Life: Water, Power and LOVE!

I thought for a change I’d send you an update on a more personal note, and as my friend Tim found the tales of my living situations to be so interesting, I thought I’d write a little about that for a change. At the bottom you’ll see the biggest news of all… so don’t miss the “Life in LOVE!” section at the bottom!

On a brief Thembalethu note… Training, training, training! Yesterday was the final day of a long string of them, it’s nice to have a rest from the meetings, coordination, catering, etc. We’ve just finished multiple trainings over the past couple weeks: 3 days on Tuberculosis, 3 days on Counseling and ARV Adherence training, and a 2.5 day foundational course called Learning to Listen by Christian Listeners. They all went very well, and although they ended up being a bit bunched together, the HBC attended in great numbers and the courses were each a great success!


Life and Water
Today’s another day without water. I learned years ago in Ecuador how essential water is to accomplish the most basic daily tasks. How easily I had previously taken it for granted, never having gone without in surburban and rural America. I remember hearing how amazing it is how adaptable humans are. Being without water isn’t a big emergency for me anymore like it used to be. The great thing is that Sofi, next door, has a bit Jojo water tank full of water that fills up our water storage containers when ours run out. Today, it sounds like either a pipe has burst or the pipes have clogged up with mud.

You see, we and two other farms as well as a small Zulu farm village get our water from an underground stream up the hill from here. Not only is our water system very hand-done, a botch-job as Sofi would call it – 1km of low pressure plastic pipes dug about a foot under the surface, running from the dam they built to catch mountain stream water and take it down the hill to our farm, Cosmos Farm. High pressures from the stream cause them to burst, or in the dry winters (coming soon), wandering cows (of which there are MANY in the land of the Zulus) step on the pipe and burst it, smelling the water inside. And the time-share development up the hill, and their dumping of topsoil has filled our water source with LOTS of sediment. Making it brown and chunky on the best of days. I’m so grateful for our little countertop filter!

So, now it’s a waiting game. Waiting to see if this great fix-it guy over in the village will sort it out before we need to, as we’re at the end of the line.

[The next day]…It’s another day, and the water’s back on! Many thanks to Derek and his quick-acting Mr. Fix-It helpfulness! Oh, how I appreciate a nice hot shower in the morning! Not to be compared with a sponge-bath over a large round basin, what the Zulus call to “geza ngendish.”

Being at Cosmos with a nice-working gas geyser (hot water heater) is certainly simpler than my last year’s water-heating situation. I was living on a farm named Meadowsweet Herb Farm just down the road, which still had an earlier form of water heater that is affectionately known as a ‘donkey.’ I suppose it got its name from its stubbornness, and I learned to understand with use. A donkey is a primitive homemade water-heating system whereby, in this case, a large metal drum is turned on its side, mounted in a cement/brick structure, and a fire is lit underneath to warm the water. The donkey at Meadowsweet required a lot of work to get the fire started, a lot of wood to keep it going, a lot of time with a roaring fire (at least 3 hours), and only gave a couple of hours of hot water as an end result. Coming back from a long day at work, or a day hike in the Berg and wanting a warm-up or clean-off shower took a lot of coordination and patience to say the least!


Life and Power
This past year at Cosmos Farm is the most rustic of my living situations so far in South Africa. But even this is nothing in comparison to many of my Zulu neighbors, which is why I appreciate the basicness of it all – it makes me feel less removed from the people I work with and serve.

Here at Cosmos Farm, I live in a three bedroom volunteer house with a large communal kitchen/living space. I’m the most permanent resident here, and as I write this it’s the first stretch in the past seven months that I have the place to myself. Slindile (18, orphaned, with two young kids) stayed here with me for almost six months, and then we’ve had various volunteers, interns and visitors also staying here. My good friend and landlord, Sofi Ntshalintshali-Cogley is about 100 yards away, so I get frequent visits from her two young kids Doong (officially it’s Lungelo), aged 6 and Miya, almost 3, and we often share meals and life together. It’s been such a blessing being able to live in community and having their friendship and family!

