January 24, 2009

It’s all connected

Here’s a story about how issues and problems here cannot be addressed in isolation from one another. It’s somewhat complicated and involved but I bet you can follow along with all the names.

On Tuesday, a young man named Mbuyiselo came to see me. “Please,” he asked me. “I want to go to school this year. Any school but I want to be in school.” It’s hard to turn down a request like that, especially one said as fervently as he did.

Before Tuesday, I was only vaguely aware of Mbuyiselo and only then because he belongs to one of the more dysfunctional families in Itipini. (And that is really saying something.) One of his older sisters has a serious mental disability and simply cannot take care of herself. Usually, she is happy and a pleasant nuisance - often she just sits on the bench outside the clinic for hours on end - but about two weeks ago she took a broom and started beating some people with it. Not for the first time, her mother had forgotten/didn’t want to/been too busy to take her to the psychiatric clinic to have her prescription refilled.

The mother, Ntombi, has her own set of issues. Another of her daughters had a child a few years back, decided she didn’t want him, dumped the boy on her mother, and went off to Johannesburg where she hasn’t been heard from since. That child is named Anele and last December he graduated from pre-school and just began first grade this week. Ntombi is overwhelmed by life and shows no interest in looking after Anele. Here’s a picture from when I first became aware of him, soon after arriving here.
As you can see, he looks pretty neglected. He wasn’t going to pre-school and just hung around all day. We spoke with Ntombi and the pre-school teachers and kept an eye out for him and he became a model student (in terms of attendance). I was especially glad because it meant he got to eat every day. More than any other child I’ve ever known, his actions demonstrate just how needy he is for loving attention. He is always clambering all over for me and hitting me for attention. That sort of clinginess I usually find repelling but he and I have, over the last year or so, come to an understanding about my boundaries and his needs and I really like him now.

Back to Mbuyiselo. I was only aware of him last year when he came in to the clinic one day and we realized he was part of the family. It turns out he was going to a high-school in town and doing pretty well. Jenny and I took to referring to him as the “success” in the family and pinned all our hopes for the future of the family. Unfair, perhaps, but we’ll base our hope on whatever shred of evidence we can find.

That one visit to the clinic was all I knew of Mbuyiselo until his visit on Tuesday. So his request came as something of a shock. Didn’t he have a school already? Why did he seem so desperate? What had happened to our “success”?

It turns out he didn’t finish school last year. His father got pretty sick and he had to stay at home and take care of him a lot of days and so he never wrote his exams. Plus, he didn’t really like that school - it wasn’t as good as we thought, I guess - and his eagerness to go any place else was proof enough of that.

The trouble was when he showed up I had literally just returned from registering six new students at high school and was resting on the laurels I felt I had earned from making the process so easy and stress-free for all of us. I had used up all my goodwill there cutting in line and getting students into the right classes that I wasn’t eager for a return trip.

More importantly, the first day of school was on Wednesday and there was a very real possibility that all the slots for grade 10 were full. Plus, he didn’t have a report card from his previous school, which he needed, and he didn’t have an application for the new school. It was a lot to get done by the next day. I told him all this but he seemed willing to try and I didn’t want him to sit around for a year with nothing to do without at least trying to get him registered in school.

Shockingly, everything went smoothly and by noon the next day he was registered. He went to his old school and got a copy of his last report card. (Amazingly, they had it.) I had an extra copy of the application form. I did some serious sucking up (in Xhosa!) with the proper authority figures at the high school and got him squeezed into one last spot in grade 10. The hardest nut to crack was the “uniform teacher” whom I had to convince to allow Mbuyiselo attend school for three days in his street clothes until we could buy him a uniform. (He had given his old one away to a younger brother now at his old elementary school.) But even this teacher melted under the full-court press of my charm. (Ha!)

Mbuyiselo was effusively grateful and I was feeling pretty pleased with myself. But there was still at least one more outstanding problem. I wanted to see Mbuyiselo’s father, Wilson. It didn’t make sense to send Mbuyiselo to school if his father was still sick and needing help. I’m no great diagnostician but the symptoms Mbuyiselo described made me think of HIV. I had checked Wilson’s card when we returned to the clinic and saw we had suggested he have an HIV test several times last year but he never came in for one. The last time he had been in the clinic was August even though he had been sick enough to keep his son out of school much more recently. (Stubborn men not wanting to go to the clinic!)

Mbuyiselo took me to Wilson (sitting in a bar, not looking particularly HIV-stricken) on Wednesday afternoon. My Xhosa deserted me and I struggled to explain how we had just got Mbuyiselo registered in school and how I really wanted Wilson to have an HIV test soon. I tried not to make it seem like a quid pro quo but that’s how I was thinking about it - I get your son into school and you get an HIV test. The conversation was really frustrating because I just couldn’t find the right vocabulary and I left thinking it had been a failure.

So I was pleasantly surprised to see Wilson show up at the clinic this morning, wait patiently, and have an HIV test. Not at all surprisingly, it was positive. He’ll come back on Monday for a CD4 count and I wouldn’t be surprised if he qualifies for ARVs right away.

If there’s success in this story, it is very limited and hard to see right now. But what is important is that I think we’ve managed to go some distance to untangling a knot - the way Wilson’s illness affected his son’s education - and changed the trajectory of some lives - Mbuyiselo in school, Wilson on the path to health. There are still untold obstacles to achieving those goals, there is still an incredible amount of work ahead, and even then they may never come to pass. But things are moving in a better direction now than they were on Tuesday morning and that is reason for a little satisfaction and joy.