Chelsea Whalen :: South Africa
As of today, I have been in South Africa for about a month. I arrived in Cape Town to be greeted by one of my roommates, who is from Australia and working at a local organization. For my first weekend here, she showed me around a few areas in Cape Town. I spent my first Sunday at Kirstenbosch botanical gardens in Cape Town, which are enormous and very beautiful.
The Tuesday after my arrival I began my internship at the School of Public Health at the University of Western Cape Town. I met my supervisor, Ehi, and was given a huge list of projects for me to work on and things to help with while I am here. My work for the past three weeks has been a jumble of tasks mostly oriented around the PURE study.
The PURE study is a global study, looking at the health effects, particularly rates of cardiovascular disease, of urbanization and development. In South Africa there are 2,000 participants some in Langa, a township in Cape Town, and others in the Eastern Cape Province. Each of these participants has filled out surveys about their age, number of family member, eating habits, exercise habits, work, and safety of their neighborhoods. Also, each has had ECG scans and blood tests, in order to moderate health. Some of this data has been collected; however a huge amount has not been either converted into a standard unit or entered into a data base. Much of my time in the last few weeks has been working on various parts of this process. I was able to do some data collection in Langa, ECG scans, and help with a survey in one of the public hospitals in Cape Town as well.
The work is interesting and very research based. After helping with research on townships and disadvantaged communities in and around Cape Town, it is strange to live in a safe apartment and commute to a University Campus daily. I feel that I am living a very middle class lifestyle. This has been my greatest frustration. However, as I have gotten more involved, I have been able to do more field work in the Langa. In meeting the participants of the study, the value of my work is much more evident.
Upon my arrival in Cape Town, although I had been told this many times, I was surprised on how European it appeared in the architecture, museums, and mass of cafes. The city center is very compact, and bustling with restaurants, shops, and businesses. However, apart from this center, Cape Town sprawls in all directions, with the poorest areas farthest away from the compact business area. The townships, or those I have visited, are a tight knit community of houses and shacks, many build out of tin. Some of these areas have been acknowledged by the government, and thus have some form or power and water supplied. However many of them have rigged up systems to get electricity from the lamp posts or stop lights, often causing fires and safety problems.
This disparity is the most challenging part for me, living so well and knowing that there are so many so near who need help and support. My other challenge has been language, English is one of the11 official languages, however Afrikaans and Xhosa are spoken commonly, Xhosa especially in the townships. I am enjoying it though, soaking in the diversity of culture and learning more and more every day at the School of Public Health and my time spent observing in Cape Town.
I am in my last week of my internship at the School of Public Health, and quickly approaching is my return to the U.S. As expected time has gone by quickly as I settled into a routine, it seems as though time has barely passed, yet I know I have learned and experience so much. Aspects of Cape Town have grown on me in this time, while other characteristics have made me happy that I do not permanently live here.
I have been pleased that my tasks in the past five weeks have shifted to less office/organizational work, to more field work and data gathering. I have been working more and more in Langa, a township made up of self funded houses, government funded housing, and shacks. The shacks, also referred to as informal settlements, are public areas which people have built “houses” on. The houses are made of tin and broken boards, have dirt floors, and are crammed into any open areas. It would be comparable to taking 5 tin sheets and a few boards, and nailing together a little shack to live in on a grassy area next to I-5.
Two to three days a week, I have been going to Langa with colleagues on a variety of tasks. First, we are trying to recruit more participants for the PURE study, which involves going to peoples houses, talking to them about PURE, and then performing interviews about their lifestyles. Second, I have been assisting with echocardiograms (ECG’s), blood draws and other health measurements which need to be completed for every participant. These tests are beneficial for PURE, as they give health measurements which will be takes annually, as well as the participants. If a severe problem is found, such as extremely low heart rate or continuing cough, we are able to refer them to clinics. Also the participants are given free medical testing for anything found in the analysis of ECG results, blood, and urine. As a result of being from the School of Public Health, we are often approached with a variety of other medical concerns ranging from cancer to HIV.
The third task I have been helping with in Langa is a small component of PURE looking at different environmental aspects. Included is a “walk-through”, a set path in which we count the types of advertisements and stores, a survey on advertising and items sold in grocery stores, restaurants, and tobacco stores, and interviews of Langa participants about health perceptions. I have been a part of meetings looking over the survey questions of stores, planning the walking path, and last week I went to Langa to survey the grocery store and tobacco store with a colleague who lives in Langa. Although it is expected, going into the grocery store was still surprising. We visited the largest grocery store in Langa which was very small, had mostly dirt floors, had an extremely small stock of all healthy food options, but quite a large, cheap stock of premade, salty options. It is vastly different than the stores in richer areas of Cape Town, which are almost comparable to Seattle’s Madison Market.
The diets, exercise habits, and lifestyles of the populations are theorized to be contributing to the huge increase in diabetes, cardiovascular disease, and obesity around the world. The World Diabetes Foundation writes that the prevalence of diabetes has reached epidemic proportions, in which 70% of those with diabetes live in lower and middle income countries. The PURE study is looking at lifestyle brought by urbanization as a cause of this increase in diabetes as well as the increase in obesity and cardiovascular disease. Diabetes intervention needs to focus on the cause as well as addressing the immediate symptoms.
Although I was primarily frustrated with research, as I wanted to do more community work, as I worked at the School of Public Health I saw the importance of research and monitoring. Government and private donors send huge amounts of funding to developing countries to help them overcome problems with disease outbreaks, education, gender inequality, and much more. Many projects are loosely monitored and money is often sent without a clue of how it is being used or the likelihood of the project’s success. As societies become more developed and we see different diseases emerge and evolve researchers around the globe search for explanations for these changes in order to prevent deaths and epidemics.
As I return to the US, I know that I will take with me a better understanding of the issues in Cape Town, as well as the process and importance of research, monitoring, and evaluation. I do not think that Public Health is in my immediate future, but I am so grateful for the opportunities and exposure that I have had here and the wonderful, generous people whom I have worked with.