Research at Witpoort Hospital

It was Friday night and the girls were out behind our house pounding tobacco in the hand-made, wooden pestle and mortar. The sun was setting out front and Mma was sitting in her usual place on a large, empty mealie-meal bag with her back against the warm mud walls of her house with feet outstretched. I had been formulating a plan all day, and it was at this point that I finally resolved to put my ideas into action the very next morning; however, I needed the assistance of the girls which required their agreement and also Mma's permission.

I went to the back window of my house and motioned for the girls to come close (so Mma wouldn't know that we were plotting) and posed to them my desire to have their help in the morning by accompanying me to the Witpoort Hospital just a few kilometers to the south of us on the tar road. They were eager for the chance to get away on the weekend but also just as concerned as I about gaining permission from Mma since everyday is chore day and I would not just be taking one of them but both. Knowing that the girls were excited about this opportunity, it helped me in my next resolve to approach Mma and try out my Sepedi once again to ask if the girls could travel with me.

As I took a seat near Mma on the stoop, I began by explaining that I had to go to the Witpoort Hospital to gather some information/statistics and research the services they had available to pregnant women (and, no, I did not know how to say all of this in Sepedi ... luckily, our sister, Anna, was home for the weekend and helped me along). Then I proceeded to explain that this was not the type of activity that I could do with Brandon along because of the sensitivity of the topic. Mma really understood this. So, I finally had the stage set to ask if the girls could go and participate in this educational experience, and she gladly obliged.

We were set! I rushed to the back of the house where the girls were waiting anxiously and told them the good news. I proceeded to tell that we would walk the eight or so kilometers, leaving around 6am in the morning and heading up and over the mountain like we did one time last year with them to reach the Witpoort Library. Unlucky for me, this did not settle with the girls and they said that they would pay their own way if we could just take a taxi. I gave in very willingly. I enjoy the walk, but the thought of walking that whole distance in the morning with the possibilities of snakes and other animals didn't appeal to me. At least not anymore now that I have seen a Black Mamba and numerous snake trails and holes around our village. So we arranged to begin waiting at our bus stop at 7am and catch the first transport through to Witpoort.



On Saturday morning we were all ready and outside of Mma's house at 7am, which is a miracle in itself since I've been in Africa for over two years now and have adequately adjusted to what is well-known as "African Time." This term applies to the tendency to tell time by the position of the sun in the sky and shifts in temperature throughout the passing of a day. It means that if a meeting is set for 6pm in the evening, I no longer tell people to come at six but to show up at the meeting just as the sun is about to set on the horizon. Furthermore, if I am awake in the morning when the sun is coming up, I can not only tell the time by the location of the sun rising behind the mountain but also the changing of season as the sun tends to get closer to the peak of the mountain during the summer season and move back away in the winter. I don't wear a watch anymore and frequently only know the official time when I ask Brandon to look at his phone or the computer, but this only happens on days when I am confused by the abnormal course of events that seems to be disrupting my concept of "normal" time like the lunch ladies serving the kids at school two hour earlier than usual.

To get back on topic though, we were ready to leave on time and just as we were heading out the front gate to walk the 20 meters to the bus stop, a white bakkie (pick-up truck) was driving past and I, along with the girls, threw up our arms in unison and began pointing in the general direction of Witpoort. We were in luck as the woman stopped for us and was driving to the hospital herself since she worked there. The interesting thing about the woman who picked us up was that I had just met her son the day before during my short visit at Maam Ditsela's house (he is a cousin to the girls, but then again, I don't think there are many people that could not claim this relation in some fashion in our village; everyone seems to be related). She lives in a village about 5km to the north of us but located completely in the middle of the fields with no real connection to the tar road except for a single dirt road that connects with our village at Salim's shop. I always wondered where that road went and now I finally know.

This woman drove us the entire way and then even let us accompany her straight into the hospital's compound. This was the part I was worried about because the only other time I had been to the hospital was two years earlier when our principal was taking us around the area and introducing us at all of the major institutions that existed. During this visit, we were welcomed everywhere except the hospital which put up a fuss about us not having an appointment and they made us sit in the parking lot in the extreme heat until they could find someone willing to talk to us. It seemed to be a problem that we were there and they didn't want to let us in. So I was going to the hospital this time around with a blind faith that I knew the language better and could possibly talk my way in. However, it really wasn't as hard as I thought and we were quickly ushered in with our driving escort. What a provision that she was the one who stopped to pick us up and had the power to get us into the compound and then even take us around the hospital and make sure that I found the right people to talk to about my pending project.



