28-5-12
MUCPP Township
Summary
I attended the MUCPP and surround township today to observe
and help educate the poorest of the poor in South Africa. We went to people’s homes and filled out a nutritional
survey on the household. We assessed as a
group (the lecturer, translator, South African student, and myself) on the plan
of action and what was important to educate the person/family on. All families were taught about how to prepare
and provide healthier meals with the income they had. To others we explained specifically what was
going on in their bodies if they had diabetes, hypertension, TB, etc. If necessary we referred people to different
areas/doctors of the MUCPP Clinic for further treatment and assessments.
Detailed Account
We were warmly welcomed to the University of the Free State’s
campus yesterday and moved into our dorms.
Kalie and I are roommates, while Brittany and Aubrey are living
together. We eagerly looked over our
schedules to obtain information about what and when we would be doing different
activities. As we scanned over them,
questions arose left and right, we were still quite confused about what lay
ahead. I tried to stay optimistic and
decided to trust the system. No matter
what I would make the best of each situation and if I really didn’t like what
we did, I knew it would change within a week.
That evening we were taken to a lovely dinner with the other
4th year nutrition majors (the students we would be working with),
some of the nutrition lecturers, and a few of the international affair staff
and students. During this time we asked
lots of questions and got clarification for a great amount of our burning
questions. After dinner I was more than
excited about attending Mangaung University Community Partner Program (MUCPP)
the following day, as well as each of the different weeks of the
internship. This excitement continued
throughout the evening resulting in a restless sleep, although I was still able
to jump out of bed.
Let the internship begin!
The nutrition student I would be working with this week met me at Emily
Hobhouse, my hostel (dorm), quarter till 8.
We walked to the nutrition department where we were picked up in a vibrant
red VW van decorated with kids, healthy snacks, and the phrase “Good choices
for better health! Kgetha hantle, o
phele hantle!” I am surprised at how
welcome I have felt in my short time in Bloem.
I entered the van and met the lecturer who addressed me by name before
having to introduce myself. Without
hesitation we were on our way to the MUCPP Clinic and surrounding Chris Hani township. During the thirty or so minute drive we
caught up about ourselves and they answered all the questions I could think of,
while explaining a little of what I should expect.
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| The van/our classroom and our wonderful security guard! |
When we arrived to the clinic we said hello to the
dietitians insides and had a mini lecture in the car describing what we would be
doing today. We then drove to pick up
our translator (also a dietitian) and security guard before today’s location in
the township. The knowledge I learned
today was so vast in so many ways. I
learned about the development of townships, the traditions of blacks and
coloreds, the health and nutrition of people living in townships, the list goes
on and on.
The townships are owned by the government and part of a
Reconstruction and Development Program.
Most townships arise from a large amount of people squatting in a
certain area. They build shacks from tin
and what little resources they can find in large open fields surrounded by
great amounts of trash (in respects to what I have seen in Bloem). When enough people live in these extremely
poor and primitive locations the government comes and builds concrete houses,
roughly 6-7 square meters) and gives them to the residents, which can range
from 2 people to 15 people. At this time
the residents are supposed to tear down there primitive tin houses (Makuko),
that usually are in their backyards, although many keep them and rent them for
income. Electricity is then installed in
these houses followed by a sewage system.
The majority of the time bathrooms and sinks are located outside of the
house unless one is wealthy enough to pay for it inside the house.
The household income is mainly received in two forms; from
people working and from government grants.
If a person is a registered citizen some of them may be eligible to
receive grants for income, but unfortunately many of these people don’t even
have birth certificates or can’t be bothered with getting registered. If the income is lower than a certain amount
people can support themselves with grants.
For every child a mother has, and registers, they are able to get a 250
rand grant per month (roughly $33 USD) until the child is 14 years old. If a female resident is above the age of 60
or a male resident is above the age of 63 they can receive an old age grant of
1000 rand (~$133 USD) per month. If
someone is unable to work because of disability they may also receive 1000 rand
per month. Lastly, many of the
population between 25 and 40 have passed away due to aids, this leaves the
grandparents to take care of a great deal of grandchildren. If a resident is taking care of foster
children they can receive 650 rand (~$87 USD) per month for each child.
With lots of new information and a bit of culture shock
coming my direction we began our job for today.
We walked through the township looking for open doors or children
playing. When we located a house with
someone inside our translator would enter and ask if we could come talk with
them about nutrition, etc. Every time we
were welcomed into their homes or outside if they preferred. Most people spoke Southern Sotho which the translator would mostly dictate the
conversation. Others spoke Afrikaans where the lecturer and student would jump in. One well educated lady also spoke English
where I was able to help conduct the survey.
When we arrived at each home we completed a MUCPP
(Nutrition) Community Survey. Most of
the time the women were at home doing laundry and chores while looking after
the children that were under five. It
was good when no one was home, indicating that everyone was at work or in
school and therefore caring for themselves.
We would begin by writing the name, sex, and age of each member of the
household. I was told that many
households were confusing and nearly impossible to understand. Lots were composed of a family with their
children, along with grandchildren, sometimes a person you didn’t know how they
fit in with their children, etc. the possibilities could be endless.
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| Doing a Nutritional Survey |
If people were present we would take their height and weight
to determine their BMI and refer them to the MUCPP Clinic if necessary. If children under 5 were present we would
also weigh them and plot it on their growth chart. For each child a parent is given a growth
chart. They take the chart with them to
the clinic for check ups, where their child’s health is plotted as well as any
notes the nurses & doctors have, and their immunization records. All of the services at the clinics are free
of charge so it is imperative that the children are taken there to check their
nourishment. All of the children we
encountered today were not needed to be referred to the clinic for supplements
but all fell between the 30th and 50th percentile for their age
category. If a child was noted to be
malnourished or abused the children would be referred for supplements and
possible the caretakers to social services or the police would be called.
