The Drive Back to Pretoria

I made it back to Pretoria. I woke up early enough to make it back in one day. It was a nice 15 hours to jam to home-made cds and sit in my own thoughts (Highly recommended by the way).

One thing I kept thinking about was how familiar this place was. For the first half of the drive I kept thinking that I had been here before and completely chalked it up to the fact that I had made a very similar drive, slightly different route, but very similar when Will and I drove down almost two weeks ago. But about half-way through the drive I started thinking my familiarity with this country was a lot deeper than one drive two weeks ago.

The grand conclusion for the drive was that this place is America all over again. Sounds crazy but that is what I have decided. Cape Town is like San Francisco, Johannesburg is Detroit. The people are obsessed with sports, almost as obsessed with sports as they are with TV. We call ourselves the melting pot bu there they have 11 national languages. They all speak English but make fun of eachother for their different accents. They have a government run by a black majority, which all the white people think is corrupt, like Memphis. Fruit grows down around the coast (California), and for hundreds of miles in the middle of the country all you see is cows and corn (Nebraska).

The only differences I could think of are that they all sing a lot better than any of us, they say howzit instead of whatzup (both equally indifferent to the response), and they drive on the left side of the road...which was contantly on my mind Thursday. That's about it.

Maybe we aren't so special over in America after all. But you still gotta love the good old Red White and Blue. There is no place like it (I recognize the contradiction). I'm coming home tomorrow. Flight leaves at 8:20 pm South African time, 1:20 pm Memphis time. I'm really ready. It has been a great experince, and Will and I learned a ton, but I'm ready to be home. Love to talk about the trip with you so just ask, or call, or make a lunch appointment.

This won't be the last post. I plan on reading back through my journal and trying to summarize some stuff, so stay tuned for a long one.

Paarl

Look it up on the globe, Paarl is this little town about 45 minutes from Cape Town. It is really beautiful (this area is probably the most scenic place I have ever been), and it is where I have been for the last 3 days, there and Stellenbosch. There is a group out here that has a bunch of clinics in this rural part of South Africa, so I have been in and out of some clinics out here and helping with different projects with these folks.

Dr. Nelis Grobbelaar runs and organizes a lot of the clinics out here and I have been in his back pocket for three days. He has been wonderful to me: incredibly welcoming, genuinely encouraging, and just nice to be around. He has been picking my American brain for the last couple of day trying to understand us, learn from us. He is 45 years old, he doesn't know me, why in the world would he give a rip aobut my opinion or perspective? But he did. Like he wanted to know what the American dream was, and what my American dream. He wanted to know about generation differences and the effects of internet and connectivity and social networking on our society. These were fascinating conversations to be having with a South African Dr. It was wonderful, made me feel great, and I think I learned as much from how he treated me as I did from how he treated patients or clinics or HIV.

On the other hand, he does have a lot of neat ideas about HIV treatment. He is on the forefront of moving clinics to nurse-initiated treatment, electronic medical records, and general HIV treatment. Because of the huge numbers of the epedemic, they are putting in place new ways to distribute drugs, keep track of patients, and break down some of the things that hinder treatment. He sees so much more to the problems than the physiology difficulties of the disease which in my experience is incredibly rare for a doctor.

There has been much more to this last chapter of the HIV tour (like Shoots and ladders baord game with an HIV twist, flipping through charts to collect clinical data, and chatting with the technology assistant guy who manages the electronic medical records system), but that is enough for tonight. Internet in Paarl is expensive.

Tomorrow I am back on the road headed toward Pretoria. Stopping tomorrow night in Kimberly... I think. It is just a long uneventful day of driving through the Karroo. Should be back in Pretoria Friday night and flying out of this deal on Sunday night. It is wrapping up in a hurry.

Entropy

Physical law of nature--in a given system, molecules tend to decrease in the degree of "order" or entropy in the system. It takes a net input of energy into the system to maintain or increase the order of the system.

