A Summer Christmas

Christmas

I have never had a white Christmas before, but now Akbar and I have had our first Christmas in the summer.  It was also notable for a few other ‘firsts’: our first Christmas spent together, our first Christmas where we did not attend church, and our first Christmas spent with Hindus.  In SA, the Christmas season kicks off summer vacation – kids are out of school for 5-6 weeks - and everyone goes to the beaches or shopping malls. 



Ballito Beach the weekend before Christmas



Despite the carols sung in church and long lines in the malls, we never did get the Christmas season vibe here.  I am not quite sure if it was because the weather was warm and humid, we were not around family, we had not been working, very few homes had Christmas decorations, or Santa Claus was just too thin and young in South African malls.  Nevertheless, we did have a lovely Christmas with a few friends. (We actually got 3 separate invitations for the day.)  We had a rich spread of food for our Christmas lunch, or rather all day eating event.  We started off with seasoned prawns and langostines and a Greek-style salad. Then we had lamb roast stuffed with green chile peppers and garlic, cinnamon and sugar carrots, and spicy potato salad with green chile peppers.  (Basically all foods in Durban have a lot of chile pepper or powder added to it, whether it is Italian seafood linguine, Chinese chicken chow mein, or Indian mutton biryani.)  Our friend tried to bring a little of America to SA and even ordered us a turkey with stuffing so we would not feel homesick during the holidays. We ended the meal with trifle for dessert, which consisted of 3 layers—sponge cake, fruit jello, and custard, generously topped with sweet heavy cream.  Although we are far away from our families and friends, we have started to make close friends here.

How’s church?

We have been going to the same church for the last 1.5 month.  It is a “full gospel” church, which seems to mean “pentecostal.”  It is like no other church that we have attended in the States—around 90% of the church members are ethnically Indian.  The other 10% of the church members are coloured, white, or black.  Of course there is no one like the two of us in church.  At home it is rare to meet a Christian Indian, but here many of the Indian families have been Christian for many generations.  Like churches in the States, church is very much cultural as it is Christian.  A Chinese American or Mexican American church service has a different atmosphere and style of worship than a White American one.  At this church people may wear saris or shalwar kameez to attend service.  For Christmas supper at church, everyone ate with their hands and we had mutton curry, chicken curry, rice and semolina pudding (a South Indian dessert). While far away from home, it has been comforting to know that all around the world, Christians of every race and ethnicity worship and pray to the same God, study the same Bible, and may even sing the same songs. 

Home Invasion                                            Luckily, we did not have a home invasion by people; it was by another species—monkeys.  I was in the living room taking a nap and I thought Akbar was rummaging for food in the kitchen because I heard cardboard boxes opening and plastic wrap crinkling.  I thought, “I don’t know why he’s so hungry, we just ate…he really snacks too much.”  Little did I know, Akbar was in his room and he thought I was in the kitchen, so he came out to see what I was doing.  Much to his surprise, he did not find me there, but 3 little monkeys!  He swore and gave the monkeys a cold stare and they quickly ran out of our kitchen window with food in hand.  Since it had rained earlier that day, we had little, muddy monkey hand and foot prints smeared all over our window sill, new white cabinets, counter and tile floor.  All of the fruits from our counter were gone; they took about 3 oranges, 2 tomatoes, and 6 bananas.They only left one white onion with a small bite in it; I guess raw onions are not a favorite amongst monkeys.  They also spilled cinnamon powder, tea, and juice from the fruits all over the floor.  When we looked outside, there were pieces of banana peels on our grass and planter.  The evil-doers sat looking innocent on our front lawn, while a group of their friends sat on the roof of the building next door, waiting for our reaction.  Some of them were eating pieces of oranges and others bananas.  Akbar started yelling and flailing his arms and initially they just stared at him, but then they realized that he was really mad so they ran across the street. I have come to think that monkeys are like young children.  They know the difference between right and wrong, but oftentimes they will do the wrong thing to test boundaries and see what reaction it evokes.  These monkeys had a feast in our kitchen, which was off limits, and they ran away because they understood that they were in big trouble.

