I've not written much about my work with the two Universities in service learning. Curriculum development, course evaluations and faculty workshops are not always the most exciting thing to read about. I guess I was waiting for some inspiring gems of wisdom to share. There have been some great moments, some real goose-bumpy, light-bulb illuminating, insight-rich moments. But now that there is only six weeks to go on our year here, I better start sharing a few. Let me start with yesterday, Friday.
4th Year Pharmacy Students and Day Hospitals
I went with two colleagues from the UWC School of Pharmacy to meet a community partner and continue the planning of a new 3rd year service learning program for the School of Pharmacy. I've done a lot of work with their 4th year program, helping it more clearly address issues of social responsibility and social justice, and providing a richer framework for reflection and learning. In their 4th year program, the students spend 6 weeks in pharmacies in both tertiary teaching hospitals and local "day hospitals." The "tertiary hospitals" include Groote Schuur Hospital, which is famous for being the place where Dr. Christian Barnard did the first heart transplant, and are generally modern and well-equipped. On the other hand, the "day hospitals" are the government hospitals that serve the majority of the population. Only 20% of the S.A. population have health care, and they use private hospitals. The other 80% get virtually free health care at these public facilities, and the "day hospitals," are the first point of access for many people. They have a reputation for being overcrowded and underserved, which is pretty true (fact: the Mitchell's Plain day hospital serves a catchment area of about 1 million people. It is the only hospital in that area!). These hospitals also have a reputation for having poorly trained doctors and nurses, which is VERY UN-TRUE! However, patients often wait for hours before seeing a doctor, and then additional hours in order to get their medicines from the pharmacy. You can imagine how crowded these hospitals and pharmacies are in the context of AIDS and TB, both of which are endemic in many of these communities. You now hae thousands of people coming in regularly for their anti-retral virals, and their TB medicines, which makes for even more stress on the pharmacies! Not a pretty picture.
New 3rd Year Service Learning Program
Working in the pharmacies in these "day hospitals," the pharmacy students get great insight into the pharmacy/drug side of health care, and the realities of the difficulties of the public health program in South Africa. BUT, given the workload, they get very little time to actually talk with patients, or to get to know the communities that their patients come from, and their social context. So for example, you give someone medicines which need to be refrigerated, and they have no electricity where they live. Or, if they have electricity, they don't have a fridge. What do you do? Or, you give someone a medicine that has to be taken 3 times/day with food, but in fact, the person only eats one meal per day. What do you do?
So, the 3rd year service learning program is designed to give the students more exposure to the patients and their communities by doing service in city health clinics which provide primary health care services to women and children. So, we went to meet with Mary (not her real name), who is the district manager for 10 clinics in the area surrounding UWC. Mary is amazing, and has been actively involved with service learning at UWC for 10 years. Ironically though, even though she has been at many meetings, she has yet to really get into a true service learning partnership with the university. Don't get me wrong, there are plenty of students who come to Mary's clinics to "serve," including many nursing students. But as Mary says, they just come with their sheets, with a number of boxes that need to be checked off: x number of babies to be weighed; y number of pre-natal consults to be observed; z number of vaccinations to witness. From Mary's perspective, this is far from service-learning. This is checking-off boxes.
Service Learning is Really about Finding Common Agendas
What truly made this conversation different was the starting point. Our initial question to Mary and her staff was, "What kinds of issues do your patients experience with regards to compliance to their medications?" Well, that question set of a flood of stories and examples and situtions which people experience every day with regards to medication. And from there, we asked, "so, how can the 3rd year pharmacy students get exposure to these struggles and issues?" Together, we then developed an idea which is both at the heart of what Merle is struggling with at her clinics with regard to medications, and which provides the pharmacy students with the real-world exposure to communities and primary health care, which they have been missing. It was wonderful to see both the 2 academics from the UWC school of pharmacy, and the two health care administrators becoming so animated and excited, as the project began to come alive, and its scope and significance became more and more evident.
