13/6

Yesterday we went to Khayelitsha for the third week. For the first half of the day SiSi led the group as normal. They began with a prayer song (which only reaffirms my impression that every person here has a natural choir voice), then welcomed the new members. This Thursday was the day to test blood pressure and measure weight and height, so SiSi mentioned a few things in her opening speech. She told the members not to be shocked if they had high blood pressure, but to be grateful that it was caught early so that they could go to the clinic for treatment. She then stressed that if the clinic recommends exercises, the members should do them. Finally, she said not to be scared or worried of the results. It may have nothing to do with their choices, but rather may be from their family. She then reminded people that they can speak freely, and ask any questions, and if she didn’ know the answer maybe the visitors (US) would. That really surprised us, to know how they viewed us. First of all, we are not qualified whatsoever to answer their questions about blood pressure, diabetes, and other health related questions. Furthermore, that put a lot of pressure on us to be able to answer the questions. If that was how they viewed us, as visitors with all the answers, we are going to have to work very hard to change their opinions of us. That got me thinking. How do we want them to view us? I don’t have time to write about my thoughts now, so I will include them in my next entry (keep you in anticipation).

SiSi then spent a lot of time talking about the importance of drinking clean water, the amount to be determined by the weight of each person. She mentioned pamphlets in the back describing how water cleans the system. She then discussed how without water the members will have pains, that water is like a medicine. Fizzy drinks will do something bad to your body, and by drinking that you will be killing yourself. But water is a cure all. It is good for your skin and kidneys. If you are not drinking enough water then your urine will be colored and will smell. At this point a woman raised her hands and said that she drinks a ton of water but that her urine smells like eggs and is dark. SiSi asked if she had ever seen her doctor about her kidneys and she said that yes, she has been told she has kidney problems. SiSi instructed her to go back to her clinic and get checked out again. I would have loved to find out more from this woman, about her experience at the clinic, what the doctors had told her, what the treatment had been, how easy it was to get the Tx and follow it, what she thinks the origins of the problems were, etc. But unfortunately she speaks only Xhosa, and I did not want to single her out later, so I will have to wait until next week to see if she has an update for SiSi.

After the group discussion, the CHW’s each went to a table in different corners of the room to take weight, height, and blood pressure measurements of each member. Based on these numbers they told each member whether or not they should be worried, and whether or not they should go to a clinic. After everyone had been measured we asked them all to arrange their chairs into a circle so that we could start our questions. Brittany and I introduced ourselves and what we were doing in their club. Brittany then spoke while I took notes. We asked them about what types of exercise they know of and they do, the types of foods and liquids that they drink, and of these foods and liquids which are the most accessible, the cheapest, and the ones they like the most.  The most popular foods are often South African foods like pap (a type of stiff porridge), umngqusho (a bean and samp mixture), and umphokoqo (mielie meal and amast, sour milk). Foods like yogurt, red meats, and some fruits are not eaten often or at all because they are so expensive.  Since Khayelitsha is such a poor community, there is basically no diversity in the women’s diets- it is just creative ways to eat mielie meal. We are now organizing this information, looking up nutritional facts (and some times exact ingredients as in the case of umngqusho), availability, and prices.  Once we have all this information, we will construct the menu that we plan to give to the women next week along with the intro survey, a brief introduction to the South African dietary guidelines, and the journals so they can keep track of how the menu is working for them. Although we have had a lot of success and progress this week, we did have some obstacles.  The largest one is our translator. We found that her translations were not very accurate; she would often put in a lot of her own thoughts and feelings.  This is fine, because we know that on top of being our lingual translator she is our cultural translator. However, she would often lead the women into giving “right” answers and sometimes chide the women who gave “wrong” answers.  For example, two of the women were new to the club and she made several comments about how they ate badly.  After that, both women mentioned a lot more vegetables in their diets.  She would also put words into the mouths of the club members.  For example, if one woman said she ate two pieces of bread for lunch, the translator would add that it was brown bread, which may or may not have been true, but to which the interviewee agreed with.  We feel like because of this, we got a healthier set of answers than what may be actually being eaten in reality.  We also felt like the way that she reprimanded some ladies for how they ate and praised others set a bad feeling to the group; it made people less willing to be honest.  We  were a little discouraged because we wanted to hear JUST the interviewees opinions. We wanted to ask them questions and hear their answers, not judge them.  Finally, the translator tried to decide what questions she thought were important.  She did this by rushing us during our interviews, telling us how we didn’t have enough time for certain questions (yet we sat at the end for at least 15 minutes).  She also would not translate certain questions. For example, we were trying to understand the demographics of the women so we asked who identified with being black, colored, etc.  She immediately responded that all the women would identify as black and didn’t ask the question to the group.  She also claimed that she knew the questions we were going to ask, and thus didn’t have to hear them in English first.  So when we were trying to ask the women about what foods they ate, which ones they liked, which ones were cheapest, and which ones were the most accessible for breakfast, lunch, and dinner, she shortened this question by just asking what the women ate for each meal.  This caused us to have to think on our feet and ask a lot of supplementary questions in order to get the original questions answered. I have ranted for awhile, but our translator is a wonderful woman and a huge help to us every single day. It was just a little frustrating today, but once we talk to her I'm sure things will be better. 

After the interview we got to join them in exercises and vegetable soup for lunch. It was a very fun day. When we got back we made dinner and Sheebs came over. We all went up to the bar and played card games and celebrity, then headed out for Long Street. We are starting to recognize people as we go out which is pretty cool. There is a guy, Angus, who we’ve seen at least five times walking down the street during the day and out at night, and another girl Monica who has been to every bar on Long Street that we go to. We’re starting to feel more and more like locals and less like tourists each day.

Today we woke up and headed to the Internet café to start making the menu that we’ll present next Thursday. It’s a gorgeous day, and hard to be indoors, but we wanted to get our work done early today so that we can go to a Braai (BBQ) that the hostel is having tonight. I’ll write more about that later.