Chasm Between the Rich & Poor

Do not wear yourself out to get rich; have the wisdom to show restraint. 

Cast but a glance at riches, and they are gone,

For they will surely sprout wings and fly off to the sky like an eagle.

                                    -Proverbs 23:4-5

Smiling When Life is Tough

“Next!” wails my nurse, an elderly Zulu woman who is pre-disposed to napping during patient encounters.

To my surprise, enters a stout, Amazon-sized, Afrikaner woman pushing a stroller with a happy Zulu boy sitting in it.  The baby is small for his age, but healthy-looking. 

“Hmmmm, this is clearly not the boy’s mother,” I think to myself, “maybe he’s adopted.”

The large Afrikaner woman sits down across from my desk, takes the baby out of the stroller and places him on her lap facing me.  The baby has short tight curls and smooth, milk chocolate skin.  He looks younger than his age of 4 months, but his cheeks and arms and legs are filled in.  He looks at me wide-eyed, and smiles.  No one can resist a smiling baby.  Immediately, my nurse and I fall in love with this cute boy.

“So why are you here today?” I ask.

The large Afrikaaner women replies, “Jacob has had a cough for 3 days.  He has HIV, but he’s on ARVS (anti-retrovirals).”

“Has he had any fever or weight loss?” I ask.

“No, he has actually been eating well and gaining weight,” she responds.

We continue back and forth with questions and answers until I have mentally listed the most likely diagnoses for the baby.

Curiously I ask, “Is he an orphan?”

“Yes.  It’s a long story how he came to be under my care.  In my home I care for several children that have been orphaned, but this is the first HIV positive baby that I have cared for, and he’s been doing quite well.”

“What happened?”

“Well, Jacob was born early at 28 weeks old.  His mom didn’t want him so she took something to abort him.  After he was born his father tried to strangle him with a cord.  Then his parents put him in a black bag on the ground and left the house.  While they were gone, thieves broke into the house.  One of the thieves accidentally kicked the bag and it began to cry; when the thief looked inside, it was a baby.  So he took the baby to the police station.”

“What happened to the thief?”

“People always ask me if he was charged, but I don’t know.”

“Well, Jacob’s lucky to have been saved; he’s been through a lot.”

“His first 2 months of life were hard.  After he was found, he had severe pneumonia and stayed in the hospital for over 1 month.  He was started on AZT at the time, but it was already too late and he became HIV positive.  The good thing is he won’t remember the first 2 months of his life.”

“It’s a very good thing,” I agreed.

How can such horrible things happen to a person who has been alive for only 4 short months?  He entered this world innocently, not of his own free will, and has had to battle to survive from the time he was a fetus.  And yet, he has overcome.  Now he sits smiling before me, all of the trauma of his past forgotten, and unaware of the tragedies that occur around him everyday.  I think, this child is resilient – he was meant to live. 

While my nurse and I play with him and speak to him in baby talk, I feel saddened that the beginning of his life was a nightmare, and that he has to live with HIV for the rest of his life.  At the same time, I’m glad that he is now in a safe, loving home, and getting medical attention.  Although his life is nowhere near perfect, I know that there is hope for him and I know that someone cares.  I see orphans, both HIV positive and negative, on a regular basis, and these stories are not unique.  These kids are tough.  God is looking out for them; for what purpose I do not know, but in them I see hope in what sometimes seems a hopeless situation.  From this baby and many others like him, I am reminded that life can get tough, but if he can struggle through and come out smiling, so can I.



Main street in town in Durban.



Issues Many Wealthy South Africans May Not Realize About Their Country (Part 1)

We frequently hear that “South Africa is not like the other African countries; we’re not so poor.  You can’t tell you’re living in Africa when you’re in South Africa.”  Many upper middle-class/wealthy people compare SA to other first-world countries.  However, most have not been to other first-world countries, other African countries, or even poor or rural areas in their own country; their assessments are far from objective, and far from reality. 

