not had any success.

We walked glumly to the preschool where our mood was instantly lifted by a horde of adorable children throwing themselves against the gate at our arrival. The teacher gathered a group of them together for a picture. After I turned the camera around to show them their picture-selves, they were hooked! In seconds I was swarmed by children clamoring over each other to be the closest to the camera lens when the flash went off. Each time I turned the camera around they’d fight to point at themselves and shriek with glee. I happily played this game for ten minutes until it was time to go. After peeling what seemed like a thousand clingy little hands off my legs in order to walk out the door I seriously considered kidnapping a few of them to bring home with me.

As we wheeled Vusi back up the hill to the clinic, we discussed what could be done for these people. He admitted that he didn’t really know. Most, if not all, of these people would prefer to be working but jobs are scarce and many are too sick to work. Government grants are very difficult to obtain and are only becoming more so. Vusi has been trying to secure support to set people up with small gardens. With a few tools and some seeds people could grow spinach, onions, carrots, and beans in their yard providing them with food to eat and possibly something to sell to make a little money. While this seems like the most sustainable solution, he’s yet to be able to obtain the necessary financial support for the few items he would need to start.

I can’t stop thinking about Vusi’s idea and how to make it a reality. What we saw today is not the kind of thing you can just witness and just walk away from.