The girls were required to sit in the waiting room while I was shown back to the maternity ward. I was greeted there by two young women who I found out were from the Venda region of the Limpopo Province and both attended university to become midwives. One woman was 25 and the other 36 years of age. I was impressed by their success and motivation in life since I have gotten used to the rural women and the apathetic nature that it produces in so many women their age.

So, now I think I should spell out my motives for really wanting to visit the hospital. I am planning with Maam Ditsela and Maam Tema a village-wide week-long workshop on family planning and general reproductive health for women between the ages of 13-30. (The details are not fully planned but I'll know more after I sit down this week and talk with my teachers.) I have been wanting to do something like this since I arrived her in 2006 and now I finally have done the research and feel like the timing is right for it. The women are excited to organize it with me, and now, the midwives at the hospital are eager to be involved.



Therefore, I spent two hours yesterday morning asking a series of questions that would help me understand not only all of the services available to pregnant women but also the culture of how our area handles population growth and some of the barriers present within the villages that could prevent family planning. It was a very educational experience as they informed me that all of their services are free including everything from pregnancy tests, contraceptives (all methods including getting tubes tied), pre-natal vitamins and sonograms to early terminations (abortion-which seems to be a word that they even try to avoid here) and the entire birthing process including overnight stays if necessary. In addition, they test pregnant women for Syphilis and HIV.

One of the more interesting things I learned which was disappointing was that while the HIV test is preceded with counseling (which I doubted but was happy to hear was taken very seriously in our rural hospital) the early terminations are an in-and-out procedure with no counseling. I would like to think that both of these events in a woman's life can be traumatic and life-altering with many health implications and it is sad that women are not even informed properly before an abortion pill is given to ensure they understand their options. This is very different from the States where there are laws in place to make sure the women gets all of the facts before making her choice. Here, it is very young girls that are going through this process alone and without any knowledge of the adverse affects it could have on their bodies and also their psychological state of mind either immediately afterward or later in life.

I was nearing the end of my conversation with the women but asked them if I could bring back my two young nieces who had come with me so that they could see the maternity ward and see all of the equipment that is used. They were very excited to have the girls come in and when I walked back into the maternity ward, they ushered us all into one of the partitioned off birthing areas and had the girls sit in turn to take their blood pressure. This was the girls' introduction to the maternity ward and it was evident that they were nervous having something wrapped tightly around their arms only to get tighter as the machine beeped louder and more frequently. They both had very high blood pressure!



After taking our BP, we were taken over to the nursery where we were able to see the incubators where they keep the premature babies, and we were lucky enough to get to see a newborn baby also!

To finish my visit with the women, I asked if I could get a copy of their statistics covering the last few months. Unfortunately, their copy machine was broken, so I sat with Ndivhoniswani, the younger midwife, and hand-wrote as much information as I thought was necessary to understand what was average in terms of pregnancy stats and STIs.

As we left the hospital, I stashed my bag with as many condoms as I could carry so that we would have enough samples for the workshop (don't worry, I had permission) and then watched in horror as the security guard searched my bag before leaving the compound to make sure that I had no firearms. Instead, she found a young, white woman laden with condoms. This could have potentially horrible connotations had it not been for Matome and Lerato there to defend me and reinforce what I was trying to tell her.



Outside of the compound, I agreed with the girls that we could walk into the RDP housing village of Thabo Mbeki and visit some of our extended family members. Now, I call them extended, but realistically, they are probably considered more immediate family here in Africa since everyone else in the village and surrounding area is considered to be distant, extended family in some way.

Let me explain briefly for those of you unfamiliar with the term used above, "RDP housing is Reconstruction and Development Property ... RDP housing is very basic and consists of one or two bedrooms, a sitting room, kitchen and toilet and is mainly provided for the poor."



As we walked back farther and farther into the housing complex where every house looks exactly the same from the outside except for the distinctive mural-like paintings and decorative doors that people use to distinguish their house from the next, we came across the girls we were looking for and walked the remaining distance with them to their house. We were welcomed inside by the girls' aunt, my "sister", and invited to sit just an hour while we waited for Joyce's husband to arrive home and then he could drive us home in his car.