To be fair, South Africa is wealthy for a sub-Saharan African nation.  And crime, poverty, and disease do exist in every country to some degree.  However, nearly all statistical indicators show that SA is doing worse than its developing country peers – whether African, Asian, or South American.  Countries like Kenya and Ethiopia continue to improve (in terms of life expectancy, HIV prevalence, economic productivity); SA regresses.  Sometimes I get so irritated when South Africans make comments about the poverty in Ethiopia or the street children in Vietnam that I just want to shout at them, “Open your eyes!  Every city in this country is full of shantytowns that aren’t even fit for dogs.  There are kids begging at stoplights.  You can’t miss them, they’re everywhere – outside that upscale mall where you bought your $100 Puma shoes, across the street from that fancy restaurant where you just had your romantic dinner.  Why is it sadder when it’s somewhere else?  Why are people in other countries more deserving of your compassion than people in your own backyard?”

I know I sound angry and judgmental, but it is difficult, day in and day out, to watch many people suffer and go without basic needs, while at the same time we see the wealthy spend money on designer clothes, iPhones, and BMWs.  They ignore the poor, or judge them as lazy.  I believe that God exists and that He is good, but He gave us free will.  We are responsible for the societies we build, and the poor have fallen victims to our selfishness, our apathy, and the failures and corruption of our political leaders. 

I cannot say that I know what it feels like to be poor.  However, from speaking to poor people in SA and other countries (including the US), many have physical or mental illnesses that prevent them from working.  Some beg or prostitute their bodies because they see no other way to feed or clothe their families.  And some, having grown up in townships or slums filled with poverty, violence, and substance abuse, internalize all the negativity of their surroundings, and come to believe that taking what they need or want by force is acceptable – whether it is sex, money, revenge, or entertainment. 

People have asked, “Why go to SA when there is so much poverty in the US?”  This is a valid question.  At home, we have always made conscious decisions to work in underserved, poverty-stricken communities, and will continue to do so when we return.  We understand that poverty-stricken areas in the US experience shortages of doctors; however, the shortages in countries like South Africa are far more severe.  Likewise, the degree of poverty and social injustice is far more severe in developing countries than it is in the States.  Both of us have always felt motivated to serve where the need is greatest.  Before either of us became doctors, we knew we wanted careers where we could work with those in need in poor countries.  (Naively, we did not consider the fact that we would also have to work with the bureaucracies of these countries.)  However, we are learning the limits one faces when trying to effect change in someone else’s country, and that it is easier (and sometimes more appropriate) to effect change in one’s own country.      

It is true that tourists visiting places like Cape Town will think they are in a modern European country, with nice paved roads and fancy restaurants.  SA wants to make a good impression on its visitors.  The sad truth is that the majority of people in this country live in abject poverty, without running water, electricity or medical care.  Having pride in one’s country is a good thing.  At the same time, by turning a blind eye to obvious problems, a person passively contributes to the decay of his or her society.  Only by honestly and sincerely confronting these issues can people overcome them, and move their country forward.  Otherwise, SA risks becoming another in a long line of failed African states.

Flying over an expansive shantytown just before landing in Cape Town.

South African Fact:

Many South Africans use the phrase “izit!?” to mean “really!?” or “is that so!?”  It is a combination of “is” and “it” placed together.  It is said as an exclamation and a question.  When we first arrived to SA, we were confused when someone would say “izit!?” to a factual statement we just made.  We did not know if they were questioning us or if we were supposed to reply “it is!”

Example:

Mary: “Today we saw over 700 patients in the outpatient department.”

Tom: “Izit!?” You must be tired.

(Note: On an average day, over 600 to 700 patients are cared for by our hospital's outpatient department.  Outpatient includes the chronic outpatient clinic, urgent care, and pharmacy.  The goal, although not always reached, is to have 10-14 doctors seeing patients and a few pharmacists and pharmacy technicians working each day.)