Klerksdorp

Today is my last day in Klerksdorp, where I've spent the past 6 weeks doing research.  Klerksdorp is a mining, trucking, and agricultural town, all of which contribute to especially high rates of HIV (19% in adults) and TB--“the twins.”  As a result, it is a promising place to do research, but not an exciting place to live.  Klerksdorp is really a town in the middle of the desert, and the weather reflects that.  It goes from 30 degrees at night to 70 degrees during the day.

Tshepong Hospital, where we work, is a public hospital so it serves everyone free.  Anyone we talk to with any money says that if they got sick, they would immediately go to a private hospital instead.  Nonetheless, the South African system works well enough for it to be a model for other countries of Africa.  The doctors are quite multicultural (from India, Europe, Cuba, elsewhere in Africa), but the "sisters" (what they call nurses) and patients are almost all black with the occasional white person.

First thing every day we attend the medicine department's mortality meeting.  Starting every morning by reviewing people who’ve died in the past 24 hours is not as sobering as it seems, and it marks the beginning of day full of learning for me.  After that, I attend morning rounds in the wards with the other SA medicine students doing a rotation at Klerksdorp.  Seeing patients on rounds has been the best part of this whole summer.  It's thrilling to see how what I've been furiously studying can be put to use to help people.  I've learned the technique of explaining HIV to patients in terms of soldiers (CD4) versus enemies (viral load).  For the rest of the day, I work on my project analyzing mortality data already collected from the wards.  Because of the prevalence of TB, and multi-drug resistant TB, I wear an N95 mask every time I'm in the wards.  At least it worked well to catch my sneezes when I was sick the first week here.

One day there were protests around the hospital, so we had to take our little Suzuki off-roading to get over makeshift road barricades and find an alternate route home.  I'm so glad to have learned to drive manual this summer...and on the left side of the road.  It's actually the first time I've ever driven abroad, and South African drivers are really not too hectic.

In the late afternoon, the four of us Hopkins students all head to the gym together.  The gym is always full of enormous Afrikaners.  Afrikaners are the descents of Dutch traders who settled at the Cape in the 17th century.  Since then, they were pushed more inland by the British and became farmers in places like Klerksdorp.  They are all natural born rugby players, and mostly blond.  They all expect us, as fellow white people, to speak Afrikaans.  It always happens that someone will come up to me and rattle off a full three sentences or more in Afrikaans before I have a chance to explain that I don't understand.  Before coming to South Africa, I thought the language would be more stigmatized and not so many people would still speak it.  However, it is still alive and well.  There are even universities where lectures are unofficially given in Afrikaans, even though they ostensibly follow an English-language curriculum.  There exist many Afrikaans elementary schools, where English or even Dutch is taught as the second language.  Less commonly, Tseswana might be taught as a second language at an English school.  There are 11 official languages in South Africa.  I really recommend Trevor Noah's book Born a Crime for learning about the racial dynamics in this country.