For example, if you put a carving (highly ordered object) in a sealed jar, give it enough time and that jar will just have dirt (much less ordering of molecules) in it.

On Saturday I hiked up Lion's Head, a small hill/mountain in Cape Town. It was a gorgeous hike, beautiful weather, great day. On the hike however, you can't help but notice all the boulders and rocks that have rolled off the top of the mountain and lie at the base and all along the way to the top. The other thing I noticed is that the trail is really well built, and someone has hauled these wire baskets or cages filled with rocks (their are kinda like portable brick walls) up the trail and placed them in different places on the trail to prevent erosion. They support and hold the dirt and other rocks on the mountain. If they weren't there the trail would have washed out long ago.

It is the law of entropy in action. The mountain tends toward disorder. It's tendency is to end up as a little pile of sand blown around by the wind as those huge boulders crumble and get smaller and smaller. Here is the deal though. Someone has put in energy into this system. Someone carried those rock baskets all the way up the mountain. You can't drive up there. There is no lift or anything. Someone carried them up or built them on the trial. Someone put a heck of a lot of energy into that system. I could hardly carry myself up there, much less a couple hundred pounds of rocks. And the whole deal, energy input deal, is simply to keep the mountain like it is, to prevent it from eroding, not even to make it bigger or better or something.

There is another place I have seen the idea of entropy at work, AIDS. The whole deal with HIV/AIDS is just a way that society demonstrates it's tendency toward disorder. You leave society alone and don't put any energy into keeping it going and it breaks down. If you don't treat and educate and work and think and love and care and pour into a community it will become increasingly disordered. It is costing 48 billion dollars and thousands of working hours on the part of tons of people just to keep the HIV prevalence at 12%. Take away all that "energy" and it is going to 50%.

Application: let's step it up and put in energy into the system, not suck the system dry to make our lives fluffier. There is only so long a system, a society, can handle its inhabitants living like parasites, using people and situations, and resources for whatever they can get out of them. We can live in a way that gives people confidence and value and courage and knowledge instead of mining people for those things and keeping it to ourselves. We can increase the order in people and in the system instead of destroying the order.

Sorry for rambling. Just some recent thoughts. More to come.

Little Moments in the Hostel

So I am living in a youth hostel called Cape Town Backpackers. Tonight is my last night here.

Ok I need to tell this story to give a little glimpse of life around the hostel. Living in a hostel is kinda like living in a college dorm room with a bunch more people in closer quarters, and then add a full bar on the hall. It is truly a combustable setting.

Last night (Friday night) I got back from Khayelitsha, got dinner, journaled and read for a while, and went to bed around 11. Between 10:30 pm and 2:30 pm is the quietest time of the night around here as everyone is finished with their drinking in the hostel and are out on the town, so at 11 pm there last night there was no one in the room and I fell asleep really quickly.

The tough part of the night was when the crew stumbled back in. My 5 roomates didn't make it back until around 4:30 am. I was more than a little frustrated at them for rousting me, but I rolled back over and tried to get back to sleep. Just as I was dozing back off I heard a huge crash and the sound of bare skin slapping the polished brick floor. I looked down to see one of the two Argentinans rolling around on the floor having fallen out of his top bunk bed. He hit really hard.

Call me a bad guy but I deeply enjoyed laughing at this guy for a couple of minutes as he rolled around on the floor in pain. The Argentinans have kinda been on my bad side because since they first got here they periodically douse the entire room with AXE spray deoderant (aweful), and after all, he did wake me up from a great sleep. I did eventually check to make sure he was ok. He didn't really acknowledge me but seemed to shake off the tumble, and after lying on the floor for a good little while, he managed to summon the courage to attempt the climb back up to his top bunk, more succesfully on the second try.

It is those little moments that stick with you ya know.

Training of Coaches Wrap Up

Today was the last day of coaches training at the Football for Hope Center in Khayelitsha. It really turned out to be a great experience as we were confronted with so many tough issues surrounding HIV and attempting to prevent it in a place like this. I have so many thoughts from the week.

