This is our final week in Swaziland, with that being said we have been trying to get as many things done as possible which has left us with not as much down time. Yesterday, Tuesday, our journey through Swaziland health lead us on may roads. Collectively we visited the community, labor and delivery, and a psychiatric hospital, attended a lecture, and entertained a special guest.
In the morning a few students sat in on a lecture on Asthma, lead by one of the hospitals Pediatricians. The presentation was reported to be thorough, as it included the epidemiology internationally, triggers, treatment and the importance of educating the patient. What was most impressive was that the physician took nearly two and a half hours to give this lecture to nursing students. Privately he shared that he is invested in making institutional changes and thought it was important to involved and engaging students to create this change.
Ali spent most of her day in the ER, while Martha, Alex and Patty spent most of their time in the maternity ward. The RFM maternity ward averages 40 births in 24 hours. During their 8 hours on the ward, 11 babies were born vaginally. Students held hands with patients, assisted midwives by fetching equipment, observed and learned. This was Patty’s first time seeing a live vaginal birth. She said it was an “eye opening experience” and was amazed to see the strength and resilience of women during this truly laborious activity.
Belma, Katie and Dr. Ken from the St. Louis School of Pharmacy visited the areas psychiatric hospital. The ward was reminiscent of the old psychiatric wards of the US, with its very prison like feel. As they entered an acute men’s ward, men flocked to the gate, stretching their hands out through the gate in order to shake hands with them. Having compassion for the patients in the ward and seeing their desire for human contact the pharmacist reached out their hands, in response. They noted that there were much more men than women in the facility and were told by the psychiatrist that upwards of 90% of the men admitted had a comorbidity of Cannabis abuse. Many patients in the psych hospital were HIV positive but currently the facility did not have an antiretroviral treatment program to manage their HIV care.
I spent my day in the community. Together with Choto from the Wellness Center, I traveled nearly 2 hours south east to the area of Matata where he was to hold that day’s Mother to Mother (M2M) meeting. Three women were in attendance, each M2M mentors. I was very excited as he was going to allow me to share one of the self esteem workshops that I have done with young women in the US, through the leadership program Future Leaders by Design. Choto began his lecture introducing the topic of “Me”, and review the aspects that create one’s self including our emotional, social, spiritual, physical, mental selves and then turned the room over to me. The workshop I shared reviewed the concepts image and identity, using a drawing of a mirror. On the outside of the mirror the women wrote how others see them (image) and on the inside they wrote how they feel about themselves (identify). Before we spent time discussing our personal mirrors, in an effort to stimulate a conversation together we created a mirror for the women of Swaziland. We discussed the affects of media on ones identity and image and ways to change the images we did not like. The women were reluctant to speak, to share their opinions; I thought this was very understandable as this was their first time meeting me and I was not a Swazi woman. I later found out that the women of Swaziland are not socialized to share their opinions nor are they encouraged to explore their individual interests; this may have contributed to their disinclination to speak. When they did speak they did so in a very low voice and often looking down. The women seem to genuinely like the exercise as they said so but also this was shown through their smiles and laughter as they began to relax. During the final part of our discussion, I asked if they felt it was important for us to make sure the image we show to others matches our personal identities and they answered in the affirmative. We then each picked one thing on the outside of our mirrors that we would like to change and discussed ways that we can improve our images. After the workshop Choto asked them to give me what I thought would be a round of applause; the women put their hands together rubbing them as if they were warming them up and gave one big clap. That one clap was full of energy, I felt special. I was happy to be able to share with them and that they were willing to share with me.
As most of our days end with a family gathering of sorts for dinner, this day we took our dinner outside of our hotel and welcomed a special guest. Our dinner was held at Malandela’s, a beautiful Farmhouse restaurant in Malkerns. Our special dinner guest was Nicholas Bhekifa Mamba, activist, artist and playwright. As we broke bread he shared his vision of Swaziland and discussed how he uses the stage as a vehicle for education and community discussion of social issues including HIV/AIDS. We discussed Swazi views of religion, polygamy, human rights, gender roles and stigma as it relates to HIV and health. He shared with us an acronym that sums up the distrust that some people in Swaziland have for the US, AIDS: American Idea for Discouraging Sex. None of us students at the table had heard of this use of the acronym and were shocked. This sparked lots of conversation about the history of colonialism and its relation to the content of Africa. Our discussion was a reminder of the need to build bridges of trust between those who we collaborate with before we can expect them to accept the messages we have to share.