Nkandla Day 15 - Teaching English

Before my little kitten adventure, I had quite a full day today. I went along to the highschool and helped teach English to one of the 11th grade classes. It's hard to describe how out of control these kids can be. Just imagine a regular-sized classroom, but with well over 100 kids in it. At the beginning, they were extremely hard to quiet down. Teaching English has been a real struggle for the volunteers out here, not only because the class sizes are ridiculous, but mainly because these kids are grouped according to age, not according to knowledge or skill in the subject. In the US, for example, you wouldn't take a Spanish 102 course until you took the 101 course, because you obviously need to start at the beginning. However in our classroom, the needs and levels of these children are all different. For some, our lesson was a complete review, while others got lost. All in all, though, it was a pretty successful class. We've decided that for the next couple weeks I am here I will go to help teach English at the school, and then do caregiver/case assessments for the Sizanani Outreach Monday Wednesday Friday, and go out with the medical teams Tuesdays and Thursdays. I'm really happy with this schedule because I think it will enable me to do the most good where it is really needed.

After class we met up with Sister Ellen and some of the other volunteers to begin our caregiver/case assessment project (mentioned earlier). The Sizanani Outreach is a fairly new program and there are several kinks to work out. On top of that, Sister Ellen is the primary Administrator and so she has quite a bit on her plate. To ensure that the caregivers are doing what they should, we decided to create an assessment form and randomly pick several client cases per caregiver and not only assess that the client is receiving the care they need, but make sure that the caregiver is working efficiently and documenting what they need to be documenting. From our assessments we will be able to give each caregiver feedback on their performance and tweak anything about the client paperwork that needs improvement. To be honest, so far the experience has been pretty grueling. Rural healthcare runs VERY slowly, and on top of that, many of the caregivers either haven't received a lot of training and support, or they lack the motivation to work efficiently and document thorougly. As a nurse in the US, it is drilled into us that documentation is EVERYTHING. Basically if you don't document it, then it never happened. Doing these assessments has truly brought that concept home to me. Like I said before, because the caregivers hardly document anything, it has been very difficult to assess the client's needs and treatments for those needs.

After working on the different cases I joined two other workers to visit one of the orphans now in the hospital, a little girl that has been at the center for about three years, but was recently taken to the hospital for treatment for TB, AIDS, and lung failure. She's been at the hospital for about 5 weeks now. I don't know her whole story, but basically she had TB that went untreated for a long time which killed her lungs. She now only has ¼ lung capacity and must constantly be on oxygen. She is also completely emaciated and has begun to develop a bedsore on her coccyx. The hospital here in Nkandla is a lot like the hospitals I visited in Mexico; not many resources and very poor facilities and treatment. The little girl was in the children's ward which, while it was very sad to see, was also a highlight of my day. While most of the children there didn't speak English, I still went around and played and talked with them. There is something just so special about little children. Here they were, some with broken bones, burns, some emaciated as a result of AIDS, and yet they are still able to find joy. While our little girl was in a lot of pain and severely fatigued, she was still able to crack a smile a few times. We brought her coca cola and chocolate ice-cream mixed with soil. Ya that's right I said soil. Dirt. I need to get further clarification of this, but apparently its normal for people to sometimes eat the dirt here. I dunno. I guess she had requesting that we bring red soil next time we came. So we put small rocks of soil in her icecream for her to suck on. Weird, I know.

The hardest part of being in the children ward wasn't the sick children, although that, of course, was heartbreaking -- it was seeing that the nurses didn't really have the energy or the motivation to engage with the children.  There were three or four nurses in this room with about 10 children, and the nurses were just sitting around the table talking to each other. I kept telling myself that they were just taking a break because they know we were there, but it also made me think about the tendancy to become jaded to suffering after seeing too much of it.  I was reminded of how I "come from a place where death just visits," but still, I was frustrated knowing that these children needed more and deserved more, but were probably getting less than any people on earth, and what infuriated me most was witnessing it and not seeing through to a clear solution, so I probably projected my fear and pain on the healthcare workers whose work environment and personal stories I could probably never truly comprehend.