The thought or summation or idea that keeps coming back to me this week is the way in which AIDS feeds off so many inequalities and injustices. Gender inequality is the most apparent. That is the incredible degree to which girls are less educated, 100% financially dependent, completely socially subservient, and devoid of voice presents quite a difficult challenge to prevention.

Poverty presents a unique challenge. You see HIV/AIDS is not urgent. It takes years to really set in, even without treatment. Hunger is urgent. Shelter is now. Safety is now. For a woman, having a man to provide for her 7 children in paramount. AIDS is the last thing on so many of these people's minds. If people don't have anything to live for why would they care about HIV?

Racial inequality destroys prevention efforts. It does so by destroying leadership. South Africa existed for such an incredibly long time under Apartheid, recial inequality that makes segregation seem lame. African people down here grew up with no vote, no voice, no social mobility. No one understands that they can make a difference. The African community is devoid of initiative, motivation, hope, dreams, confidence, etc. There is no leadership, not in townships like Khayelitsha. So when an organization like GRS goes to get people from the community to train them and pay them to implement and cook-book, ready-made AIDS prevention curriculum, they can't find anyone, not many. The last two days the trainees have been doing "teach-backs" where they basically practice presenting a lesson to their peers for evaluation and training purposes. Quite honestly these two days have been pretty discouraging because although it seems they have received excellent training, very few (maybe 5 out of 20) seem to have been able to succesfully present the curriculum. I am not talking about being great, dynamic teachers, I am merely talking about tying together ideas in a coherent way to deliver a basic message about HIV/AIDS. These trainees are awesome. They are great people. Truly. They just have incredibly low confidence, self-esteem, and they one by one got up to practice talking in front of a group struggled. It was tough to watch.

I don't want to sound too tough on these guys. I think they will get there and GRS continues to work with them and develop them. They will go with experienced coaches for a while to sort of learn the methods in more of an apprenticeship fashion. But the repercussions of inequality and repression are so apparent.

While all that inequality is depressing in a lot of ways, and the challenges facing AIDS continue to seem overbearing and impossible. However, I really noticed something today that was exciting. Although this AIDS prevention stuff my have no hope whatsoever, it may decades before the epedemic is in any way manageable, the problem is a wonderful excuse to deal with some of these deeper issues. Like GRS may not succeed in making this group into effective implementors of their prevention curriculum, but every day this week those people heard over and over again that they were valuable, that they matter, that they can change people's behavior, that they can influence a child's life. They were told and shown that what women say has equal weight to what men say. They were given a cause to increasingly be knowledgable about and have tools to contribute to the battle. They were given 2 meals and 10-20 Rand a day (about $1.50). Way more than the roughly 80% unemployed in Khayelitsha. And next week they will be placed in schools and communities where they will have the ability to present that same sort of justice to 40-80 kids a day. Pretty cool. So what if we can't beat AIDS. Maybe AIDS is exactly what Khayelitsha needs (obviously there would be a lot of people who disagree with that last statement). It is worth thinking about.

Culture...What is the answer???

3rd day in Khayelitsha sitting in on the training of coaches to do AIDS prevention education.

It was a really tough day in a lot of ways, but it was also an incredible day in terms of what we experienced first hand. Today we were apart of a couple of group discussions (the group of "coaches" consists of 20 young adults from poor, urban backgrounds). In these discussions the topic of sexual practices and condom use were discussed with incredible frankness and honesty. It was certainly the most realistic and open look at the culture in South Africa and the cultural difficulties that underly the AIDS epedemic here. We weren't reading about this stuff from a book or hearing some white, American academic talk about. We were seeing it in real life. We were watching people talk about this stuff and revealing their own personal history and experience. In many ways it was really exciting to be there for these conversations. However the truth that these discussion revealed was deeply disheartening.