Alien at 1st trimester of pregnancy

Adopted Children

We were only in S. Africa for about 2 weeks before we adopted our first child.  Her name is Alien because she has wide set green eyes, a small head, and round body.  She is a young calico cat (less than 1 year old) that initially just came to our house once a night to ask for food.  Quickly her visits became more consistent and frequent, increasing to morning, lunch, and dinner, and sometimes snacks.  Then we made a bed for on our veranda which she would sleep in every night.  We were planning to neuter and save her from the cruel, African outdoor life, but we were too late and she was already pregnant.  We felt like horrible parents.  We only had her for 1 week and she was already pregnant!  We should have kept a closer watch on her!  Then I realized she must have gotten pregnant prior to meeting us.  Alien realized she needed a dependable food source and made us her patrons.  I started feeling fetal movements last week and I think she will deliver in the beginning of January.  We have moved her bed into our attached storage room so she can deliver and care for her new babies in a private room without feeling endangered by the outdoor environment.

Samson at 4 weeks old

About 2 weeks after we adopted our first child, we adopted a second one…accidentally.  One morning, around 5 AM, we heard a cat mewing outside.  I ignored him and continued sleeping.  The mew was very small, but persistent and I found that it was coming from a small, ginger and white kitten from below Akbar’s room window.  The day was very windy so I figured the little kitty was just distraught by the weather and was waiting impatiently for his mother.  Hours passed but he never stopped crying and his mother never came.  Meanwhile, I saw a circling hawk flying overhead, so I worried about the baby and went out to take a look.  Initially, the baby approached Alien, thinking she was his mother, but Alien hissed at him.  Then the baby approached a post-partum orange tabby cat that we feed; she tried to smack him and hissed at him too.  For some reason he did not remember who his mother was and no one would take him as her own.  After checking on him several times, he eventually started following me around and I was happy to have such a cute kitten follow me.  He even followed me into the house!  I guess he thought I was his mother.  He was about 4 weeks old at the time, so he was still unable to survive in the wild alone.  He still needed milk and there could be dangerous animals outside that may attack and eat him.  Since he had been crying for 5 or 6 hours straight that morning, I knew he must have been tired and hungry.  I took the medicine cabinet from our old bathroom, lined it with a bed sheet, and he immediately started purring, curled up, and fell asleep for hours.  And this is how Samson came to our home.

Samson at 8 weeks old

Unfortunately, Samson was only calm, sweet and cuddly that first day.  After bathing him and removing his fleas, we kept him in my bedroom where it was cleaner and safer.  Like most babies, he required feedings (of special kitten formula) and attention in the middle of the night.  He became so rambunctious that I was not getting much rest at night because he would sleep only 2-3 hours at a time, eat, and then play, which consisted of jumping, biting and clawing at me.  Akbar thought he could fare better than me so we traded rooms, but he quickly realized that sleeping with a young kitten is not an easy task.  As a result, Samson now has taken over my bedroom completely and we have moved my bed to the dining area.  Over the last few weeks I have actually slept better in my “new room” because it is darker and quieter.  Samson did very well at his first veterinarian visit and car ride last week and he will be back next month for his well-kitten vaccines.

South African Fact:

One US dollar equals a little more than 8 South African Rands (R).

60% of all workers in the formal economy earn <2000 R/month (<$250 US)

15% of all workers earn <500 R/month (<$62.50 US)

In 2010, the UN said that 44% of workers in S. Africa lived on <10 R/day. (<$1.25 US)

($1.25 is the most recent international poverty line.  Keep in mind that there is a high unemployment rate, so many people are not even working.)

One gallon of car gas is ~$5.50 US.                 

One avocado, peach, or small pineapple is ~$0.75 US and a liter of milk is $1.25 US.

A Women’s Bible from the bookstore at the Pavilion Mall is ~$40 US.

Riches Among Shambles, or is it Shambles Among Riches?



Wentworth Hospital



How’s Work? 