By the time the meeting ended, there was a wonderful sense that the beginning of a truly meaningful and reciprocal program had been created. Then, unprompted, Mary started to talk about her frustration with all the requests for research that she receives. As her clinics are right in the middle of neighborhoods hard hit by TB, by HIV, and by the "methamphetamine" scurge, they are prime targets for research. And yet, Mary's sense was that none of this research really had any impact on her capacity to delivery health care to the population. She recognized that there were undoubtedly some important insights that had been generated by the research, and that perhaps they did lead to some new laboratory-based innovation. But, none of this helped her deliver health care. Her issues continue to go un-met. It was then that she said, "I should just shut the door and say, 'No More.' Our clinics are so over-researched. We need some real research.
Hopefully, some "real research" will be one of the fruits that grow from the seeds of collaboration that were planted the other day.
Blog ya later.
Seth./.
Saturday, May 23, 2009
Thunder Storm in Cape Town
We were woken up the other day to incredible thunder. This was unusual, because like our hometown of Monterey, CA, thunder and lightning rarely happens in the Cape. It felt as if 
the storm was right over our heads, as the lighting flashes were followed immediately by thunderous booms. It made for some pretty wild morning commuting, as the lightning was still going strong, and the rain was coming down in buckets.
Later that day, we receiveds some incredible photos from friends. I like this one, because you can see the incredible mountains which form part of downtown Cape Town, and which we have come to love so dearly over the past year. On the right, is Lion's Head. In the center is Table Mountain, and on the left Devil's Peak. This picture was taken from the North, looking across the harbor to downtown Cape Town. We've been living on the back side of Devil's Peak and Table Mountain, around to the left.
Blog ya later,
Seth./.
the storm was right over our heads, as the lighting flashes were followed immediately by thunderous booms. It made for some pretty wild morning commuting, as the lightning was still going strong, and the rain was coming down in buckets.Later that day, we receiveds some incredible photos from friends. I like this one, because you can see the incredible mountains which form part of downtown Cape Town, and which we have come to love so dearly over the past year. On the right, is Lion's Head. In the center is Table Mountain, and on the left Devil's Peak. This picture was taken from the North, looking across the harbor to downtown Cape Town. We've been living on the back side of Devil's Peak and Table Mountain, around to the left.
Blog ya later,
Seth./.
Wednesday, May 20, 2009
San Rock Art in the Cederberg
We have made some amazing trips during our year in South Africa, but one of the most stunning was our weekend in the Cederberg looking at incredible examples of San rock art. The 
Cederberg is a mountainous area about 200 miles from Cape Town. It is incredibly stark and barren, with few trees, and some amazing sandstone formations and rock outcroppings. And for perhaps 20,000 years, the San (arguably the oldest of all ancient peoples) lived in the caves of the region, doing their "hunting and gathering" thing, while using the regions many caves and overhangs as both shelter and canvas for their "rock art." As a result, the Cederberg is just a treasure chest of pictures, painted on these rocks thousands of years ago. This was definitely the coolest art gallery that I've ever seen.
Cederberg is a mountainous area about 200 miles from Cape Town. It is incredibly stark and barren, with few trees, and some amazing sandstone formations and rock outcroppings. And for perhaps 20,000 years, the San (arguably the oldest of all ancient peoples) lived in the caves of the region, doing their "hunting and gathering" thing, while using the regions many caves and overhangs as both shelter and canvas for their "rock art." As a result, the Cederberg is just a treasure chest of pictures, painted on these rocks thousands of years ago. This was definitely the coolest art gallery that I've ever seen.For Naomi's birthday, I wanted to splurge and take us to a really high end resort called "Bushman's Kloof" (check out their website: http://www.bushmanskloof.co.za/), which is in the area, and is famous for its rock art (and luxury accommodations). But, being the ever practical realist, Naomi didn't want to spend the big bucks, so we went with a down-market option called "Traveler's Rest." 
We went up with our friends the Boraines, and rented two cute cottages, each with a fireplace and braai (BBQ) area. Right down the road from the cottages was a 4 km trail that took you through the cliffs and to 10 different rock art sites. The paintings were amazing, between 6,000 and 500 years old! It was so cool, as you wandered through these beautiful cliffs and hills and then would come across these amazingly beautiful cave paintings. One more beautiful than the next. At first, you didn't see much. But the more you looked, and the more trained your eye became, you started to notice that there were pictures everywhere you turned. You just couldn't help but feel the centuries and centuries that have past since these pictures were made, and wonder, "what would we leave behind, 6,000 years from now? Would it be as simple and beautiful and expressive?."
