Over the past five days, I have gone to all the sites where the UWC 4th year pharmacy students do their service learning. They work at a very diverse set of PUBLIC health care institutions, including five public hospitals, and five Community Healthcare Centers around Cape Town. The hospitals include the very famous Groote Schuur Hospital, where Dr. Christian Barnard performed the first heart transplant. It is an amazing teaching hospital, with all the latest, greatest health care toys. They also work in places like Crossroads CHC (Community Healthcare Center) . 
Crossroads is a black township, and the CHC is smack in the middle of blocks and blocks of shacks and shanties. HIV is rampant, and about 50% of the clients who come in for medicines are getting their monthly supply of Anti-Retral-Virals (HIV treatment). The pharmacy is cramped, and the 2 pharmacists, 3 pharmacist assistants, 1 retired pharmacist helping out as a "volunteer", are moving as fast as they can in the cramped environment to fill the prescriptions and get them out to the dozens of people who are crammed into the waiting room, waiting...
Crossroads is a black township, and the CHC is smack in the middle of blocks and blocks of shacks and shanties. HIV is rampant, and about 50% of the clients who come in for medicines are getting their monthly supply of Anti-Retral-Virals (HIV treatment). The pharmacy is cramped, and the 2 pharmacists, 3 pharmacist assistants, 1 retired pharmacist helping out as a "volunteer", are moving as fast as they can in the cramped environment to fill the prescriptions and get them out to the dozens of people who are crammed into the waiting room, waiting... It was an incredibly powerful experience to see such a thorough view of the public healthcare system in South Africa. As overwhelmed as the system is, and as sad as it was to do rounds in a district hospital and see so many patients with TB, HIV, Meningitis, etc., there was one thing I kept having to remind myself: AT LEAST THERE IS A PUBLIC HEALTH CARE SYSTEM! EVERY ONE OF THOSE PRESCRIPTIONS WAS FREE, AND NONE OF THOSE PATIENTS IN THE HOSPITAL WAS GOING TO GO BROKE AS A RESULT OF THEIR HOSPITAL STAY.
I was also really inspired by the commitment and the humanity of the staff. Working under incredibly stressful conditions, there was a level of humanity and compassion present that was really tangible. [MORE ON THIS...]
But, the most powerful experience was driving from hospital to hospital with my driver, a "coloured" man named Lee. Lee is 38 years old, from a coloured "suburb" as he called it (to differentiate it from a black "township"), and has had a rough life including gangs and prison. He would call me "Prof" --which is the name that most folks seem to use for university faculty here-- but would always speak to me in the third person. For example, he would say: "When does Prof want me to pick him up?" Or, "What does Prof think about life in Cape Town?" But what was most powerful is that as we drove from "suburb" to "suburb" to "township" to "township," he would reminisce, somewhat matter-of-factly, about the limits on his life that he experienced growing up. For example: "Prof, see this hospital entrance here? That was for the whites. This whole side of the hospital was for the whites. The coloureds and the blacks had to go around the back, and only use that side." Or, "We couldn't wait there for the bus Prof. That was for the whites. We had to wait over there in the open, even when it was raining. Prof, what a pain!" Or, "Prof, that was a white neighborhood over there. We couldn't walk through there to get to the store, even though it was right on our way. We had to walk all the way down there (4 or 5 blocks), and then turn left..." Or, something just as simple as "A few years ago, Prof, we couldn't be driving together like this in the same car." --referring to the fact that I had been sitting in the front seat next to him.
Our last day together, I took Lee to lunch. I asked him to choose the place. He chose a "muslim place," which was actually an Indian buffet, featuring the foods of the "coloureds" of Cape Town, many of whom are also muslim and from Malaysian descent. The food was fabulous, but the conversation was even more fabulous. I learned more about Lee's life as a "young gangster," about the lack of options growing up in a "coloured suburb," and finally, he started to share some of his anger over the wasted lives of his friends from the "suburbs." (Again, these are not the "Southern Suburbs" where the white folks like us live, but he is referring to the "coloured suburbs," which were isolated, removed, and oppressed during Apartheid. He shared his commitment to providing a better life for his girls (who are 1 year older than Alex and 1 year younger than Maya respectively), by sending them to private school, and giving them a stable family life to grow up in.
It was an amazing week, as I've come to gain a much better idea of the great work that the School of Pharmacy has done to build these connections with the community, and also, of all the potential work that we can do to get the students "out of the dispensing booth" and "into the community."
Blog ya later...
Seth./.
