What are you doing for Easter?

Me? I'm going to Splashy Fen, a 5-day music festival out in the Drakensberg Mountains. It looks like there are more than 100 bands scheduled to play, and everyone will be camping out in tents taking in the crisp mountain air.

Musically, it might not live up to SXSW - which just finished up in Austin, TX - but I'm sure the views at the 'Fen will be better.

Here's what the festival looked like from above in 2006. Looks pretty good to you, doesn't it?

Another busy week!

Some highlights:

Clearly the most exciting part of this past week was that I was finally able to pick up my new (to me) car! It's a 1990 cream-colored Toyota Conquest with nearly 200,000km under it's belt - and it's absolutely beautiful. Don't I look happy (and bizarrely smug) sitting on my ride?


I haven't come up with a proper name for her just yet, but it must be done soon - I'm currently planning on having a proper christening when we hit the 200k mark in the coming weeks.

As for work, both projects I am participating in have really gotten rolling. I've spent 5 of the past 6 days at different clinics and NGOs in the greater-Durban area - working on systems mapping and analysis of their clinical and psychosocial programs. Each clinic is run very differently, and the requirements for creating comprehensive HIV care at each of the sites are going to be very different. However, I feel that each site probably knows the population they serve the best - whether they be located in the inner-city or in the rural townships - and that we (the large hospital with lots of funding) should work with them to the best of our abilities to allow them to maintain their underlying treatment pedagogy while trying to bring them up to speed with streamlined data collection systems and an operational plan that starts to conform with the Department of Health requirements.

I'm not sure how clear that principle is when I write it out like that - but I hope you guys understand what I'm saying. To paraphrase: each clinic is more of an expert in their particular area than we could ever hope to be, and we should use our funding to help them out in a few specific areas while relying on their expertise to guide development of their HIV programs.

And, tomorrow morning I leave for Lesotho. I'm going to be spending some time in Maseru and Semonkong - checking out a rural clinic, checking out the local culture, and enjoying the natural beauty of Lesotho (I think there's going to be some pony-trekking involved). and I'll try and come back with some nice pictures to share, but here's a nice little map of the country for you to check out in the interim (courtesy of Wikipedia):


And then next week I'm moving into my own apartment in the Barea. I've already purchased some art to hang on the walls and am looking for a stereo system from which to bump my tunes; I'm quite excited about my imminent change in address. I will also have wireless access at my new place, so I won't be tethered to the hospital for all of my e-mail, blogging, and (very soon) application needs. This should hopefully translate into more satisfying communication for all!

Alright, friends, it's time for me to roll out. Hope you all are well, and I'll be back on Saturday to share all my exciting pictures &c. with you guys.

Oh yeah, and congratulations are in order for both of my brothers. To Ed for getting into college(!), and 'Drew for turning the ripe old age of 21. If you see any members of the Bearnot clan, please feel free to let them know how awesome you think they are - or at least congratulate them or something.

My apologies

Hey folks -

I've really been doing my best to post as frequently as I can, but this past week has been pretty rough. Please accept my sincerest apologies for the dearth of information about my travels. Hopefully I'll be back to my prolific self soon enough!

Talk to you soon,
B

Further incompatibilities of international health care and partisan politics

Below is the first page of the form that PEPFAR (the President's Emergency Plan For AIDS Relief, which I have talked about before) and the Center for Disease Control (CDC) require all clinics receiving American funding to fill out each quarter and then again at the end of the year. The page that I'm presenting to you is included in the section designated 'Prevention.' I ask you, please take a look at the metrics being asked for in this reporting form.


As a budding Monitoring and Evaluations specialist, I now find these questions even more infuriating than I would have before. Partisan politics and political agendas aside, collecting these sorts of numbers from each clinic contributes ABSOLUTELY NO VALUE when measuring the efficacy/impact of an HIV clinic or evaluating programmatic strengths and weaknesses. Clearly my ranting will have no impact on this sad state of affairs whatsoever, but I just thought I would share my personal distaste for the strings attached to the (ultimately, extremely beneficial) funding provided by the US government to combat HIV/AIDS in the developing world.

The scariest horror story I've ever come across

There was a recent news report that's been circulating by word of mouth here at the hospital regarding HIV prevalence amongst university students in South Africa. I didn't quite believe what I was hearing and assumed that people were just making up the astronomical numbers I was hearing. However, after a quick internet search, I would like to point you to the following article from the South African Broadcasting Corporation. I encourage you to sit down before reading on:

At least 60% of SA tertiary students HIV positive
March 09, 2007, 12:00

At least 60% of students in South Africa's tertiary institutions are HIV positive, according to the South African Union of Students, who presented these figures at the launch of an HIV/Aids programme for tertiary students.

