Friday, March 4, 2011

D'Kar

In mid-February, I left Maun and headed to the settlement of D'Kar about 300 km away. I knew this was going to happen. I knew I'd have to leave the relative comfort of Maun and head out to the bush. I won't lie. I was apprehensive. I've had it pretty easy in Maun. Sure, I didn't have any water my last two and a half weeks in town, but I had friends who thankfully let me shower at their place. I also always had access to a grocery store, ATM, restaurants and an abundance of friends; all things I would be lacking in D'Kar.

Despite my reservations, I arrived in D'Kar with a positive attitude and ready to immerse myself in work and the town. To be honest, I was a little happy to be out of Maun because I'd had the worst week ever the previous week. My first day went well. I arrived around noon after an uneventful bus ride from Maun. Laura, my new boss at Letloa Health, picked me up on the side of the road and took me to my new house. I don't know what I was expecting, but I was pleasantly surprised. I've got a good sized kitchen, a big room and decent facilities. I even have water most of the time. And sometimes it's hot! Like boiling!!!! Its like heaven!

I'm working at Letloa Trust, one of the trusts that make up the Kuru Family of Organizations. The main goal of Kuru is to build the capacity of the San (they are also called Bushmen or Basarwa). There has been a lot of confusion and conflict about the fate of the San in Botswana. The San were traditionally hunters who switched to agriculture as the result of government mandated modernization schemes between 1950 and 1990. In the mid-90s, the San were forced off their ancestral land by the government who then utilized the land for tourism. The San were forced to give up their traditional livelihood and move to settlements. The relocation of the San has been a great debate in Botswana with support from some and disdain from others.. Kuru aims to empower the San and teach others about tolerance and acceptance of the San.

The goal of Kuru  is to develop a network of modern and professional development organizations with competent and responsible San leadership, facilitating a development process with marginalized communities to independently make informed decisions and to implement their own viable response to their situation.

I'm working with the Community Health Program which aims to prevent and treat TB. Although TB is curable, it is a lengthy treatment process and with many people living in isolated communities with no access to health care, it is a major killer in this part of the country. There is only a 59 percent cure rate in Ghanzi District where I work.

Letloa aims to raise that number to 75 percent in the next year. The first step is to bring the treatment to the affected communities. Through Community TB Care (CTBC), people in isolated settlements are gaining access to much needed health care. Not only are do they have access to health care in their communities, but they are receiving it in their local language.

There has long been a linguistic barrier between the health care workers and the communities they serve as many doctors speak English or Setswana. The San speak numerous traditional languages. The most commonly spoken language in D'kar in Naro. If, for example, a San from D'kar makes it to the hospital in Ghanzi, there is a strong possibility that they will not be able to communicate with the nurse or doctor. Since it already takes a lot of effort and time to make it to the hospital, many won't even bother since they are not receiving satisfactory treatment. Can you imagine walking into a hospital in Canada and you can't understand a single person working there? I know it happens to new immigrants and the older generation of immigrants, but in general, most us can leave the hospital with an understanding of what is wrong with us and how to deal with it. This is not the case for the San.

In partnership with local nurses and clinics, CTBC promoters ensure that TB patients receive and take their drugs daily. There are many patients who default on their treatment because they cannot make it to the nearest clinic to take their tablets. CTBC promoters bring the medicine to the patient in their homes. It is still a difficult task as many patients are not settled and move to farms or other settlements without telling the CTBC promoters. But it's a start.

The CTBC promoters do so much more than simply hand out tablets. They provide health talks to patients, family members and the community about TB symptoms and prevention, healthy living, the negative effects of alcohol while taking TB treatment and the link between HIV and TB to name a few. They test people for TB and encourage patients to test for HIV.

Community TB Care is working. Like any program, it has its challenges. We lack transportation to make it to the extremely rural settlements every month, there are still TB tablet shortages in the district as well as bottle and glove shortages to take samples. However, the program is growing and continues to improve. I am proud to be a part of its growth.

I used to fear coming to D'kar. I used to think this city girl couldn't handle herself in the bush. But I've surprised myself. Not only am I adapting, I think I'm thriving. I don't even dread the lonely nights as I've become accustomed to my nightly routine of running, showering (if there's water), cooking, working and reading. It's not even that repetitive to me. It might be a new found maturity (I recently turned 29), but I think it has more to do with accepting my situation and going for it.




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