I've included a couple of pictures here, but for more, check-out the slideshow as well. Originally, the pictures had multiple colors --so they say-- but some of the colors didn't last as long as others. So, some of the figures are without heads, etc. But what is amazing to me is how delicate and descriptive the pictures are. (OK, the one I included to the right is not so delicate, but it is very descriptive!).
We went up with our friends the Boraines, and rented two cute cottages, each with a fireplace and braai (BBQ) area. Right down the road from the cottages was a 4 km trail that took you through the cliffs and to 10 different rock art sites. The paintings were amazing, between 6,000 and 500 years old! It was so cool, as you wandered through these beautiful cliffs and hills and then would come across these amazingly beautiful cave paintings. One more beautiful than the next. At first, you didn't see much. But the more you looked, and the more trained your eye became, you started to notice that there were pictures everywhere you turned. You just couldn't help but feel the centuries and centuries that have past since these pictures were made, and wonder, "what would we leave behind, 6,000 years from now? Would it be as simple and beautiful and expressive?."
I've included a couple of pictures here, but for more, check-out the slideshow as well. Originally, the pictures had multiple colors --so they say-- but some of the colors didn't last as long as others. So, some of the figures are without heads, etc. But what is amazing to me is how delicate and descriptive the pictures are. (OK, the one I included to the right is not so delicate, but it is very descriptive!).
Last South African Adventure?
Anyway, this might have been our last adventure in South Africa --sad but true. We have one more trip planned, to Grahamstown for the National Arts Festival for 3 days before we catch our plan. So, I guess there is still more adventures to come. But nonetheless, this trip was very poingnant, as we all reflected on the amazing beauty and incredible history that we've seen and learned about during the past year. Quite astounding.
Blog ya later.
Seth./.
Friday, May 15, 2009
Democracy Malian-Style
Democracy in Africa
While I was in Mali, South Africa went to the polls and elected Jacob Zuma as president. This was a very interesting election, as for the first time there was a viable "African" alternative party to the ANC --The Congress of the People, or COPE. Until this election, the parties were pretty segregated, with the ANC collecting over 75% of the vote, mostly from Black africans, while the Democratic Alliance was the most dominant "opposition" party, with around 10% of the vote nationally, mostly from white voters. Well, while COPE was not overwhelming, they did take enough votes away from the ANC so that for the first time, the ANC does not have a 2/3 majority in congress. So, for the first time, there is a viable opposition in South African politics, which most folks seem to think is a very positive development.
Well, though I missed the South African elections, I was in Mali for the final two weeks of campaigning for their local elections. Mali has recently implemented a decentralization plan, giving more decision-making authority and budget control to local elected officials. So, these elections were a big deal, and there was campaigning going on everywhere. Banners with the party symbols (the bee, the ram, the star, the shaking hands, etc), people wearing T-shirts, and even full-on "grande boubous" with the party symbols and pictures of the local candidate.
It was all pretty straightforward, since Baba was the man with credibility, and Baba was with ADEMA. So, after listening to the perfunctory promises, the "che-koroba" eventually nodded his approval, and said that he would encourage all of his extended family members to support ADEMA. (And in this land of patriarchal authority, that means all the votes from the village were just locked up! I guess the "che-koroba" was the kind of person that the Democratic party would have called "a bundler.") The ADEMA folks then gave him one of their red&white posters, and asked him to put it up on the wall of his mud hut, just so that everyone who goes by (yes, ALL the traffic on the donkey-cart path between Tourourkoro and Genguan...) will know that they are an ADEMA bougou (village). The "che koroba" held the poster admiringly, handed it to his first wife, with pride, who also looked admiringly and proudly at the poster, and said, "we'll definitely put this up on our wall, so everyone can see that we are ADEMA-people!" At this point, Meme, the 8th grade son of the che- koroba, subtly came over to his mother and gently took the poster from her hands, turning it right-side-up, and then giving it back to her. Clearly, Meme was the only one of the twenty-some family members who could have noticed that everybody had been admiring the poster upside-down! Yes, the birth of democracy in a land of strong patriarchal authority, with a very low level of literacy, is a slow process indeed.
