Food for Thought...

Food for Thought...

Saturday 4 October 2014

There are no lines in Africa


Whether it’s the physical space between two people in a Spar queue, the row of individuals waiting at a mobile SARS office or the emotional boundary between a health care practitioner and their patient, this month has reminded me that there really are no lines in Africa.

September has been another whirl wind of a month but I have decided to focus this post on a simple statement mentioned by my supervisor when I mentioned that I was going to try and get my tax return at the mobile SARS point one day. As she plainly put it, “Remember Caryn, there are no lines in Africa.”

My SARS line experience
Filing for tax returns can be a somewhat tedious process, as we all know, but when the structured, air-conditioned Durban SARS office decided to reject my proof of address letter written by the hospital HR manager, I thought the process was going to become even more of a mission.

To my misguided fortune, I found out that SARS would be visiting Manguzi Hospital to help employees with their tax returns by using a mobile office they seem to have created. Unfortunately for me, that particular day proved to hold a high patient load and I only managed to arrive at the bustling van at 3pm. I was told that due to my status as a ‘medical clinician’ in the hospital (rather than a cleaner or another apparently ‘less important’ job) I

would be prioritised so I could get back to work as soon as possible. While this all sounded rather classist to me, I wasn’t going to argue with a system that assisted in ensuring I would still be able to see my mounting patient load. My acceptance of this unjust system was further heightened when I realised that the arrival of the SARS van clearly called for a day of rest as lazy government officials left their posts around the hospital to sit on the grass and watch the chaos unfold.

While I was fast-tracked through the first of two queues by the possibly classist HR manager, I was not so lucky with the second queue. After receiving my number in the first queue (I was deemed to be 181 in the building chaos of people), the friendly HR manager told me to return at 4pm so I could continue working while the line subsided and he would then assist in fast-tracking me to the front of the second queue later. The flawed logic of this only dawned on me later as I wondered why I didn’t just finish the process right there and then. Nevertheless, I was now stuck in this mess. I returned at 4pm to find the HR manager having given up on trying to instil the slightest sense of order to the crowd. I was left to fend for myself. Eish. The line had turned into an absolute dog show in the space of an hour and after waiting for 30 minutes without moving from the spot on which I was standing, I realised that this experience was really going to test my patience.

I began asking people around me for their numbers and found a place where I seemed to fit in. I stood patiently and waited for what was left of the line to begin to move in a forward direction. I chatted absent-mindedly to the people surrounding me: being the only white girl in a group of 200 odd people inevitably called for some questions. I returned home twice for refreshments and to fetch my book but always hurried back hopefully, desperate for the line to have become a little shorter in my absence. Tensions rose as dusk turned to darkness and the group of people seemed to subside in only miniscule fractions. By that stage, our assigned numbers had become meaningless and I realised that I’d have to push my way forward if I hoped to be home before 9pm. As the shoving increased and seats were fought over, the three phenomenally slow SARS officials did nothing to quieten the rising resistance movement I was witnessing grow before my eyes. All of a sudden the crowd seemed to move forwards quite drastically and I unwillingly became a part of the scramble for the random empty seats dispersed amongst the group. At that moment, the ridiculousness of the situation hit me and I started laughing uncontrollably at the pandemonium of which I had become an inevitable part. Others joined me as they noticed the young white girl’s reaction to common practice in Africa. Soon the mood had lightened and humorous banter rose throughout the crowd dispersing the mounting tension. I was grateful for Mr 182 as he pushed me forward with every empty seat that became available, as if refusing to leave me behind in this obvious self-centred pursuit of our tax return rewards.

With only 7 people in front of me (and a good 50 people behind), one of the SARS officials announced that they needed to return to Jozini as it was getting extremely late. The crowd erupted into a mass of discontent and I began to consider the power of what anthropologists may call “mob mentality.” When the official submissively stated that it would be difficult driving the large SARS van back along dark roads with many cows to content with, his words were met with jeers, waving hands and further shoving of people towards the crowded van. He wearily looked at the angry crowd, made a phone call, and continued to work. We had won our first battle together. I laughed openly about how the character of the group quickly changed to one of comradery when we had a common enemy and couldn’t help but liken this to the downfall of the apartheid system who had tried so hard to disintegrate ties between people of similar oppressed groups. The man next to me broke through my thoughts as he happily waved me on to a suddenly empty seat with his half eaten stick of sugar cane. After instructing a few other people where he thought they should sit, he squeezed in beside me and chuckled, “perseverance is the mother of success ntombazane.” Oh yes. That night, his words could not have been more accurate.

