Home Visits in Soweto

This has been a week of no visits to the Outreach Center; Meisie was in a car accident yesterday morning and, though she's okay, is weakened by aches in her muscles from the impact. She is staying home to recover the rest of this week. I have been doing research on systems of care for vulnerable children in South Africa.

However, I did want to report on events before Meisie's accident. A week ago today, after our usual late start, turned into a full afternoon of home visits to Nomsa’s granny clients around Soweto. Our task was to distribute donated school uniforms to seven grannies for the HIV+ children they care for, entering their homes and chatting with them for a bit. Meisie encouraged me to take photos of each granny and they seemed happy to have photos taken of them and their grandchild/grandchildren. The poverty and cleanliness of each grandmother varied quite a bit. The first granny we visited lives in a one-room tin shack; neat piles of children’s laundry covered a single bed, but the “kitchen” wall was cluttered and the space was dark and rather dismal. Margaret, the grandmother was warm towards us, though she was clearly unwell and almost emaciated. Meisie told me after we left that Margaret was “positive” but has taken no steps to deal with her illness until, maybe, recently. She told Meisie that she’s been tested, but refuses to come to support group. It’s difficult to understand the degree of denial that can squelch concerns about the children’s welfare. Who will look after her grandchildren after she dies of AIDS?

Almost every granny was doing laundry or ironing when we arrived! Nomsa gave each of them a rather hideous knitted ski hat and scarf—all donations. About three grannies were not home, but we were able to leave the uniforms either with the children or a neighbor. The uniforms are for the children who are HIV+. Donations of uniforms may make the difference in whether a child can attend school or not. Some of the kids also got shoes with their uniforms.

One home we visited stood out dramatically from the others because it was bright, well-furnished, decorated with bright patterned curtains and chachkis, such as animal statues, a head of Mandela, pottery, and a beautiful enlarged photo of her eldest daughter in traditional Nbele clothing. The leather couches, while very worn, were shiny-clean, with linen squares of embroidered cloths along the backs. The granny showed me her beautiful, new tin bucket that she uses to get water for cooking or washing, as well as the two tin shacks in her back yard where her sons live. It was all very neat, and one shack had a rustic sculpture near the door made of metal and string. She was very proud of her home; as we left, I noticed and commented on her succulent garden at the front of the house. Her grandson, who seemed about ten years old, was quiet but polite and sweet. His head was covered with lesions, probably karposi’s sarcomas, and he was very thin. But, he was eating a sandwich he made for himself when we ended our visit.

Across the road and over the dusty red-dirt ‘yards’ was another client’s home, tucked behind a brick house. There were two shacks there, as well as an elder couple who seemed to live in one of the buildings. The client was not home, but someone went to fetch the two children, who would receive the uniforms, and the elder neighbor woman would sign for them. The children were delighted with their uniforms, which they took inside their shack (after posing for me). Meisie told me that Cotlands had built the shack for this granny & the children because it had been too crowded for them in the house fronting the road. It was a one-room shack constructed of corrugated tin. Cotlands also makes sure that each client has a small refrigerator (to make sure the ARV’s are kept cold), a stove, and a space heater. None of the homes we visited had running water and used outhouses for toilets. In one home, an entire room was filled with a queen-sized bed covered with stuffed animals for the children.

Home sizes varied from one room to four—I don’t know how many people actually lived in each, although none held fewer than three people. Men were few and far between. In the back of one home, the yard for two shacks and a house, several men were building coal stoves out of scraps of metal or old appliances. Another backyard that we entered held a shack and a shabeen. The client was not at home in her shack, so Nomsa had the shabeen owner accept and sign for the uniform. Four very drunk men sat outside the shabeen with their almost-quart-sized cups, filled with a yeasty brew that has high alcohol content. Alcoholics, the men will spend every cent they should to buy food on drink, much like alcoholics the world over. The little girl client appeared as we were leaving, running up to and embracing Nomsa with a huge grin on her face.