The volunteer house has a long-drop toilet (think outhouse) which we recently moved outside, accessed by a door in the bathroom. It has greatly improved the general house smell since then… wouldn’t recommend an indoor outhouse! Yet the bees have moved in, thinking it a good home, and flies and mosquitos love to breed in the depths. Naja, in the scheme of things these are just small adventures in Africa. The house runs off solar with natural gas for the stove, fridge and water heaters. The two solar panels on top of the house charge during the day and we can keep high-efficiency lights burning until late at night, and still have a little power left to charge our laptops. We monitor the battery life by beeps of the regulator.

One beep: means you’re starting to use the battery’s power (maybe something like 10% used),
Then it beeps three times: (which I guess is 30% battery drained) sometimes it does this a couple of times, depending on what we unplug along the way, it can move to
Five beeps: the regulator is telling you the battery is almost gone (it’s hard on the battery if it goes dry). At that point, you stop everything for a moment to switch off all non-essential power. If the charge was low (lots of electricity out for charging a laptop or a cloudy day), it can quickly move into
Seven-plus beeps: At this point, you get up QUICKLY and look for the closest matches and candles as the electricity will be going out within the next 60 seconds or so.

I’ve like to think I’ve mastered the system by now – I can say for sure that with a good system up (ours isn’t in the best state at the moment, unfortunately), it is definitely VERY feasible to live off solar power. It’s cool to use the power of the sun, to not be affected by the frequent South Africa nationwide energy shortages. (Nationwide people have “load sharing” two hours a day three days a week where their electricity is turned off completely. While it isn’t in nearly the crisis stage it was a couple months ago, it continues to disrupt a lot of people’s daily transactions and business operations, and the sale of generators has boomed since it started.)


Life in LOVE!
The big news is that I’m engaged to be married! I’ve known this great Afrikaans South African guy named Eugene Meyer for almost three years now, and have been dating him for almost 8 months now. (I’ve attached a couple pics.) Eugene is a strong Christian leader originally from Cape Town who is committed to serving God’s servants around the world. He is currently working for a Christian NGO named Philanjalo that also supports Home-Based Caregivers (300 to our 35), has an HIV/AIDS Care Centre for adults, and another one for children, does residential and community-based orphan care, and does HIV/AIDS and TB research with various US universities (Yale, Harvard, Brown, Albert Einstein). Eugene has been working with Philanjalo, through the Church of Scotland Hospital in Tugela Ferry (1 ¾ hour drive from here) for four years and is now their financial and office manager.

The natural next-question is what this means for me. Well, first off, we’re in the midst of planning an August wedding in Tacoma, Washington. After that, the plans are for me to move in with Eugene in the sprawling Zulu metropolis (hahaha ;) of Tugela Ferry. (I’ve attached a picture of the hospital – the company house he’s in is just behind the complex, just against their back fence.) My plan from the start of Thembalethu was to get it to a place where it wasn’t dependent on my daily presence to continue and thrive. Being just under two hours away from Amangwe/Winterton, I’ll be able to support Xoli as she takes on the primary management responsibilities, by working back in the Berg two days a week, taking on fundraising and administrative roles. It’s such important work and as a board member and co-founder I’m committed to seeing the work go on! Xoli’s been such a Godsend to Thembalethu and the community and is already a great asset, and is in fact already gracefully leading most relationships with the Caregivers, patients and orphans. With the rest of my time, there are multiple opportunities already presenting themselves for me to continue serving HIV/AIDS infected and affected adults and children in the Tugela Ferry area. I envision that the next couple of years will be spent between Tugela Ferry and Amangwe/Loskop/Drakensberg, with the possibility of returning to the Seattle area sometime in the future.

As for Thembalethu, our funding with the Winterton Methodist church (and some generous contributions from UPC) will be running dry about September this year. Yet, a church member and friend has helped signed us up to be the charity of choice for a Golf Day in Durban that her brother is planning for late August. They normally raise about R100,000 to R120,000 ($13,500 to $16,000) for the charity, which would go a long way to allowing Thembalethu’s work to continue. Please join us in praying that this funding opportunity will come through!

Love to you all!

Betsy

Life in the Field

The story of precious eight year old Sbonelo (his name has been changed) is one demonstrating the challenges and successes experienced by Home-Based Care volunteers.