I made it to the front of the queue after a mere 4 hours of hustling my way through the nonexistent African SARS line. Surprisingly, as I sat near the front I found a lot of 180s around me in the queue, with the odd sneaky 200 and something every now and again. I finished my tax return within the space of 5 minutes and jubilantly bid the crowd a farewell. I was greeted back with comical waves and laughs. I ran home, thrilled to know my tax return was secured and remarkably thankful for my unconventional SARS queuing experience. I was grateful for the chaos, the reminder that I live in one of the most unique countries in the world and felt a strange sense of belonging that I could add my presence to the disorder.

The Clinician-Patient Boundary
The line between a patient and a therapist is frustratingly blurred. While there are obvious lines that one does not cross when treating a patient, I often struggle to know how far to reach into their lives. This month, God turned the tables on me, and to my complete surprise, showed me exactly how far His love can reach.

On one particular day this month, the weight of exhaustion due to poor sleeping patterns rested heavily on my shoulders. I cursed my old creaky bed, my annoying hot room and the powers that be that seemed to be adamant to keep me from my precious sleep. It consumed my mind and I went about my day in a daze, wishing for the moment I could step back into my house and rest my head on my pillow.

My annoying sleeping patterns and inability to get them under control is a continuous struggle for me. I think the worst part is that it affects my job and ultimately the way I express God’s love to the people with whom I work, live and share life. I become an edgy and impatient (well, more impatient) person, hoping only to keep to myself and continue in a quiet manner throughout the day. This never bodes well as my job demands the exact opposite – enthusiasm, patience and a whole lot of energy.

Yet it was on this day that God chose to bless me through the words of a complete stranger.

I was taking a painfully slow walk with a Gogo who had had all the toes on her right foot amputated. Together, we trudged slowly towards the bathroom at the other end of the corridor (her with a walking frame continuously muttering under her breath; me with my head down, hands in my pockets, consumed by my own thoughts). As we finally made our way back to her bed (a good 30 minutes after I had managed to motivate her to get up), a nurse passed us and smiled. “Do you know what Gogo is saying?” the nurse asked me. “No,” I flatly replied, having barely noticed her apparent unintelligible ramblings. “She is praying. For you” the nurse replied simply. I was stunned. This Gogo with whom I had barely engaged, was praying for me!

While I will never know what exactly she said, her actions reminded me that God is with me, no matter how mundane the task may seem. He will never let me get through a day without revealing Himself to me in some small or big way – it is my choice whether or not I decide to see and hear Him. While I always question whether I can ethically cross that professional line to pray with my patients, God seemed to answer my question through the Gogo’s simple action. “Yes, pray for them Caryn because they are already praying for you!”

September memories:
Spring is here!! This beautiful tree stands right outside my house and reminds me what season it is . In the space of a week all the old brown leaves fell off and new ones have started to grow.


I visited a mobile clinic this month and provided rehab services inside the derelict building on the left. 
Cameron (Njabulo), a physiotherapist, napping on our way to clinic in the overcrowded 4x4
Time for some paper mache' with the OT assistants as we built a standing frame for a CP child. Messy but fun!
Who says physios can't make splints? My supervisor, Maryke, made this soft splint out of old wetsuit material and velcro. Check out the difference she has made to rural rehab in South Africa: Mail and Guardian 200 Young South Africans
Home-Based Care visit with Nonhlanhla, a physio technician, to catch up with Nelly, a gogo who suffered from a stroke recently
Nelly practising using a walking frame outside her homestead
Little Zaida, the current princess of paeds ward, discovered herself in the mirror
Adri reading with Zaida in the ward
Kelly, a Speech Therapist, teaching a little girl feeding techniques
Home exercise program for a gogo who can't read