The last home I will describe was, as most of them, at the back of a house fronting the road; four children sat on a wall and got very excited by our appearance (and my camera). Meisie showed me the house garden next to the granny’s shack, which Cotlands had helped her start, and which she had added to. While it was impressive, I am skeptical that it would ever provide a significant amount of food for the family. Meisie’s goal is to have every granny in the program have a home garden to help decrease her poverty. This garden had a primitive wire fence, a box of used plastic bottles at the end, and a pile of trash or some stuff at the other end. There is much to be done with such chronically poor people, even these who are so committed to improving their lives and those of their grandchildren.

Memory Books & Home-based Care

Last week marked the initiation of Memory Boxes and Memory Books at Cotlands Outreach Center in Soweto. The Memory Books were primarily facilitated by volunteers from World Hope, a Christian NGO that recruits volunteers from places around the world. Five women from Colorado spent Monday through Friday (today) working with one or two Home-based Care clients to create their Memory Books, which can be both a legacy for their children/grand children and a positive/therapeutic process of building their story for perhaps the first time. For these folks it is also important for them to be encouraged to plan for a time when they will no longer be alive and to make a permanent record of their love for the children they leave behind. Along with the books, they have made “Memory Boxes” in which to store their Memory Books and put any things they want to leave behind.

This is a group uniquely suited to this narrative program: the grandmothers are old and the mothers are HIV+--both generations may not survive the decade. I observed that, in comparison to the young mothers, the grannies took to the task more readily, seemed to have fun, and were more talkative with each other and the volunteers. The client Meisie and I visited last Friday for our "intervention" came for the first time to the Center; she told me she was feeling a bit better and smiled radiantly for my camera.


The Memory Book and Box process has superceded the ususal support groups for the mothers and grandmothers that take place Monday through Fridays at the Center. I'm sorry to miss being able to attend these, but I doubt I would be able to follow them because very little real conversations here are in English. With enthusiastic support from one of the careworkers, it was decided that I would do a training with all of them on basic counseling. It may be that one area where I can be routinely helpful each year is in offering trainings. I think they could use some basic diagnostic knowledge, at least to identify depression and trauma, in the hopes that someday psychological services will be available to their clients. It also appears that family counseling skills could be very helpful in cases where family conflicts add to the stress of HIV+ mothers and to grandmothers caring for young HIV+ children.

The new Outreach Center building (donated in part by the NBA!) has a very large living/dining room, which accommodates couches & stuffed chairs for support group meetings. There’s a good-sized, well-equipped kitchen, two bathrooms, another function room or craft room, the office, and at the end of the hallway, a large room for childcare/Educare. The children in the program can attend while their mother or grandmother is in support group, making crafts, or sewing with the "Philagogos" ("Go Grannies!"). Tuesday, I went into that space with Busi (director of the outreach program) to dance to music with the children, who range from toddlers to preschoolers. There must have been ten or more children in a room that was too small for the. Nolobabalo, the teacher, was occupied elsewhere, and then Busi left me alone there. There was rough-housing between the two older boys, a couple girls wanting to be picked up (signalled by the universal, "Me! Me! Me!"), and a toddler systematically licking a wall heater. I was afraid to leave them alone, but finally I’d had enough and raced down the hallway, looking for Nolobabalo. Breathless, I asked if the kids were okay left on their own, and looking at me as though I were an idiot, she said, “of course!” I am clearly an ignorant foreigner! Nolobabalo must be very good at her job, for I rarely hear any distressful sounds coming from the Educare room.

The Philagogos do their sewing in the two-car garage space, which is a huge (literally) improvement from the other building in the Orlando neighborhood of Soweto. There’s a large cutting table, storage closets, and three or four sewing machines. Four mothers have joined the grannies. The former building was not only sketchy but the men living in the adjoining buildings were all ex-cons. Only women and children came to the Center, and so we all felt a bit vulnerable in that place. I learned yesterday that one of the men, who often tried to socialize with the Cotlands careworks, had been (is?) a serial killer! I don’t quite know what to make of that…what was he doing out of prison?

The new surroundings consist of permanent family homes and a high school at the end of the block. Cotlands has received a generous grant to create a large garden on school property, where the grannies will cultivate vegetables for Center lunches, to sell, and to give to those without enough food. Meisie’s goal is to have every granny in the program have a home garden to help decrease her poverty.