We have not worked for 7 weeks now.  No one at the Health Professionals Council of South Africa or the non-profit organization that recruited us, Africa Health Placement, can tell us the reason our application has not been processed.  It has been a disappointing and frustrating process for us as well as our hospital.  The hospital has been waiting for us to start work since September because it is very short-staffed.  We have already been approved by our hospital, the embassy, and health department months ago. Even though the doctors on the committee of the HPCSA approved us to work in October, we have not been registered because there is a breakdown in the system on the administrator level so our papers have been repeatedly lost and not processed.   All the doctors here have their own horror stories concerning their interactions with the HPCSA. We initially chose to come to South Africa because Africa Health Placements marketed themselves as a mission-driven organization that would assist us in the application process.  As of this coming January, it will have been one year since we started this endeavor.  Please keep us in mind in your prayers. 

How’s the house?   

Day 1

Day 3

 

Day 12

After patiently waiting for over 3 weeks for them to start work on our house and then another 2.5 weeks of living in a construction zone, I can safely say that our house is significantly nicer, much more liveable, and there are no leaks! They replaced the old, broken linoleum with light peach tiles in the kitchen, shower room, and toilet room.  Our kitchen cabinets were painted white and they put in a new cabinet under the sink.  They also painted the kitchen and hallway a light yellow.  They completely gutted the shower room and put in new white tiles, shower door, window, sink, and medicine cabinet.  They also installed a new toilet.  Since the country is at a standstill now due to the Christmas holidays, they will return in the beginning of January to put the finishing touches on the house and start work on the wall around our yard.

The Good, the Bad and the Ugly

Race/ethnicity, crime, and poverty, all intertwined, affect the daily lives of South Africans.  There are very clear distinctions between the blacks, whites, coloured (people who are part black and part white) and Indians.  These groups for the most part do not associate with one another.  Most of the people here are a shade of medium to dark brown and sometimes I cannot tell if someone is black, coloured or Indian.  Even within the same race, the blacks and whites have strong prejudices.  For example, there are clear divisions between the black people of Xhosa and Zulu background or white people of Dutch or English descent.  (One black African thought Akbar was white, which illustrates that sometimes the color of a person may not be so obvious, rather more relative.  And these superficial differences do not reflect who the person is or his or her life experiences.) Sadly, these arbitrary skin colors, and the cultures and social constructs that go along with them form the crux of many conflicts within this country.

Although in the US and other countries people of mixed descent are considered “exotic” or “more beautiful,” in South Africa the coloured are considered “lowly” people who get drunk and commit crimes.  The areas they live in are considered more dangerous and poor.  Even the coloured people who have white skin and blonde hair are not considered equal to their white or black counterparts.

Crime, especially violent crime, is prevalent here.  Everyday the papers have horrible stories of murders, rapes, shoot outs, stabbings, home invasions, drug smugglings, and more. People are robbed, injured and killed for their cell phones or just 75 cents!  These crimes occur irrespective of neighborhood.  As a result, wealthier homes have big dogs in the yard, burglar bars around the windows and doors, alarms systems, and razor wires and electric fences on the walls.  Many people used to carry handguns, but the government is encouraging people who have them legally to turn them in.  Like in the States, it is difficult to control those who have illegal weapons.  One man told us it is no longer worth it to carry a handgun for protection because you can be put in jail and fined even if you use it for self-defense.

Despite the seemingly “bad” things in this country, there are many people fighting to make this country better.  The doctors at our public hospital get paid far less than the doctors in the private sector to work far more, in worse conditions, with less resources, and with sicker patients because they are passionate about helping the very sick and poor and teaching the next generation of family medicine residents.  There are also many people who, for better or worse, do not trust the police and the country’s judicial system, so when they see a crime committed, will take it upon themselves to chase down the criminal and institute their own justice.

We have been graciously blessed by the people at the hospital and church because they have been exceptionally kind, hospitable, generous and encouraging.  They drive us out shopping, to the beach, church, movies, etc several times a week.  They make it a point to make sure that we are always entertained and overfed with lots and lots of curry, alcohol, and sweets. One friend has given us his television and fan and another couple cooks and gives us food to take home several times a week.  Since our house was under construction for almost 3 weeks, people have shared their toilets and showers with us also.  It is encouraging to know that despite all the racism, crime and poverty in this country, there are still genuinely good people.