Sunday April 26 was election day. I got to join the Diarra-Keita family in Kati on their trip to the voting station at the local elementary school. Everyone got dressed up, almost as if going to a social event. We first ran into Maria's son Sam, who proudly showed us his purple-dyed finger, sure sign that he had done his civic duty and voted. Then, at the voting station we found hundreds of people milling about, some having just voted, others about to vote, and still others making tea for the dozens of folks who were "witnesses" at each polling station. In each classroom there was one voting booth, where the voters hid themselves to mark the ballot. Then,
in the center of the room was a plastic box, where the voter would put his ballot. And next to the box, with their eyes peeled, were a group of 6-8 people, all watching the ballot box to make sure that nothing fishy took place. It was quite an amazing site. No "hanging chad" problems. No electronic computer malfunctions to worry about. Just enough eyes on the box, making sure that each person only put one ballot in! (And oh yes, the all important "inker," who made sure that immediately after putting the box in the ballot, the person who have their finger inked! (Clearly, this was not like Chicago. No voting "early and often" here!).
Toward the end of the day, mini-bus taxi cabs were cruising all over the backstreets, picking up people who had yet to vote, and helping them get to the voting stations. Surely, these taxis are being paid for by the parties in power, a slight variation on the "vote early and often theme." the taxis kept buzzing till 6:05, when a loud siren went off, signifying that the voting period had officially ended. Later that evening, I saw a very strange parade of sorts in Kati. Each ballot box was being carried back to City Hall, surrounded by an entourage of a dozen "body guards" of sorts. It was a rather incredible sight to see: the future of Malian democracy in the hands of so many people...
And the Results are...
Well, it is now over 2 weeks since election day in Mali. And you probably didn't hear it on CNN, but, Ibrahim's party did not win in Kati. So, Ibrahim's dream of being mayor are put on hold for a few years. But, Baba's party ADEMA swept the region of Banamba, including all the tiny farming hamlets of Madina Sacko, Boron, and Touba. So, Baba is now officially a member of the "commun council," and will get to participate in the development decisions of the region. He was one proud guy! I gave him enough money to buy himself a new suit!
It was a pretty amazing event to see such a traditional society, with such low levels of technology, struggle with this thing called "democracy," and the principle of "one person, one vote." In a place of such strong traditional patriarchal authority, where not everyone feels like they are worthy of having an opinion about public affairs, this is an amazing transformation that is just beginning to take place. Quite the change from 22 years ago, when the ballot was either "yes" or "no" for the military party in power, and somehow, 99.8% of the votes cast were "YES." Democracy: the newest game in town!
Blog ya later.
Seth./.
While I was in Mali, South Africa went to the polls and elected Jacob Zuma as president. This was a very interesting election, as for the first time there was a viable "African" alternative party to the ANC --The Congress of the People, or COPE. Until this election, the parties were pretty segregated, with the ANC collecting over 75% of the vote, mostly from Black africans, while the Democratic Alliance was the most dominant "opposition" party, with around 10% of the vote nationally, mostly from white voters. Well, while COPE was not overwhelming, they did take enough votes away from the ANC so that for the first time, the ANC does not have a 2/3 majority in congress. So, for the first time, there is a viable opposition in South African politics, which most folks seem to think is a very positive development.