The honesty about the prevalence of people having multiple sexual partners was unbelievable. These people mostly come from the Xhsoa ("click"osa) culture which for centuries has practiced polygamy. The president of the country before the current president had multiple wives. Under that culture it is completely common for a man to have multiple (as many as possible) sexual partners, whether married to them or not. That is how men think and that is what even the women expect.

We had a conversation with the head instructors during one of the break and they said that the idea that kids will abstain from sex and wait for a mutually faithful partner/marriage is an absolute "pipe-dream" and isn't a legitimate education stance for an prevention organization that wants to actually make an impact in South Africa. Wow!

On top of that, there was incredible honesty about the infrequency of the use of protection. In the heat of the moment, these people admitted to rarely using protection. For an hour the group went back and forth about why and gave many different reasons. They were telling personal stories and admitting to the frequency of unprottected intercours. Another Wow!

So how do you do prevention?? The two halmarks of prevention (abstainance and protection) seem to be absolutely useless here, if not useless they face a long, uphill road until they actally have an impact on AIDS prevalence and incidence.
We have our own thougths but very few answers.

AIDS is a beast. It is incredible how it strikes at the heart and thrives on these deeply entrenched cultural values. We have mentioned it before but it is so much more than a medical disease. It is a social disease, it is a cultural disease. How do we defeat that?

The typical Amerian solution, that is for the most part true about how our nation is handling this problem in South Africa, is to sit from a distance and throw our money this way and hope for the best and pat ourselves on the back for our noble "altruism," but, as was said today by one of the South Africans, the people of the world who are trying to help need to come and actually see what is happening in South Africa and understand all sides to the HIV/AIDS epidemic problem. More is needed than just a supply of ARV's. These people need role models, and cultural alternatives. How do you change a social norm by throwing money at a culture? It won't happen. There is something deeper at work here than a simple medical disease? We are at a loss for how the epidemic can be stopped with the existing social norms. Something has to change in the minds and culture of this people. How to bring this change about seems beyond anyone at this point in time, but there are multitudes of people here who care and are trying.

Despite all this negativity, we had a great day and learned a ton. We really felt included by the group and we participated in all the activities of the day, and the group listened to our input on the different discussion that took place. We also go to just sit and listen to some really powerful, open discussions that really brought the roots of this HIV epidemic to light.

Update and Thoughts

Last weekend was tourist weekend: Table Mountain, Cape Point and the Cape of Good Hope on Sunday. Neat stuff.

This week we are back at GrassRoots Soccer in Khayelitsha. They are training a group of about 20 young adults to present/teach/use their curriculum for HIV/AIDS education and prevention. Interesting in a lot of ways. They do an incredible job of modeling in the training sessions how they want their trainees to teach the kids. Without even knowing almost, the trainees are being taught with the same methods that that are going to use to teach the high school kids (not sure if that makes sense). But you can see how effective a method that is at training these people who have never been teachers to teach in a week. The training works not by telling these guys how they are supposed to teach but by showing them. After they get through this week of training they will have spent 9-5 in the kind of classroom environment that they are supposed to create when they go to schools and communities. Interesting to see in action.

One thing that is discouraging to me however is that the only tool AIDS prevention seems to have is condoms. That is all the education curriculum is based on getting awareness out there about what HIV/AIDS is and how it is spread and then getting people to use condoms. Some of these classes are taught to 12 year olds and they are going to hear the message: "you are probably going to have multiple partners so make sure you always use condoms." It is like culture is too tough of a beast to tame so all we can do is tell them to use condoms. What about someone saying you can sacrifice your little petty desires short term and wait until you find someone you are willing to serve unselfishly for your entire life. And when you do that it is awesome and difficult yes, but so worth it and emotionally fulfilling etc. etc oh and by the way you won't get AIDS either. But culture is too tough of a beast so we give up, give up on 12-year-olds. Seems sad to me. I think they can be different. Maybe I'm naive.

Sorry if that was a little more than you bargained for.

Off to more prevention education sessions and making posters and flip charts. We are getting really artsy.