Vuka zenzele!

I took a very sick patient to the hospital the other day. After being seen by the doctor, he was admitted for further examination. But before he could be admitted, he needed to have some x-rays done. I wheeled him up to x-ray department, explained the situation to the women there, and left, because I needed to be back in Itipini but hopeful that they would be able to do the x-rays and make sure he ended up in the right ward.

But I have learned enough by now not to expect that to happen. So I went back an hour later and there was the patient, lying on his stretcher in the hallway, his x-rays at his side. His destination was on the same floor so I wheeled him down the hall and made sure he ended up in the right place and was admitted, as planned. It was a long hallway, about 100-meters, but the whole thing only took about five minutes.

As I was leaving, all I could think was why I had to be the one to wheel this particular patient down the hallway. Of all the hundreds of employees at the hospital, wasn’t there one who could have pushed him where he needed to be, when the admit instructions were clearly written on a card on the patient’s stretcher and the x-ray department knew the story? Why did I have to drive out of my way, back to the hospital, to ensure it was done?

I am reading a terrific book right now, Dark Star Safari by Paul Theroux, about his overland travels from Cairo to Cape Town. On a train ride across the Tanzanian bush he comments:

No showers made this hot train reek with the smell of unwashed humanity. The toilets were vile. The dining car was filthy, not that there was any food after such delays. I liked riding this train because it crossed a part of Tanzania where roads were impassable. A little activity with a broom, a mop, a scrubbing brush, and the trip would have been agreeable. But the dirt, the litter, and the drunks made this side of travel in Africa hard to bear. The train was a necessity. The pressure of numbers and very poor maintenance made smooth running impossibly, but there was no excuse for the filth.

This is a theme - along with the general solipsism and worthlessness of most aid workers - that he returns to frequently: yes, there are many tasks that are outside the realm of possibility of some African governments and people. Maintaining a colonial-era train might be among them. But there are simple things, like cleaning that train, that are definitely possible and yet are not done.

It reminded me of my experience in the hospital this week. Curing this patient might be beyond the realm of possibility but isn’t there one person to push him down the hallway?
It frequently seems to me that some people seem incapable of doing tasks that strike me as basic. Some shacks in Itipini are just disgusting. Yes, I want to tell these people, it is true that you live in a dump but that doesn’t mean the inside of your home has to be filthy. There are many shacks here that are quite clean and well-cared for inside and out. It seems to me that if I was living in poverty, I’d be doing everything I can to put into practice St. Francis’s words, “First, do what is necessary, then what is possible, and soon you are doing the impossible.” But that doesn’t seem to happen here.

I think there are a lot of reasons why this might be the case. In part, I believe it is a learned behaviour. After years of trying and not succeeding in changing anything, might not some people just decide nothing they can do will ever change the situation? (More on that in another post because I’ve been thinking about it a lot.) If people get used to a place like the Itipini Community Project doing major things for them, like taking them to the hospital when they are really sick, might they not start to believe that we can do everything for them, like drive them into town when they want to go grocery shopping? (A semi-frequent request I always turn down.)

To be clear, I want to underscore - as I have in the past - that I am not calling anyone lazy around here. You can’t possibly see how hard some women (and men) around here work just to survive and think anyone is shirking anything. And yet at some point the impetus for improving the situation here has to come from the people themselves. Sometimes I see that impetus. Sometimes I don’t. And if people don’t do the basic things to improve their situation - or, if our efforts are encouraging them not to do those basic things - how (and why) should we help them?

There’s a great Xhosa expression that I see frequently in Mthatha - vuka zenzele, which means, “Get up and do it for yourself!” It is perfect for situations like these.