Following the head of the household was established as well
as who and how many people provided money for the household (including
employment and grants). Access to fresh
water was noted as well as the presence of a vegetable garden. We tried to promote having their own gardens
as a means of constant food and to lower expenses of healthy vegetables. If they were interested in making a garden we
provided them with spinach, beetroot, carrots, and cabbage seeds, as well as a
pamphlet on how to have a garden.
Questions regarding going to the clinic for children and for sickness
were asked. If people didn’t go to the
clinics we asked why and helped to explain how important it was for them to
attend to remain healthy.
We then asked if anyone in the household had any of the
following conditions; diabetes, heart disease, hypertension, peptic ulcer, loss
of appetite, TB, overweight/obesity, diarrhea, constipation, weight loss,
HIV/Aids, other. To my surprise people
were extremely open about their health conditions and most were thankful to
have the clinic to obtain regular assessments of their health. The most common conditions we encountered was
diabetes, which they understood as high sugar levels, and hypertension, which
they called high blood. Many of the
people who had been diagnosed with these conditions were unaware of what
exactly they were doing to their bodies so we used pictures and simplified
versions to explain why their body sometimes felt the way it did and gave ways
for them to improve their health, while still acknowledging their limited
resources and funds. We gave everyone
pamphlets on the three main food groups and how to prepare and eat healthy
meals as well as pamphlets for certain diseases that were encountered within
each household.
The other diseases we were aware of was the amount of people
affected with TB and HIV/Aids. I noticed
more people with TB, and most being children.
If someone had TB they were required to take a supplement daily to help
with their immune system, although I am unsure if they knew why it was so
important that they do it even if it tastes bad. If one person in the family had TB all children
under 5 were tested and put of medication to protect them and be
proactive. People with HIV were also
recommended to attend the clinic and receive supplements and treatments,
especially when their CD4 count was lower than 200. Although in each case the personal situation
had to be assessed to determine what was necessary.
A question about family planning was always addressed. It was common that most of the higher
educated women understood how important family planning was and they were also
the ones with one or two children.
Although most women took advantage of injections (1 every 3 months) some
did not and many less educated women had multiple children, many of which they
could not care for. If injections caused
unbearable side effects birth control tablets were administered, but rarely due
to cost. Lastly sterilization would
become a possibility but almost never happened due to fertility being highly
regarded to the African men.
This brought up a great deal of information about traditions
in the black culture regarding wives.
Almost all black and colored men still, in some way, pay for their wives
before they are allowed to marry. Men
will make an offering to a woman’s family, weather it be cattle or money, etc.
in hopes of marrying. Most of the time
the man will make sure the woman is fertile by impregnating her before
marrying her, and many times will not marry her at all. In many instances it will take a man a long
amount of time to come up with the sum to pay the family and by that point he
will already have multiple children with his future wife, therefore supporting
a family and paying for his wife. This
makes many men believe that they own their wives and therefore can have many
children with them and highly regards fertility. Surprisingly the more education a person
receives nothing changes with this system except the woman is worth more money
to the family. I found this extremely
interesting and surprising in more than one way.
Lastly the family was asked to do a brief recall of the
foods the ate for breakfast, lunch, and dinner.
Most of their meals were pup (high in salt and porridge/grits like),
milk, chicken (if they could afford it), and a vegetable, but usually only one
or two of these at any given meal.
Obviously they were not able to get a well rounded diet eating only
these foods so we suggested how to make their meals healthier with foods they
could afford. It was also very
interesting to note that families with little money, little education, and many
children would often be undernourished yet the parents still acknowledged they
spent money on alcohol. I observed that
many mothers were slightly over nourished, children all somewhat under
nourished, and men mostly under nourished and relied on alcohol. It was a culture shock to see where their
priorities were and we did our best to convey to them the importance of a
healthy diet without being offensive.
If people were in need we would refer them to the clinic on
all sorts of accounts. If their teeth or
eyes were bad they were referred to the dentist or optomologist. This extended to people who needed psychological
counselings, dietitians, AIDS treatments, social workers, doctors appointments,
etc.
One of the most shocking families we visited was smaller,
being just a couple and their one 4 year old child. Surprisingly the 4 year old was the only one
who put money on the table each month.
The mother did not work but kept the house clean. The father almost lost his hand from a cut
and had an operation. He was on
disability but was removed from it so now the family is surviving off 250 rand
(~$33 USD) per month. The child was just
above the 30th percentile on his growth chart, the mother slightly
overweight, and the father average. When
we addressed what they ate they told us they would eat foods from eggs, to
vegetables, to biscuits, to chicken, etc. when they could afford it but nothing
was guaranteed each month or day except for alcohol. It was heartbreaking to see the sweet, well-behaved
4 year old, whose eyes lit up when we gave him a balloon and then realize that
his parents don’t understand the importance of his or their own health.
It was nice to know that when we were helping families and
telling them how to improve their quality of life they seemed to be so grateful
for us. The children were sometimes a
bit startled by us but it could be due to the fact that they might have never
seen a person with white colored skin before.
The majority of the people were extremely receptive and seemed to really
take their new knowledge seriously.
Although it was a big culture shock and an experience I will
never forget I feel like this is a step in the right direction for South
Africa. There are not nearly enough
people doing what these nutritionist are doing, it is a start. We were mearly a drop in the oceans of townships
but we educated and helped the best we could.
After today I believe a great majority relys on the education these people receive
in order to change their lives and the lives of the next generation. If we can teach one person in the family and
if they can share what they learned with the others, etc. we can begin to
improve the system.
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| Some township homes |