Elections in Mali
Well, though I missed the South African elections, I was in Mali for the final two weeks of campaigning for their local elections. Mali has recently implemented a decentralization plan, giving more decision-making authority and budget control to local elected officials. So, these elections were a big deal, and there was campaigning going on everywhere. Banners with the party symbols (the bee, the ram, the star, the shaking hands, etc), people wearing T-shirts, and even full-on "grande boubous" with the party symbols and pictures of the local candidate. Maria's husband Ibrahim was atively campaigning with the URD in Kati; and my friend Baba who is a high school teacher from Banamba, was on "the list" to become a councilmember with ADEMA in his home town. Every afternoon there was drumming and dancing, as one political party or the other would be out doing "la campagne." For each gig, you would have huge speakers blaring traditional music, rental chairs placed around a circle, and the obligatory shaded 
"famaw" or VIP seating area. Remember, 110 degrees! Then, little by little, the people would gather, and the dancing would start; usually featuring folks sporting the party colors (in this case, blue for PARENA). But, no Malian political campaign in Kati (a middle class suburb of the capital) would be complete without the obligatory 
plastic can full of ice water. This was all new for me. Having left Mali 22 years ago, in the days of the one-party military dictatorship, all this political campaigning was new. But, the ice water was also new. It was amazing watching these incredibly beautifully "bou-bou"'ed women meticulously unwrapping blocks of ice, and adding them to the big blue container. This ice water was then assiduously distributed to those who either danced their tushies off during the "warm-up," or the "famaw" (VIPs) who came up later on to give speeches of support. No doubt, most everyone getting the ice water at this event was wearing the blue/white of PARENA.
"famaw" or VIP seating area. Remember, 110 degrees! Then, little by little, the people would gather, and the dancing would start; usually featuring folks sporting the party colors (in this case, blue for PARENA). But, no Malian political campaign in Kati (a middle class suburb of the capital) would be complete without the obligatory 
plastic can full of ice water. This was all new for me. Having left Mali 22 years ago, in the days of the one-party military dictatorship, all this political campaigning was new. But, the ice water was also new. It was amazing watching these incredibly beautifully "bou-bou"'ed women meticulously unwrapping blocks of ice, and adding them to the big blue container. This ice water was then assiduously distributed to those who either danced their tushies off during the "warm-up," or the "famaw" (VIPs) who came up later on to give speeches of support. No doubt, most everyone getting the ice water at this event was wearing the blue/white of PARENA.La Campagne Comes to Genguan
One of the most amazing "birth of democracy" scenes that I witnessed took place in Genguan (see the post of XXXXX). I had gone out with Sambou and 3 of his sons, to visit his family's farming hamlet, 30 kms on pretty ugly dirt roads. It took us about 90 minutes to get there, where we ended up spending an incredibly peaceful afternoon. Believe me, I doubt that they see
one or two cars/trucks passing there a week. But on this day, not only did I show up with Sambou in our pick-up, but a couple hours later, we heard engine sounds in the distance. Sure enough, la campagne had arrived in Genguan. ADEMA (Association pour la DEmocracy MAlienne) had arrived!
One of the most amazing "birth of democracy" scenes that I witnessed took place in Genguan (see the post of XXXXX). I had gone out with Sambou and 3 of his sons, to visit his family's farming hamlet, 30 kms on pretty ugly dirt roads. It took us about 90 minutes to get there, where we ended up spending an incredibly peaceful afternoon. Believe me, I doubt that they see
one or two cars/trucks passing there a week. But on this day, not only did I show up with Sambou in our pick-up, but a couple hours later, we heard engine sounds in the distance. Sure enough, la campagne had arrived in Genguan. ADEMA (Association pour la DEmocracy MAlienne) had arrived!Coming up from Bamako, I had brought my friend Baba, who is a high school teacher at one of the best schools in Bamako, and runs his own private school, Ecole Sirido Baba. He told me he was happy to come to Banamba with me, but little did I know that as soon as we arrrived, he was to be swept up by his political buddies, and off he sped in his pick-up for some unkown bougou (village). Baba's home town, Sirido, is not far from Sambou's homestead. So Baba (standing up in front of the truck wearing the sport coat), was an important man in the area. The families in the area all know Baba, and know that he is a person of integrity. So, if Baba supports ADEMA, then they will too!
When the truck pulled up, a ragged bunch of about 10 ADEMA campaigners got out, led by Baba. It was 2pm, and this was their 10th stop of the day, going from rural hamlet to hamlet, spreading the good ADEMA word. It was incredibly hot, and believe me, there was no ice water on this campaign stop! In fact, there was no electricity within probably 30 kms, so no chance for raucus campaign music either! After they piled out of the car, they came up respectfully to the "che koroba" (head of the family), greeted the family, and were offered food and water by the mamas. After a quick few handfulls of "toe" (millet poridge), they said thanks and shared some blessings for the family. Then, they went into their campaign spiel, telling the family of the benefits of voting for ADEMA.
