The "Rural" Excursions

This blog post is so long overdue that I am a bit apprehensive about covering everything while writing it. If you want any further elaboration on anything, please message me or email me!

We spent all of last week in “rural” homestays in Impendle and UMtwalume. We divided our group of 16 into two groups of 8 to avoid having an overbearing influence (which we still were). We stayed in homestays in groups of two and stayed three nights in each home. My group went to Impendle first, which is a community nestled up in the mountains, a 40-minute drive to the nearest “town”. This place was picturesque, albeit not what I was expecting. For me, preparing for “rural” homestays involved preparing for an excursion into what I had been exposed to as “rural” in Kenya. I brought outdoor bath wipes, my ‘all-terrain’ pants, my sturdy shoes and so on. This place was not really rural. While the inhabitants of Impendle mostly have pit latrines (ventilated pits or long drops) and do not have indoor running water, they all HAD pit latrines, running water at a tap and had indoor electricity to watch the favourite South African soaps (especially this show called Generations). In Impendle, we stayed with “Stylish Mama”; I am still unsure of her real name, but is a few years older than me and takes care of her family, plus seven of her orphaned cousins. There were eleven people total in her family. They had three different houses in the homestead, including the round ancestor home that is not lived in (besides the ancestors). Every traditional Zulu home has this ancestor room and their religion surrounds their ancestors. There was one large square house with several rooms, and another circular room that we stayed in and shared with 2 – 6 people per night. It was interesting sharing a room with strangers, but they were all so kind that it was not difficult or that uncomfortable.

Our first day in Impendle involved an excursion to the town. Our trip was focused around exploring the assets of the community. Instead of coming into a region and immediately seeing what is lacking or wrong with the place, our program wants us to see what is working and then explore what could be improved upon. It’s just a slightly different way of exploring a new place, which I enjoyed. Downtown Impendle was far more developed than downtown Kimana (in Kenya). There was a library, a police station, a home affairs office, a grocery store, several food vendors, a butchery, etc. We had several discussions and friendly debates surrounding development. Here is a quick excerpt from our paper that I wrote about it:

“In Impendle, development was a constant feature of discussion in our group and in my mind. The focus on promoting development in the area was quite clear, given the vast investments in roadwork and infrastructural development. In Impendle and in  Nzinga, there were always people working on the roads, with machinery and materials aplenty. The other key development initiative was the new Impendle Library, a recently built facility with computers, lots of books, health promotion posters and a quiet place to learn. These two different initiatives led me to a conflicted notion of development, the purposes behind it and its effectiveness.

I was surprised when we first pulled into Impendle and I saw all of the road infrastructural development because I had been expecting (and found) a relatively rural area with few residents owning cars. Also, the mini-buses and taxis rarely frequented the area. Who were these roads for? They didn’t seem to be for the community members because they didn’t drive. Likewise, they didn’t seem to be for the taxi companies because the route was not a busy one.

We spoke to a man at a grocery store in downtown Impendle about this and gathered his opinions on the development. He thought the road developments were a waste of time and money. His main opinion was “why invest in roads that no one will be driving on”. He believed that the money would be far better spent on education or healthcare, so that people can be healthy and prosperous enough to afford cars to drive on a road. Then the road could be repaired. I realize that only speaking to one man severely limits my sample size, however I felt his input was valid and provided an interesting perspective. His input also suggests that the community was not consulted before the development project began.

On the other hand of the discussion, investing in infrastructure provides jobs to people who otherwise have no options for employment. Providing them with temporary jobs might boost their experience, provide them with some income and enable them to foster their own development on their own.

As for the library, the facilities were very high quality, with internet, clean and quiet reading areas, all kinds of books, and so on, but for some reason the library was very empty(our guides said it was more full during the school days). They also had health promotion posters, mostly for HIV awareness and promoting safe practices. As I stood there, I questioned the relevance of it. Who are these posters for? Who is reading them? Who are these books for? The answer I would speculate is: everyone. However, only four people were utilizing the library and all four of them seemed very studious and involved in their reading. They were clearly educated. Is this message really reaching everyone it could? Is this library really the best use of the space, if most people don’t use it? Our tour guides all said that they would never come here, and laughed at the prospect of it.