 

Moses Mahbida Stadium
(Taken from plusmood.com)



Since we arrived, people have mostly taken us out to the very nice parts of Durban.  They take us to the nice beach that was redone for the World Cup or the nice shopping mall that is the biggest mall in the Southern Hemisphere.  If I was randomly dropped from a plane on to one of these places, I would think I was in a first world country, like the US or Australia.  I think for the South Africans, it is a way to show off their country, to show us that their country is modern, wealthy, and respectable. However, the places we have visited most of the last month do not represent most of Durban or the country.  While driving, it has been very jarring for me to see a hillside of dilapidated shanty houses across from a hill of mansions and below a huge, modern mall. 



(Taken from ellenschnier.wordpress.com)

  Wentworth, the neighborhood where we live in Durban, is similar to Compton, but it is not home to the poorest of the poor.  It is considered a “bad” or unsafe neighborhood, but people here live in small, run-down houses or flats with electricity, running water and paved roads.  A level below where we live are ‘townships’--expansive, maze-like areas with narrow, bumpy roads, full of small, poorly built, single-room government-subsidized housing.  Sometimes half a dozen or more people can live in a little house that is less than 500 sq feet.



(Taken from ncccusa.org)

  A step down from the townships are the shantytowns, which are comprised of crooked, make-shift shacks, less than 200 sq feet, built of scrap metal, cloth and wood pieces nailed together.  These homes are erected by people from rural areas or poorer African countries who come to the city looking for jobs and a better life.These homes do not have organized plumbing or electricity.  They are built pretty much right on top of each other, connected only by foot paths.  This becomes a danger and health hazard because it facilitates the easy spread of fires from the cook fires as well as tuberculosis from poor ventilation.



Poverty is never easy to see and its existence is never easy to explain.  Intertwined with the complex history and racial dynamics in this country, part of the poverty can be explained by the nearly 50% unemployment rate and 40% HIV/AIDS rate in some areas.  South Africa is a country that has made huge strides since its break from Apartheid over 15 years ago, but she still has a long way to go.  It is a country blessed with an abundance of natural resources and wealth and only time will tell where its leaders will take her.

 



South African Fact:

A popular South African fast food is the bunny chow, aka bunny, created by the Indian community in Durban. It consists of a hollowed out loaf of bread filled with curry that people eat with their fingers.

(Taken from laraferroni.com)

Safe in South Africa

Dubai, UAE    
    

Burj Khalifa in Dubai.
The tallest building in the world since 2010.

 On our way to South Africa, we spent a day and night in Dubai, which is probably one of the easiest airports to travel through.  It took us less than 10 minutes to step off the plane, get a free visa, and exit the airport.  Dubai is an interesting place with surprising contrasts: the extremes of conservatism (Muslim women covered in all black except for their eyes) alongside monuments to materialism (the Dubai mall, a 4 story monster with over 1200 stores, like Gucci and Louis Vuitton, 300 restaurants, an indoor waterfall, and the largest outdoor water fountain show in the world – all open until midnight). 


Wentworth in Durban, South Africa

     Upon arrival, I did not think Wentworth was that bad at all compared to other places that I have been to or how I imagined it to be.  However, after we were taken to some of the nicer areas in Durban, the contrast was obvious.  Where we live would be like Compton and some other places like Newport Beach. 

     Everyone tells us that it is safe here, but they also all have personal stories of attacks and robberies.  One man had 7 cars stolen! 

     The surroundings are beautiful and lush.  Although it is a big urban city, there is still a lot of nature, trees and animals.  I would compare Durban more to a city in Maui rather than Los Angeles.

What’s your living situation?

     
We live on a hill and we can see the Indian Ocean from the hospital compound, which is spread over at least 1 square mile.  We live about 1 mile from the nearest beach, but people say it is too dangerous to walk there. 

      Our small brick house ("the Matron's Cottage") has 2 bedrooms and 1 bathroom.  It was built during WWII when the hospital served as a British military hospital.  We pay a little over $100 US/month (it looks like it is worth about that). We have a grassy yard that surrounds the house and the monkeys like to play on our trees and roof, or even come into our house. We have also been trying to make friends with the kittens in our yard.