We went on our first home visit with Sbongile to see her patient Sbonelo was June 2007. At that point, we found his mother a shining example for others: HIV positive, but healthy and on ARVs for over a year, with a healthy week-old baby. She had taken nevarapine to prevent transmission of her disease to her baby girl.

Sbonelo, in grade 2, and also HIV+ wasn’t doing as well – his hair was badly thinning and he had bad oral thrush and sores as well as a light fever. They had started him in the process for ARV treatment, but had run short of funds to continue. We gave money for transport to the clinic, and told Sbonelo’s mother and gogo (grandmother) to urgently fetch his CD4 results, the indicator of his immune system strength and requirement for initiation of ARV treatment. As we had suspected, his results indicated that he needed to start treatment, so we wrote a referral letter to the ARV clinic at the hospital explaining that the mother had already taken the required ARV adherence training, and so her son, Sbonelo could start ARVs straight away. (Without some intervention, seemingly simple cases like this can face difficulty and delay at the hospital and/or clinic.)

With the CD4 results and our referral letter in hand, more transport money assistance in their pocket, Sbonelo and his mother left for Estcourt Hospital where Sbonelo received his first dose of ARV treatment that he’s been taking ever since. His smile brightened our day when we visited the other day: he’s doing VERY well on his treatment, the oral sores gone and shine back in his eyes.

But that’s where the good news of our last visit (March 2008) stopped. Sbonelo’s mother had abandoned him and his baby sister (now 9 months) to their gogo’s care while she went off to get married to a neighbor guy. Even worse, she didn’t just leave her children behind, but also her ARVs. This treatment for her HIV is a sensitive one, whereby a meagre 5% default rate can lead to drug resistance. The mother’s defaulting on her ARVs is a serious matter, as is the fact that Sbonelo was left to manage his own ARV treatment, without his gogo knowing how to give him his triple-drug cocktail. Xoli went through the pills with him, gogo listening on, and were impressed how much an eight year old child could remember about his pills. But unfortunately, that wasn’t good enough, for he wasn’t taking all the pills, all six different types, 100% correctly. To make matters worse, Sbonelo’s mother had left with her cell phone, the only way they had of checking the time to ensure he took the pills on time. In addition to taking the correct pills in the correct way, ARVs require 12 hour intervals in between each dose, making careful adherence much more crucial.

We closed up the visit by giving the gogo a referral letter and money to get ARV adherence at the clinic for two days in the following two weeks. We also gave a phone call to Sbonelo’s mother inquiring about her ARVs, about the wellbeing of Sbonelo and her 9 month old, and referring her to the local VCT counsellor to help her work through all the issues surrounding her HIV status. Two days later, Sbongile, Sbonelo’s HBC volunteer brought them a small clock we bought to help with their adherence. Things for Sbonelo’s health are looking up, and we have referred Sbonelo’s mother to an excellent VCT counsellor to ‘empower her’ about the importance of making her health, and her treatment adherence.

General Thembalethu Updates

• Registration as an NPO: We are just weeks away from formal approval as a Non-Profit Organization in South Africa. Our documents have been sent off to the appropriate government office, and we will soon be officially “Thembalethu Care Organization,” Lord willing!
• Drop-In Centre Plans Underway: Exciting new plans are underway to coordinate an Amangwe community drop-in centre in collaboration with a local business man, Thembalethu and a recently re-emerged local organization. The precise details of the drop-in centre are still being ironed out, but initial discussions include implementing the following: a feeding scheme for orphaned and vulnerable children (OVC) and other indigent people as well as satellite feeding schemes in more remote areas; Voluntary Counselling and Testing (VCT) for HIV, and potentially a municipal clinic.
• Maize Meal Distributed from Winterton Farmers to Emangweni (Loskop) Orphans: Thanks to a surplus of mealie meal donated to the local inter-church organization Matthew 25, we started this month distributing big bags of mealie meal to orphan-headed households and extremely vulnerable children. We gave out fourteen bags of mealie to fourteen families, the worst cases we have found, as there are SO many orphans in the Amangwe community that are in great need. As funds are available, we will supplement this with beans, fruit, soya mince, and other staples. We are working towards improvements in social welfare’s service delivery as well as developments in the drop-in centre mentioned above to bring broader assistance to these kids in need.
• Nurse Volunteer Helping Out: We now have a volunteer nurse from Winterton Methodist (Jenny Braithwaite) who comes out with us every couple of weeks on home visits to patients. It’s a great help to have her nursing expertise, experience and way with people as we reach out to sick patients in their homes. Thanks, Jenny!
• Regular HBC Home Visits: We are just one HBC short of completing our goal of monitoring each and every one of our home-based care volunteers, many of these new carers over the past couple months. Monitoring includes meeting their patients and checking their work with them. In doing so, I can’t help but be wonderfully encouraged by all the love, care and hours that they put into assisting their sick neighbors.
• New Forms to Track HBC Patients Better: We have just completed simplifying our patient intake and monitoring forms, as well as training the HBC in them. The tracking forms help us keep track of our over 100 patients, enabling us to monitor their health status and activism, as well as being able to submit reports to the local Clinic. Because the average grade completed by our HBC was grade 7, we exchanged text for pictures, and streamlined the patient data that we really wanted to collect. We have collected the first round of forms, but have yet to get full feedback about the changes we made; at the time of training there was a lot of positive sentiment.