We are brought to the resounding question in global/public health and development discussions: how to provide the greatest good to the greatest number. I am not sure whether either of these initiatives reaches the greatest number, but they are certainly bringing a great-‘er’ good (improvements). Perhaps these improvements will prompt further change, development and prosperity. Perhaps they won’t. It brings us to another question surrounding the development and global health paradigm: how to break the cycle of poverty and disease. Will it be through investing in infrastructure and top-down initiatives or through grass-roots education, health promotion and empowerment? What comes first, the chicken or the egg? I do not know the answer, but I am more than intrigued to find out. “

I find this development discussion fascinating. A common theme and discussion on our trip has focused on the concept of “it” (overly inclusive term, meaning relatively everything in life) not being “either-or” but rather, “both-and”. In other words, I think that both infrastructural and social/educational development notions are important and useful, but neither should be on its own.

One aspect of the round ancestor houses that I forgot to mention is the massive amount of smoke I inhaled and am now exuding from my pores. They have a raging fire in the centre of the room and cook and burn anything (including clearly toxic plastic bottles) into this room with absolutely no ventilation. I think I may have taken a few years off my life from that.

The next day, we set out to visit several Sangomas (traditional healers) and the village chief. We did not forsee this being a huge endeavour, but boy were we wrong. We ended up walking for over an hour to the first Sangoma, to find her too busy to speak with us. Luckily, we found a wonderful Sangoma a few minutes away who was willing to talk with us and share her story. A Sangoma is a traditional healer who consults with the ancestors about the health problems of a patient. They believe that many health problems are a result of the ancestors not being pleased with you and seek to provide a link between the ancestors and the patient. Interestingly, a Sangoma does not choose his or her career path, they are chosen by the ancestors to be a Sangoma. If a person is unwell and western/clinical medicine does not appear to work, they will go to a Sangoma and this Sangoma will tell the person that they have “a calling”. The Sangoma we spoke to was fascinating because she was a rarity in that she did not like being a Sangoma. She told us that if she had the option for another life, she would take it in a heartbeat; she does not like being a Sangoma. One girl on our program is doing a really interesting independent study on the intersections of clinical and traditional medicine. Many people go to both traditional healers and clinics, taking both medicines at once. This can be very risky, as the ingredients in traditional medicine, known as muti, are not known and the medicines are unlabelled. They also don’t have an established dosage and are untested. Common problems include side effects when taking both medicines, non-compliance of both medicines, leading to drug resistance and counter-productive habits. For example, Sangomas often prescribe a muti that makes a person vomit to rid their body of toxins. However, if an HIV positive patient is given this, it severely weakens them and is detrimental to their health. Also, cold baths in the morning are often recommended, yet for a TB patient this can also be very risky. This Sangoma was so fascinating; she goes to the local clinic for diabetes medicine and high blood pressure medication.

I suppose this next topic warrants a whole paragraph: nutrition. I was astonished at the prevalence of diabetes in South Africa. I don’t know the exact figures off the top of my head, but numerous people have told me they have diabetes. This was not surprising to me once I saw people’s diets here. It is astonishing how they eat: carbs on carbs on MORE carbs. The starches are endless. It makes sense because they are the cheapest, but carbs and sugars consist of much of people’s diets. They also put endless amounts of mayonnaise and butter on everything. It is quite bizarre. Fruits, veggies and cheeses are a foreign delicacy to us now. Luckily, we students are on our own for lunch and have been living off of vegetarian meals!

The next day we left for UMtwalume, and again I was very surprised about the lack of “rural-ness”. We stayed in a two story house with a shower, our own bed room, a huge flat screen tv, etc. It was really bizarre. In UMtwalume, we walked around the community and explored the surrounding area, seeing the schools and the paths the students would walk on to school. The next day we went to a house with six or seven sangomas. We were able to ask them questions and they danced for us! It was very entertaining.

After returning from the rural homestays, we have had an extreme amount of work (over 50 pages have been turned in the last week). This is why I haven’t been able to update my blog in a timely manner!