December 16, 2008

Means and Ends

Nelson Mandela Academic Hospital is the premier public health-care facility in the region and from the outside it looks really impressive. When you go in the main entrance, you enter a large atrium with an information desk and pleasant potted plants. On the far side are two escalators, leading up to the various wards and clinics.
Here’s the problem. In all the many times I’ve entered that atrium, I can count on one hand the number of times both escalators have been working. At least one always seems to be broken. Sometimes that means it is just shut off and the escalator turns into a staircase. Other times, as it has been recently, one is completely blocked off and the innards are exposed. This escalator has not been working for at least six weeks.

A broken escalator isn’t exactly the end of the world. After all, the escalators only go up to the second floor. From there, you have to a find a staircase to take you the right floor or hop on one of the elevators that usually are working, unless there’s been a power cut. (None of the staircases go all the way from the ground floor to the top floor. Frequently I climb one to find it stops a floor or two short of where I want to be so I have to find another one to take me all the way.) The only time I’ve been seriously put out by the broken escalators was the other day when I was in a hurry to get downstairs but the down escalator was broken and none of the nearby staircases went down, only up. I was contemplating running down the up escalator until, with some searching, I found a hidden staircase that went down.

Broken escalators might actually be a good thing, given how foreign they can be to some of the patients in this hospital. I was escorting a mother and her very sick baby into the hospital the other day and she was visibly intimidated by the escalator and nearly dropped her baby getting on and off.

It’s experiences like these that make me wonder whose idea it was to put in the escalator in the first place. I would bet that when the hospital was being designed, the escalators were seen as a way to signal that this was an advanced and up-to-date institution (never mind that there are never any paper towels in the dispensers). This, in turn, gets me thinking about means and ends and how easy it can be to confuse the two.

The intended goal is to get people from one floor to another and the chosen means is the escalator. But there are lots of other ways to reach that goal, like elevators or staircases. But I wonder if the escalator doesn’t become a means to another end, showing off how advanced the hospital is. And in a larger sense, the escalator almost becomes an end in itself.

But the hospital evidentially doesn’t have the wherewithal to keep the escalators functioning. There’s no shame in that, just an acknowledgment that there is less technical expertise and spare parts available in Mthatha than there is in, say, New York City. Perhaps it would have made sense to put in stairs in the first place.

I wonder about this confusion about means and ends in other ways. Mkuseli, our after-school youth director, takes great pride in making sure the after-school garden is well-tended and fruitful. I often see him out there watering or weeding while the children are in school. I’m all for taking pride in your work but the primary goal of the garden is not to produce a whole ton of spinach or lettuce; it’s to teach the children about gardening and keep them busy after school. If he does all the work, there’s nothing left for them to do. But he must think we measure him by how much the garden produces and works away at it. In fact, I’d prefer he spend less time out there. I just haven’t figured out a polite way to say it yet.

Based on the events - funerals, graduations, and so on - that I’ve been to here, it seems that Xhosa people stand on ceremony far more than I am used to. And the ceremony and formalities they use are largely adopted from European culture - the idea of a “vote of thanks,” of public speakers who are exceedingly polite and formal, and on and on. They take their formality to such a point of ridiculousness that it aggravates me and it is my own culture that they are borrowing from. The end in this case is, say, the burial of a dead person or the graduation of a student. But the means used to achieve that end are so flowery and so over-the-top and so foreign to the culture. But the means are seen as an intrinsically good thing; they must be, or else they wouldn’t be so widespread. I find them annoying in that they get in the way of the true end.

The end that everyone here should be directing their efforts towards is to improve the quality of life for all people. I think that effort is often hampered by the use of illogical means that are largely foreign, adopted for no particular reason, and become ends in themselves. It is so frustrating to see.


brant said...

I love what you have said on your blog today. It is exactly what I have felt like as a volunteer. Your words are so helpful. Please continue posting your observations and frustrations. I plan to use your blog with the people from Nelson Mandela Hospital in an attempt to let them understand where we as volunteers are coming from. I wish to assist them in a fashion with a hand in hand approach, not a hand out nor a hand me down. I look forward to talking with you in Mthatha. Let's plan a trip over to Coffee Bay sometime.
My best wishes,