An Unfiltered Glance of Carers for Orphans and Vulnerable Children

Blog-Challenge-2016

This entry’s topic for the blogging boot camp challenge: community member profile (aka interviewing someone that resides in my current home).

Interviews are a significant but unwritten part of my current job description. As a health extension volunteer, I frequently interview community members for informal needs assessments as I try to get a grasp on the current situation. Since my service I have coordinated focus groups of teen mothers, people living with HIV, and the largest source of pediatric health knowledge in rural South Africa: Child and Youth Care workers. (CYCWs)

I have the public health context behind South Africa’s response to the HIV epidemic at the end, but for now I will yield to the real expert in my area of Amajuba: a woman who serves as a CYCW for my organization. We did this interview in broken English, so her words are not verbatim (we are working towards an isiZulu tutor, it still may take a while) but I tried to maintain her thoughts with as much of her sentence structure as possible. Take it away inkosazana (fair maiden in isiZulu).

What do you do as a Child and Youth Care Worker (CYCW)?

As a child and youth care worker, I work with children. We do home visits and a lot of primary school visits. We especially support orphans, as many of them are HIV positive.

Who is an orphan in South Africa?

Orphans have both parents’ dead. Usually they live with a gogo/granny. If one parent is alive but they are not present in the child’s life, they are considered OVC (Orphans and Vulnerable Children).

How did you become a CYCW?

Amajuba District started the program last year. Other districts in KZN province have had CYCWs for a while, but my guess is our schools started to overwhelm the government social workers with cases. So they started to train workers at Drop-in-Centres (DICs) who were already working with OVCs directly affected by HIV.

How did you first encounter HIV in the community?

I would say the schools, because HIV is taught in the local schools. Also the local clinic.

What was it like when HIV first came to Amajuba?

It was awful. Many people died before resources were available. However after about 2007 when ARVs (antiretrovirals) and VCT (voluntary counseling and testing) things got better. People are still scared to get testing but peer pressure from the schools, where children talk about their HIV positive family members.

What was our community like before Child and Youth Care Workers?

Not good, because referrals were slow, if there was a concern. The Social Workers did not have the time to investigate the school’s concerns. Now CYCWs can visit the schools and refer if needed. It is much better.

What do you like about being a CYCW?

I love working with children and being a support. The children are too scared to talk to their granny so I play with them. Then they talk to me about their problems.

If you could change one thing about the CYCW program, what would you do?

I would get the government department to try and provide emergency money. Sometimes a child needs food now, and I use my own money for an emergency food parcels.

What do you want Americans to know about South Africa?

We became free but we still suffer.

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Checklist the CYCWs use during home visits

 

 

In the South African context, Home Based Cares (HBC which provides care for people living with HIV/AIDS at their homes) and Drop-in-Centres (DICs places that provide psychosocial, homework, and nutrition support for OVCs directly impacted by the AIDS pandemic or OCVs) were established as the model for the governments delayed response. The history of South Africa’s, the response to AIDS is a tragic story. The first documented deaths in the country connected to AIDS occurred in the early 1980’s, when South Africa was still in the grips of apartheid. In 1994 when apartheid rule dissipated, the government had the tedious task of restructuring the country. Until 2008 government officials denied that AIDS was caused by HIV, and through policy treatments like ARVs were not widely available in the country. The result was that HIV and deaths were rampant in communities. After 2002 the government prioritized the care of HIV positive individuals, increasing lifespan for people living with HIV. Today, South Africa is the nation with the highest population of people living with HIV in the world.

Currently, South Africa is in the midst of an international conversation over the effectiveness of Home Based Care, and funding towards HBC and DICs reflects the changes. The majority of organizations CHOP (Community HIV Outreach Project) PCVS are partnered with are a mixture of HBC and DIC(both of my organizations implement both models). Regardless of their future, these organizations have shaped the communities of rural South Africa for the past decade, helping families heal, grieve, and thrive in the midst of the HIV epidemic.

A Plea to ASPPH

Dear ASPPH (Association of Schools and Programs of Public Health),

As a proud graduate student at one of your accredited invitations (Bear Down MEZCOPH), I love the “This is Public Health” campaign. Stickers in both Spanish/English grace my planner and this laptop.

I do not lie...

I do not lie…although the Spanish one has seen better days.

However I have a request, I noticed that on your the research page under the sticker tab the only South African languages represented are English and Afrikaans. The language spoken by most of the population, isiZulu, is not. I may be biased as a PCV in amaZulu tribal authority, but having Afrikaans without any of the indigenous languages does not sit right with me.

I do not believe that anyone was malicious with the decision, and with 11 official languages in South Africa alone it is hard create stickers for every language group. Before moving to South Africa, I would have assumed that Afrikaans would be sufficient. To be fair there are many people in South Africa, my 90 year old host gogo/grandmother in Mpumalanga for example, who only know Afrikaans. Honestly until I moved to South Africa and familiarized myself with the history, I would have assumed this is okay. I want to use this as a teachable moment.