I still can’t quite wrap my head around the idea that March and April bring the cold, trees turning, and an end to summer rains. Yet, the battle here is on. Summer’s here, winter’s there. Autumn on its way here, spring bringing Seattle back to life. Summer and winter struggling day by day to see who will win out; a linen and tank-top day followed by corduroy pants and a jacket. Though autumn is brief, perhaps non-existent here, it’s clear that winter will soon win out. I am enjoying the summer days while they last, looking forward to an end to the mud, mud, mud!

A Full House

If I ever thought living in a big house, a big farm mostly on my own was isolating, I couldn’t have set myself up for a bigger change. After many seasons in the former, for the past year I have been living in my friend Sofi’s new volunteer house (built in 2006). For six months, I had it largely to myself, excluding regular visits from Sofi and her two young children (Doong, aged 6 and Miya, almost 3). Since October, however, the community element has boomed. In late October, Slindile Hadebe, a now 18 year old orphaned girl who is part of the first family I met in South Africa, came to live with me, desperately needing a place after the repeated infidelity of her fiancé. She and her then month-old baby and 19 month old toddler have been living with me ever since. Of her own initiative, she’s attending 9^th grade, after a two year period of absence. She and her little family are an additional three members to our ever-expanding community.

In January, days after Sofi returned from a visit to her family in Australia, little Siyabonga (his name meaning Thank You) came to stay with us. Sofi found his mother, one of her patients, too sick to look after him, his father an alcoholic, and the neighbors stealing the baby’s formula. Siyabonga’s mother was grateful for Sofi to take and look after her then two-month old baby. The little guy’s been staying with us ever since, is now four months old, over a terrible colic, and continues to teach me lessons about the sleepless nights involved with little babies (he seems to not want to give up multiple night-feedings). Despite the occasional sleep deprivation, Siya is a gorgeous baby with a full head of hair and we get great pleasure from watching him smile and coo!

In addition to all the folks listed above, the other night we had a record 19 people sleeping at ‘my’ house and Sofi’s, nine of these children (most staying temporarily) under the age of twelve. After a long day at work, it’s almost enough to make one mad!

With all these people around, the sanity moments come in the quiet of the mornings, when I’m the only one up. I love sneaking outside to watch the sunlight gradually stream over the Berg, cup of steaming tea in hand, Bible in lap. Those minutes reading, in prayer and meditation on God’s word are my salvation when it all becomes too much. Gazing upon the mountains, I can’t help but be grateful for the beauty God created, for the many blessings I’ve received. And, though I’ve left off keeping you informed the last bit, I continue to thank God for YOUR amazing generosity that allows my being here, this work to continue. Please check my blog at http://hopeforaids.blogspot.com for periodic and past updates, when I don’t succeed in getting an email out.

Brief financial update…

I raised funds to cover my living expenses from April 2007 to the end of April 2008, the end of which is nearly here. Over this period, I received more than I needed ($25,000 instead of $20,000). The surplus I have put into caring for Slindile Hadebe and her two kids for the past six months, financing her going back to school, and fixing up a new house for her little family to live in.