It was all pretty straightforward, since Baba was the man with credibility, and Baba was with ADEMA. So, after listening to the perfunctory promises, the "che-koroba" eventually nodded his approval, and said that he would encourage all of his extended family members to support ADEMA. (And in this land of patriarchal authority, that means all the votes from the village were just locked up! I guess the "che-koroba" was the kind of person that the Democratic party would have called "a bundler.") The ADEMA folks then gave him one of their red&white posters, and asked him to put it up on the wall of his mud hut, just so that everyone who goes by (yes, ALL the traffic on the donkey-cart path between Tourourkoro and Genguan...) will know that they are an ADEMA bougou (village). The "che koroba" held the poster admiringly, handed it to his first wife, with pride, who also looked admiringly and proudly at the poster, and said, "we'll definitely put this up on our wall, so everyone can see that we are ADEMA-people!" At this point, Meme, the 8th grade son of the che- koroba, subtly came over to his mother and gently took the poster from her hands, turning it right-side-up, and then giving it back to her. Clearly, Meme was the only one of the twenty-some family members who could have noticed that everybody had been admiring the poster upside-down! Yes, the birth of democracy in a land of strong patriarchal authority, with a very low level of literacy, is a slow process indeed.Election Day
Sunday April 26 was election day. I got to join the Diarra-Keita family in Kati on their trip to the voting station at the local elementary school. Everyone got dressed up, almost as if going to a social event. We first ran into Maria's son Sam, who proudly showed us his purple-dyed finger, sure sign that he had done his civic duty and voted. Then, at the voting station we found hundreds of people milling about, some having just voted, others about to vote, and still others making tea for the dozens of folks who were "witnesses" at each polling station. In each classroom there was one voting booth, where the voters hid themselves to mark the ballot. Then,
in the center of the room was a plastic box, where the voter would put his ballot. And next to the box, with their eyes peeled, were a group of 6-8 people, all watching the ballot box to make sure that nothing fishy took place. It was quite an amazing site. No "hanging chad" problems. No electronic computer malfunctions to worry about. Just enough eyes on the box, making sure that each person only put one ballot in! (And oh yes, the all important "inker," who made sure that immediately after putting the box in the ballot, the person who have their finger inked! (Clearly, this was not like Chicago. No voting "early and often" here!).Toward the end of the day, mini-bus taxi cabs were cruising all over the backstreets, picking up people who had yet to vote, and helping them get to the voting stations. Surely, these taxis are being paid for by the parties in power, a slight variation on the "vote early and often theme." the taxis kept buzzing till 6:05, when a loud siren went off, signifying that the voting period had officially ended. Later that evening, I saw a very strange parade of sorts in Kati. Each ballot box was being carried back to City Hall, surrounded by an entourage of a dozen "body guards" of sorts. It was a rather incredible sight to see: the future of Malian democracy in the hands of so many people...
And the Results are...
Well, it is now over 2 weeks since election day in Mali. And you probably didn't hear it on CNN, but, Ibrahim's party did not win in Kati. So, Ibrahim's dream of being mayor are put on hold for a few years. But, Baba's party ADEMA swept the region of Banamba, including all the tiny farming hamlets of Madina Sacko, Boron, and Touba. So, Baba is now officially a member of the "commun council," and will get to participate in the development decisions of the region. He was one proud guy! I gave him enough money to buy himself a new suit!
It was a pretty amazing event to see such a traditional society, with such low levels of technology, struggle with this thing called "democracy," and the principle of "one person, one vote." In a place of such strong traditional patriarchal authority, where not everyone feels like they are worthy of having an opinion about public affairs, this is an amazing transformation that is just beginning to take place. Quite the change from 22 years ago, when the ballot was either "yes" or "no" for the military party in power, and somehow, 99.8% of the votes cast were "YES." Democracy: the newest game in town!
Blog ya later.
Seth./.
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