      In the kitchen we have a microwave, mini fridge and hot plate.  The electricity and water have been reliable.  We each have a little flimsy cot in our room, which is not working too well for Akbar.  Our bathroom situation is quite sad.  We have a toilet room and a shower room, but both rooms have major leakage problems.  Water comes up from the ground if we flush the toilet or use the shower so it smells like a 3^rd world urinal with mildew….GEEEEE ROSS. The huge blessing/miracle is that the hospital sent over a maintenance man and contractor and they are completely gutting our bathrooms over the next few weeks.

What’s the weather like?

     We are now in the beginning of summer; it stays warm until May.  The days have ranged from 60F to 85F. Like at home, the days are warmer and nights cooler, requiring a jacket. It is not humid, but less dry than California.  It is sunny most days with a light rain in the late afternoon which is normal in the summer.

How’s work?

     Unfortunately, we have not been able to start work yet. Yes, we have been in this frustrating process for almost a year now.  Since it is a teaching hospital, we have been going to lectures daily and learning more about HIV and TB. About 60-80% of the patients admitted have HIV and/or TB.  We are at the last step with the S. African Health Professionals Council, which can take several weeks.  We definitely need prayer for God’s perfect timing because once December hits, the country goes to a stand still for a 1.5 month summer break.

South African Fact:

Indians have been living in South Africa for about 150 years. They were first brought in by the British for labor.

Prayer Letter

Though h  

Though it is two months later than originally planned, Akbar and I are leaving for South Africa (SA) on November 2nd. We will be there for the next year.

The decision to practice medicine abroad after residency was an easy one for us.  Both of us have been traveling to work in developing countries since high school, most recently on short-term medical trips this spring to Papua New Guinea and Haiti.  Though some have been skeptical, we have been grateful for the many friends and family who have supported our decision.  It is one that is grounded in faith, and that follows a long tradition of those who have gone before us and sacrificed far more.  At this point in our lives, with healthy parents and no children to support, we are acutely aware that we have a freedom not many enjoy.

Our decision was also motivated by the ‘brain drain,’ which is crippling South Africa and the rest of the developing world. Each year, thousands of physicians from poor nations leave their native countries where they received their educations and emigrate to the US to fill positions that American physicians refuse. Of those who remain in their homelands, many cater only to the wealthy, leaving the poor without care. This is the case in SA, where there is a huge shortage of health professionals in the public sector, which—just as in the US—serves primarily the poor. The organization through which we are working, African Health Placements (AHP), works to expand health care to the poor by bringing American and European doctors to work in under-staffed public facilities in SA.
We will be working at Wentworth Hospital in Durban. Durban is the 3rd largest city in South Africa with a population of over 3 million. It hosts the country’s largest port and two major oil refineries. It also has the most East and South Asians of any city in sub-Saharan Africa. The suburb of Wentworth was home to many “coloured” South Africans during the apartheid era, after many were forced to move there from the city center. (As an industrial, urban, beach city with great ethnic and socioeconomic diversity, we figure we’ll be right at home there—it sounds like South Africa’s version of Long Beach!) 

While caring for the underserved in Long Beach, Compton, and South LA the past 3 ½ years, we have seen that social injustice exists not only in developing countries but right in our own backyards. God has already challenged us with difficult patients, difficult work environments, and seemingly hopeless medical and social situations. These have all prepared us in some way for what we will face in SA. Our goal is, together with our South African colleagues, to empower our patients and strengthen the community to be its own adovocate.

Moving to South Africa is certainly daunting and exciting. Thus, we have many prayer requests. Please pray for….
     *God’s wisdom, patience, and love

     *Faith & hope in the midst of suffering

     *Health

     *Safety

     *Our relationship

     *Ability to adjust rapidly

     *Openness to doing things in new ways

     *Humility
     *A home church

We thank those who have already been praying for us the last several months. The year ahead is one sure to be filled with challenges we have not even imagined. We are embarking, though, in a spirit of faith and adventure. To share our experience with everyone back home, we will be maintaining this blog (we’ll try not to bore you with medical stuff) and posting pictures.

See you in 2013!

Much Love...