When I was preparing to come to South Africa, I was advised to have as few expectations as possible because the trip undoubtedly would be different than anything I had experienced before. Since arriving, I would agree that this place is indescribable and the only way to explain our experiences to others would be to bring them here and show them where we have visited and who we have met. I truly believe we are in the most incredible place to have a study abroad experience because we are at the crossroads of incredible natural beauty, a new democracy and deep-set race and gender inequality. We have had the opportunity to visit the sandy beaches at the foot of a series of mountains, and to climb the magnificent Table Mountain. We have eaten at amazing restaurants with cuisine ranging from Ethiopian to South African dishes to classic fish and chips. We live comfortably and sometimes when walking downtown can forget that we are not in a city in the states. However, I think this trip’s true learning experience will be when we focus on the problems that this country still faces with its history of apartheid, struggle with human rights and gender equality and with its extreme poverty overlapping with a progressive, modern city. I am working with Michelle at an organization titled Olive Leaf, formerly associated with the global group Hope Worldwide, which works to fight HIV and AIDS in the township Khayelitsha. Before coming to Cape Town, I considered myself well educated about the epidemic as a result of my interest in public health and participating in a college course that focused entirely on the disease. However, I am quickly realizing after my first week at the internship that it is impossible to understand such a problem until you are immersed into the environment and culture in which the virus is spreading rapidly. Not to say that HIV is not still a huge problem in the United States, but here it is obviously more prevalent and much more out in the open. About one fifth of all South Africans are HIV positive, and this is closely tied to the poverty and lack of women’s rights in the area. AIDS clinics and advertisements about getting tested seem to be abundant in the townships but the rate of infection has yet to drop, and this has to do with the complexity of the disease.
After meeting people at the office, hearing their stories, going to the homes of people very sick with the virus and visiting several clinics in Khayelitsha, I am beginning to see some of the huge barriers the country must overcome to lower the incidence rate. Abuse of women in these areas is extremely common and women often do not have the voice to make men use protection. Michelle and I were amazed when reading the statistics that Olive Leaf provided us, as we learned that in this township 2 of every 3 women’s first sexual encounters is forced, a reality that is hard to fathom. There is also a huge stigma associated with the virus, which complicates the matter even more because people infected become isolated from their communities. When I initially thought about these problems, I questioned why more of these women did not take advantage of the women’s shelters and move out. However, if these women decided to move out, they have no money, no marketable job skills in a country with a 40% unemployment rate, no place to live and usually several children to support. In order to tackle the epidemic, people must not only provide resources for prevention, testing and treating, but also to educate and work with both men and women in regards to their views of relationships and the treatment of women. One story that resonated with me was when one woman told us about when she found out she was HIV positive soon after high school, which kicked her out when she became pregnant, and she told the man she had been sleeping with. She told Michelle and I how he could not care less and he later told her that he knew before sleeping with her that he had HIV but did not tell her because he wanted to have control over her. Hearing this story from a woman who had been through more than I can possibly begin to explain, put a face to the epidemic. It was the first time for me that the issues were not completely abstract, and was one of those experiences that can never be learned in a book. I will not fully process this or any other story we have heard for a long time as it is such an emotional and intense subject, but I feel so privileged to have the opportunity to come over and learn and be more aware of such problems and share my experiences with others back at home.
I also am learning a lot about the organizations that help fight HIV, and the whole other set of problems they face. Many nongovernmental organizations in South Africa are extremely under funded and the government has unfortunately taken the position of denial about the breadth of the HIV epidemic. Olive Leaf formerly was part of a religious organization Hope Worldwide, and broke away last November for several reasons and is dealing with trying to get enough money and resources to continue growing. Michelle and I spent the first day of the internship cutting and pasting pieces of paper into books that were going to be donated to schools, and left early because we used up all the glue and they could not find anymore. At our house meeting that evening, our RA Ben pointed out that it not only are we learning about fighting the AIDS epidemic but also about the monetary challenges these organizations face as they couldn’t even provide enough glue for us to complete the task at hand.
I have also become more aware of whom funding comes from and how this affects the effectiveness of the programs. Olive Leaf receives a substantial amount of funding from the United States government and thus for the past decade has had to use this money to stress abstinence in its prevention campaign. While I am sure that is not the only reason Olive Leaf tends to be more conservative in their approaches to fighting HIV, it is frustrating to see how the United States does not understand the reality of South Africa and that when women struggle to have so few rights, abstinence just is not realistic. However because the United States has the monetary resources the organization must comply to a lot of conditions that lessen the effectiveness of their efforts. Witnessing some of the effects of this has made me question the worldwide effort to fight the spread of HIV or really to fight against poverty in general, and how much of the money we pour into these efforts is probably wasted. I feel like many governments and international organizations have more of the resources, but each country and community is so unique that giving money to the community based organizations that understand the intricacies of these problems would be more successful. However in South Africa, these are the organizations that struggle to realistically have enough resources to carry out their programs.
While I reflect upon what I have learned in my internship in the first week, I can only imagine how much I will learn over the course of our stay. I think just as much learning and excitement comes from all the other activities I have done such as climbing Table Mountain and living in a house with fourteen other people. Whatever expectations I had have already been surpassed and I cannot wait to experience and learn new things everyday.