In 1953, the South African government under apartheid rule established the Bantu Education Act. The whole purpose of this act was to control access to education for all races in South Africa in order for the Whites to maintain power. Blacks were provided with “an education designed to provide them with skills to serve their own people in the Bantustan ‘homelands’ or to work in manual labor jobs under white control.” There is blatant evidence that the government initiated education during apartheid was inadequate. This full impact of this act continues to instigate the blatant economic disparities present in South Africa. However one of the most horrific acts of violence during apartheid rule, the June 16, 1976 Soweto uprising same event the National Holiday Youth Day originated from, was triggered in part because the government decided to intensify Bantu education by making Afrikaans a primary language of instruction. It is estimated hundreds of learners/students were killed in the Soweto uprising, but statistics from that time period are inaccurate.

Afrikaans is a part of South African culture, and in order to meet South Africa where they are at, it is appropriate for ASSPH to have an Afrikaans “This is Public Health” sticjer. What I am asking is an isiZulu sticker on the website as well (and maybe a Tswana one as well to represent the Sotho-Tswana language family) . There are 4 Kenyan languages featured, I think there can be two more South African language stickers one for each Bantu language family present in the country. In the last South African 2011 census, the most prevalent 1st language was isiZulu spoke by 22.7% of the population, followed by Xhosa at 16.0%, and then Afrikaans at 13.5%. Both isiZulu and Xhosa are from the same language family (Nguni) and even with the differences native speakers can understand both languages.

It may seem ridiculous to type a 2 page plea over a sticker. However I love my field, and see how public health improves lives. The province I live in, KwaZulu-Natal is ground zero for public health especially with HIV/AIDS and tuberculosis. When I think about what epitomizes public health, I see my home based carers. They are the ones preventing further illness and helping their communities live fully with HIV/AIDS. Maybe the international community disagrees with the effectiveness of Home Based Care, but these individuals are public health. I cannot help but think that they would view these stickers only in Afrikaans as a slap in the face with the history. Someday I would like to show their value and how they contribute to the public health field with these stickers (and if I can order them please let me know…I will pay). However they do not understand English well, if I had an isiZulu sticker as well they could have a brief language lesson as well.

Afterall, Nelson Mandela said it best:

“If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.”

“Uma ukhuluma nomuntu ngolimi aluqondayo, uyakuzwa. Uma ukhuluma naye ngolimi lwakhe, lokho kugxila enhliziyweni yakhe.”

Ngiyabonga, Ke a leboga, Dankie, Thank you for listening and the consideration.

Respectfully,
Katey Redmond PCV South Africa
Community HIV/AIDS Outreach Project, 2015-2017
MPH student, Family and Child Health, Global Health Option,
Mel and Enid Zuckerman College of Public Health, University of Arizona

PS: ASSPH did not have an contact e-mail so I did not send an e-mail. I just wanted to respectfully share my thoughts (but if anyone would like to send this on my behalf, you have my consent).
Here is a rough (it has been a scramble to get my site in order) representation of what an isiZulu sticker would look like:

IMG_1754

Because Impilo Kawonkewonke sounds  livelier than Public Health

Sorry that I did not have the time to research a Tswana translation.

Icebreakers: Lost in Translation

isiZulu word of the post: iswidi
isiNgisi: sweet (what South Africans call candy)
Meaning: The thing that can make or break my icebreakers in the Rainbow Nation

A common activity in American leadership workshops and diversity talks is to do something called an icebreaker which comes from American slang “to break the ice”. Icebreakers gets strangers to get to know each other through outlandish behavior or deep questions. I have a love/hate relationship with icebreakers. I love meaningful icebreakers that use storytelling and questions to reinforce the importance of listening. However I am not a fan of the goofy icebreakers that involve yelling.

Caregiver camp was a weekend full of icebreakers and I enjoyed watching how the AmaZulu women (and one man) reacted to the icebreakers. My director (who is American but after 10 years in South Africa she is capable of conversational isiZulu…she refuses to say she is fluent) was translating my roommate’s instructions and sometimes it took a while for the caregivers to understand the directions. Our name game and first activity was a bust. They also did not like the icebreakers that involved yelling!

On the schedule, I was co-facilitating one of my favorite and versatile icebreakers called color Jacuzzi. The activity involves a set of colored candies (in South Africa Smarties work well which are “naturally” colored M&Ms and more delicious than their chalky American counterpart) and each color is assigned a question. The questions can be whatever the facilitator deems appropriate. Our questions developed by my roommate (who has a master’s in Child Development and is a former Child Life Specialist) involved feelings like share a time when you were very happy, sad, or embarrassed. For example, this time I got yellow which was sharing a time that I was very happy and talked about swearing in as a PCV! People pick their candy and before eating their sweet, they are supposed to answer the question.

Unfortunately our transportation to the camp was two hours late and the schedule had to be cut back. We had a chance to do the activity with my organization’s home based carers during a staff meeting the following Monday. Before we started the activity we distributed three candies, discussed the questions, gave participants a minute to pick one color/story to share and eat the two that they choose not to use. We almost made it around the circle without an accident, and then one of our carers ate all of their Smarties and forgot their colors before their turn! Thankfully we had extra candies, which also worked well as motivators for the discussion afterwards. I loved hearing what the advice our staff had for other carers and tips for a healthy lifestyle!

I also learned that the subjunctive tense is also hard to place into isiZulu. I was trying to lead the activity’s debrief with my director translating and said something along the lines, “If your clients were well you would not be their carer”. Eish, I wish y’all saw how wide her eyes got when that came out of my mouth! I made sure to give her a break (and be more cautious not to use subjunctive language or as I call it, passive aggressive English)!