Being Needed

When I first arrived in Itipini, I was quite clear about my frustration at not being able to do anything. I felt helpless and didn’t know how to contribute. But gradually that began to change. I figured out how to give pills to TB patients; I started bandaging a few wounds; I got better at finding patients’ medical records; I learned where the hospitals are so I could drive patients there; I learned what pills HIV patients need on a regular basis and started handing those out. Before I even realized it, I was actually doing quite a bit in the clinic.

This lesson hit home for me the other day when I realized I was helping five different patients simultaneously. There was one who wanted her TB pills; one looking for the nutritional supplement we give HIV patients; one whose ankle was on ice because of a recent fall; one who wanted to drop off her results from a recent blood test; and one who had just been discharged from the hospital following knee surgery and wanted to show me the record of his time there. Somehow all these balls stayed in the air at once and everyone got what they needed. I even impressed myself at the conversation I had – in Xhosa – with the knee-surgery patient about how his knee was feeling and when he needed to return for a review. My goal in coming here was to help people and slowly I am figuring out just how that is done here. An important lesson of my time here is that you can’t just show up and expect to be useful right away. It is immensely gratifying not only to want to help someone but also to know how to help them in their particular context.

The other day while I had stepped out of the clinic for a minute – dealing with yet another request – a patient I know well stopped by. She has a chronically sore wrist and grossly swollen feet. She’s often a little tipsy and she’s always loud, demanding, and cuts the other patients in line. When I returned, she was her usual aggressive self and pounced on me when I walked in the door. I immediately smelled the alcohol on her breath and started directing her towards the door as we don’t serve drunk patients. But she got right in my face and unleashed a torrent of Xhosa at the top of her lungs. I didn’t catch nearly all of it but I did catch a few key words “go,” “Mqanduli” (a town nearby), “tomorrow,” and “Brufen” (a pain pill we give out). She was also pointing to her wrist dramatically. I asked when she was coming back and she said she didn’t know and launched into her spiel about Brufen again. Realizing she wasn’t going anywhere without the pills, I calmly wiped her spittle off my face, got her the pills – better to treat a drunk patient in 30 seconds than spend 30 aggravating minutes trying to get her out of the clinic, I reasoned – and sent her on her merry way. The point of the story is that when I first arrived I wouldn’t have been able to do this. I wouldn’t have understood her, I wouldn’t have been familiar with her history to know about her wrist, and I wouldn’t have known where we keep the Brufen. Something that would have taken me at least five minutes and someone else’s help to figure out last August took me 30 seconds today. I even got a round of applause from the other patients when she left because they were happy to see her go as well.

There’s a flip side to this as well. The people in the community are now quite comfortable with me and aware that I can help them. In fact, they probably have an inflated sense of what I can do. Everywhere I turn, people need something and they expect me to provide it. In addition to all the things I’ve already mentioned, there are many more: a blanket for their baby; money for a million reasons; to be added to the list of people to whom we give food every day; more supplies for the pre-school; more colouring books for the library; for me to fill their gin bottle with medicine; for me to weigh them; a ride into town or to the hospital; and on and on and on. Two of my most well-worn phrases are “linda apha” – “wait here” – and “hayi ngoko” – “not now” – which I find myself using when I’ve got several requests coming my way all at once. When I leave Itipini, there’s only more neediness: everyone wants money for something, as I’ve written about before, and they’re not shy about coming up to me and asking for it.

It’s reached the point where I assume at the beginning of every conversation that there’s going to be a request for something during its course. I am always on the lookout for what it is so I can anticipate the request, decide if I can help, and get to work providing it so I’m ready for the next request that is surely just around the corner. I feel like the vast majority of people I encounter on a daily basis look at me instrumentally, i.e. they see me as a means to achieving their end. I don’t blame them and I’d probably do the same thing if I was in their position but it is incredibly exhausting. Some times it seems like no one cares about me for me; they care about me because of what I can do for them. It would also help if everyone were a bit more consistently grateful for the help. It doesn’t help my mood any to bend over backward to help someone, only to have them take the help for granted and walk out without saying thanks.

I guess this is a natural part of any service-oriented type job, at home or overseas. When you work in a community project that is dedicated in part to meeting needs, its no wonder that people expect you to, well, meet their needs. And it is gratifying to effectively meet a need and know you’ve made a small but positive difference. And there’s even relief occasionally: sometimes during the day, I’ll go hide out in the kitchen where I know the ladies who work there won’t overwhelm me with requests and will just let me sit and practice my Xhosa.

But wouldn’t it be nice if when someone asked me how I am, they really listened to the answer instead of blowing through my answer to their request?