As we sat in complete boredom, the girls took Joyce's phone and began listening to music. Still not over all of my American habits, I fidgeted and thought about all the wasted time of just sitting around and asked permission to walk around outside and take photos of the surrounding houses. This turned into a family event and we all trekked outside and I was lead, instead of around the neighborhood, to the river. At first, I was disappointed because I wanted photos of this unique housing development, but was quickly intrigued by the Palala River located such a short distance away.



I was astounded by the fact that there was still water in the river since most other parts of the river are dried up right now because of just coming off the winter months which are the dry season here and we have not had rain in over six months now or more. This section of the river though retained the water and even had evidence of fish life below. The fish were sending up air bubbles occasionally just to prove the fact and the girls proceeded to tell me that the river provided good fishing for the locals. Upon hearing this, I got very excited and wanted to share with Joyce that I loved fishing. Unfortunately, my language skills only extend as far as the vocabulary necessary to teach PGC and talk about crafts and sewing and I had still not learned how to say, "I love fishing." So instead, I settled on, "I love fish" thinking that this would suffice and was partly true ... as long as the fish didn't taste like fish. Well, this translated very well to Joyce and on our walk home, I was pleasantly surprised by our stop at a house where all ages of men were hanging out and drinking traditional beer.



It provided wonderful photo opportunities and I enjoyed the chance to enter a setting that I otherwise would have been very wary of. A few minutes later, I no longer knew where Joyce was and quickly sought out the girls to find out where she had disappeared to. To my dismay, I learned that she was inside the house purchasing fish that had been caught earlier that morning to give me as a gift.



My initial alarm at this kind yet misguided gesture of hospitality quickly evaporated as I considered the fact that it was already an hour past the time promised to us for a ride home and that quite possibly the fish was for me to take home and fix for Brandon and I both. I knew that if this was the case, I could re-gift it to the family without offense. My luck had reversed for the day though and as we arrived at the house, Joyce asked me how I liked my fish prepared and proceeded to fix it in spite of my protest that I could prepare it at home with my own spices and supplies so she didn't have to use her own. This didn't work and I spent the next 30 minutes resolving to swallow it down no matter how bad the taste so as not to offend her. In the mean time though, my mind began coming up with all other types of excuses as to why this was a bad idea including but not limited to the fact that people pee, bathe, wash clothes in the river and donkeys and cows wade into the river and also drink out of it and likely excrete their waste. It was stagnant water in the river and the fish could not be edible. There was bound to be pollution that could affect my own health if I ate the fish.

My worst thoughts were confirmed as I along with the girls were each given a small plate with two pieces of bread (I had three) along with a portion of fried fish (the girls each had a tail, but I lucked out with the entire fish: head including eyes, tail and fins). I tore into my fish still trying my best to resolve that eating it was the only and best option, but my first bite tasted like dirty, fishy, river water with sand particles still stuck to it, and my resolve failed. I proceeded to "fish" through the contents in my mouth to eliminate the tiny bones I had not seen and then quickly ate a piece of bread and contemplated how I was going to gracefully yet discretely discard of the remaining contents on my plate. The opportunity provided itself after a few more laborious bites when Joyce was called outside by a neighbor man wanting to purchase airtime for his phone. I made haste to ask Matome if she wanted an extra portion and slid my fish onto her plate leaving only skeletal bones on my plate to show that I ate some.



While I would like to say that this was a sly solution to my dilemma, I'm fairly certain that Joyce understood that I didn't eat my entire fish and was most likely offended, but in the end, I was just happy I didn't have to eat it.

...Then again, maybe she never did catch on that I didn't eat my own fish. Four hours later than promised, her husband appeared to give us a ride back to the village. Upon our arrival back at our family compound, I ran into my little house to grab toilet paper to make use of the pit toilet that I had been desperately needing when a knock came on the door and I back tracked to answer it. As I opened the door, there stood Joyce holding out an extra bag of frozen fish with a smile on her face! This concluded my travels and adventures for the day. I spent the rest of the day resting on the bed completely spent from the mental exercise I had gone through during the first part of the day.