My future plans remain somewhat foggy, as there is currently a man in my life, a South African guy, which could very likely bring some exciting changes in the next months. Nevertheless, I remain committed to supporting Thembalethu and the Caregivers, as time goes in an ever less-visible way. Xoli Msimanga has been a true Godsend to the organization in her love for God, the Carers, patients and orphaned youth. I really don’t think I could have managed so well without her expertise and way with people. She is already leading the majority of interactions with the HBC, patients and orphaned youth, all that lacks is administrative (mostly computer) training which is underway. Having her at the day-to-day management helm will help me be able to focus on other administrative needs I never get to, as well as being freer to seek grants and other sources of funding for Thembalethu. (I’ve attached an update for more info, which I will also post on my blog in the next couple of days.)

While the remainder of last year’s personal giving will hold me over during the next month or so, and this is supplemented additional giving I have recently received, my funds for the coming year are running short. I need jut shy of $20,000 to carry me through another year. Please let me know if you are planning to change or alter your giving in the coming months. Giving continues through UPC, the details of which I will include below.

Thank you guys so exceedingly much for partnering with me in this work to bring love, life and hope to those infected and affected by HIV/AIDS in Amangwe Tribal Area. Your generosity of heart and spirit, and God’s good provision and providence makes it possible to reach out in love and grace to many needy people. Bless you!

I look forward to hearing from you!

With love,

Betsy

Thembalethu Report (April 2007 – February 2008)

The past ten months since Thembalethu started have gone by in a flash. We’ve learned and done a lot in the process. A great deal of time has been spent in developing relationships, systems and policies, as well as the organization itself. Through the Home-Based Care givers generosity, and with the support of Winterton Methodist Church, we have been able to help a large number of sick people get improved home palliative care, and provide advocacy and assistance for patients in accessing ARV and TB treatment. Additionally, many orphaned families have received advice and advocacy to help them access Social Welfare grants, as well as food assistance.

Summary of Activities

• Working with 30 Home-Based Care volunteers in 10 different villages of Emangweni (Loskop) who have cared for 96 patients since April 2007. Of these, 70 remain under HBC care, the bulk of these fully ambulant and strong, many of these stabilized and supported with treatment adherence support. We have been very sad to have lost 26 other patients over the course of the last six months. Our focus has been primarily HIV/AIDS and TB cases, which make up a total of 95 percent of all HBC patients.
• Supporting HBC volunteers in monthly support meetings to monitor patient status, do on-going training, and find solutions to patient situations. Introduced and trained HBC volunteers in filling out patient forms to monitor patient health, visits, trainings and information conveyed, and their children.
• Distributed veggie seeds (onion, spinach, carrot, beetroot, and pumpkin) to 30 home-based caregivers for their family gardens and to assist their patients and neighbors in need. Additionally, we are distributing seeds to the orphaned families and indigent patients that we are supporting who are interested in planting veggie gardens.
• Distributing protein-packed nutritional booster porridge to critical immuno-suppressed Home-Based Care patients. Over 110 packets of porridge have been distributed to date.
• Gave out food hampers to 35 Home Based care volunteers, the first they had ever received, to thank them for their voluntary work with the sick and orphaned in their communities.
• Meetings to initiate and strengthen relationships between the Local Tribal Authority and Local Municipality, as well as local Social Workers, the Injesuthi Clinic, including the TB tracer, and the government’s paid Community Health Workers. On-going collaboration and cooperation with these partners to better reach the community. Referral letters to the clinic, hospital and social workers are assisting with patient and orphan care and access to resources. Rape cases that had been going on for months without intervention have been expediently and effectively handled by collaboration between the HBC volunteers and the social workers.
• Supporting 27 families of orphans and vulnerable youth (83 children in total) with advice and assistance in obtaining foster care grants and other social welfare assistance. Also, helping meet their immediate needs for food, clothes, blankets, etc.
• An HIV/AIDS awareness and prevention presentation to 120 school children in grades 4, 5, 6, and 7 a (October 2007) and an HIV/AIDS awareness presentation to 35 parents at Madolobheni Primary school. (November 2007)
• 83 individuals tested and counseled in two days for HIV at a successful VCT drive in Gourton, at the municipal offices. The VCT counselors from Estcourt Hospital came to help us out with this, and plans are underway for the next VCT drive after the first was so successful. (September 2007)
• Registration of Thembalethu Care Organization as a South African Non-Profit Organization is almost finished.

Challenges

Social Welfare: There continues to be a major backlog at the local Amangwe Social Welfare (Child Welfare South Africa) office, where as many as 100 cases dating back to 2003 have fallen through the cracks. Additionally, there are many cases where we’ve been able to assist orphaned families in accessing the emergency three month food parcel, only to find that after the three months, their case is far from being finalized for the foster grant. This is aggravated by the inexperience of the social workers and their NGO’s six month lack of a supervisor which has created an even bigger backlog of recent cases waiting to be signed. With a committee of other concerned community members, we've just sent various letters to the Department about the NGO's lack of service delivery and the resulting unnecessary suffering of orphans and vulnerable children.

Training: Almost three years ago, Xoli was trained as a trainer of Home-Based Caregivers by the Department of Health. We have been working with various other HBC organizations to try to find additional train-the-trainers courses on the recent developments in HIV/AIDS, TB, and ARVs, without luck. It seems in the past few years the trend has been to move to Professional Nurse trainers/managers of Home-Based Care programs. Nevertheless, I will continue to look for a refresher course for Xoli, and into other training sources.

Looking Ahead

Working together with a local businessman, another local NGO, and the Imbabazane Municipality, a Loskop Support Centre has been opened. The initial plan is to used the municipally-donated buildings to cook orphans and vulnerable children food before and after school, and to help with their school work until they receive the social assistance provided by the government. Additionally, Voluntary Counseling and Treatment (VCT) services are to be provided, giving the community a much-needed alternative location to test for HIV.

A three-day Direct Observation Treatment (DOTS) TB training for all HBC volunteers is in the pipeline for April 1-3. The first part of Christian Listener’s three-part training, Learning to Listen, is scheduled for early May. The following two trainings (Listening in an HIV+AIDS Environment and Listening to Children in Difficult Circumstances) are set for August and November.

We are also continuing to seek out trainings in nutrition and ARV treatment literacy, as well as community care of orphans and vulnerable children, although additional funding sources may be needed to make this possible.

Financials

ADDITIONAL INCOME (above church sponsorship, from South African and US Sources): R 54,300.90

THEMBALETHU EXPENSE BREAKDOWN TO 31 Oct 2007

R 1,162.03	Admin
R 6,875.82	Communication
R 21,386.65	Total Program Expenses
R 70,000.00	Program - Bakkie
R 19,523.82	Transport (Petrol +Maintenance + Insurance)
R118,948.32	TOTAL

Babes galore

In desperate need for a place to live, Slindile (18) with four month old Alwande and 22 month old Lusanda "Buki" moved in with me in late October. What an adventure it's been to deepen my relationship with Sli, to to journey with her through raising two young babies. It has been a journey of joy and struggle: being waken many nights to crying babies, watching a growing Buki eat phenomenal amounts of food and grow in his understanding of language (Zulu and some English), being thrilled by little Alwande's first smiles, and helping Sli get the supplies and helps she needs to get back to school.

Back in late October, after her fiance's continued infidenlity, Slindile, whose mother passed away when she was 12 and whose grandmother has been missing for almost two years, had no place to go. She and her three younger siblings have been like family to me for the past four years, so inviting her to move in was the most natural option for her. Sli and her two babies moved into my house with me, and I've been supporting them ever since. After being out of school for two years with her babies, Sli is enrolled again, attending grade 9. Plans are currently underway for her to move into a place of her own, and continue her studies.

Additionally, Slindile's 10 year old sister moved in with us for a month back in November after sexual abuse at the unregistered orphanage where she was staying. Her younger sister, and two younger cousins were all moved by social workers to a place of safety, and will be soon placed in a family at SOS Childrens Villages.

Slindile hopes to be reunited with her grandmother, and get a place of her own so that one day she can again care for her three younger 'siblings'. If you are interested in helping to fund Slindile to get a place of her own (buy the land, put up a simple house), please let me know. It will cost between $1500 and $2500 to get her set up in new digs, an amount of priceless value in supporting an orphan and potentially her younger siblings as well.