Samora Mohaka, a spokesperson, says students at tertiary institution are struggling to get the necessary support to deal with the HIV/Aids pandemic.

The health ministry yesterday called on the education department to review its life-orientation programmes, as they seem ineffective in preventing the high teenage pregnancy rate.

Nosizwe Madlala-Routledge, the deputy health minister, said the situation raises concerns about risky sexual behaviour among schoolgirls. She said such behaviour renders them
vulnerable to this pandemic.

***********

And that absurd final paragraph about promiscuous schoolgirls? Just another piece of evidence that South Africa doesn't understand the nature of the epidemic in any way that will allow them to overcome it in the near future. It quite sad when you think about it.

Brief Encounters

I don't really feel like blogging today so I'll just share two small, entirely unrelated points:

1) Two men entered the Sinikithemba Clinic this afternoon, armed with guns and smoke bombs(?). They were looking to empty the meager register that the clinic keeps on hand for the patients who pay a small (R140, or approximately $20) monthly access fee to use the clinic. Fortunately, the guys showed up after the main register had been emptied by the armed guards several hours before - so they only got away with the few thousand Rands the clinic keeps on hand for 'emergencies'. Luckily, I was safely hidden away in the upstairs Monitoring and Evaluation office until the guys left, setting off a smoke bomb as they departed from the scene. The security guards weren't able to catch up with them and they eventually got away. It was quite a scary experience, and I'm still a bit shaken up. But - most importantly, I guess - no one was hurt, and the patients were eventually able to be seen after a brief police investigation of the Crime Scene. I am and will continue to be baffled by the fact that are people in SA disparate enough for cash that they would terrorize a clinic full of sick HIV patients.

2) The Smarter Than the Average Bearnot readership is now up to 32 countries. I'd like to welcome to the new readers in:

Swaziland
Vietnam
Dominican Republic
Ireland
Austria
Taiwan
Netherlands

Accidental Poetry

I stumbled upon this intriguing note stapled into a HIV patient's chart yesterday, and was immediately reminded of that William Carlos Williams' poem 'This Is Just to Say'. I've always loved his work in general, but became particularly fascinated by this particular piece after it was used as an example of 'Incidental Artworks' in the Aesthetics seminar I took in college. From what I remember about the discussion of this work, it is unclear whether his lines were written as a poem - per se - or whether he had just written out a note for his wife to see when she returned to the kitchen. The question discussed in class was - more or less - does/should intent determine how a work is viewed? If his note was never intended to be a work of art, can we think of it as one?

Here is the note I found attached to the chart - with some notes to help you guys out with the HIV drug class abbreviations - followed by the text of the William Carlos Williams poem.



Things To Do

Please check for
the genotype results
I remember seeing
it sometime ago

I think this patient
was resistent to all
the PI's but not
the NNRTI's/NRTI's

*notes*
PI = Protease Inhibitors
NNRTI = Nucleoside Reverse Transcriptase Inhibitor
NRTI = Non-Nucleoside Reverse Transcriptase Inhibitor

This Is Just to Say

I have eaten
the plums
that were in
the icebox

and which
you were probably
saving
for breakfast

Forgive me
they were delicious
so sweet
and so cold

Trippin' and Bumpin', Bumpin' and Trippin'

Hey All -

Got back from my wonderful trip into the Southern Drakensberg yesterday evening. It was a weekend full of stunning vistas, beautiful (cool) weather, and one gut-wrenching trip up the Sani Pass into Lesotho in a Landie (South African for Land Rover).

The Drakensberg range is actually not so far from Durban - 2.5 or 3 hours - but we left at the crack of dawn on Saturday morning, enabling us to get as much out of the weekend as possible. We arrived at the backpackers' lodge by 9am and immediately piled into the Land Rover that had come to take us up the Pass. It was an extremely entertaining and bouncy ride; we climbed more than 5,000 feet over the course of less than 5 miles.


After making the final ascent and passing through Passport Control, we entered the 'Mountain Kingdom' of Lesotho. This was a memorable experience for two, very distinct, reasons: the obvious poverty of the people and the flatness of the terrain (I guess I hadn't really mentally accounted for the fact that the top of a plateau - regardless of how steep it's sides are - is always going to be relatively level).

We went to go visit one of the small villages several kilometers from the Pass and were greeted by a family living in several small, thatched-roof huts.

The two siblings who lived in the household were extraordinarily cute - but seemingly malnourished and undersized.

We also got to see the massive herds of sheep and goats that comprise the bulk of the economy of the Basotho people. The animals are too precious to be eaten for food; the wool and angora they produce provides a steady, but very small, income for the families who own the herds. Additionally, the weather in parts of Lesotho drop to such extremes in the winter (July and August) that the shepards are forced to relocate the animals to warmer areas.


We also managed to stop for a beer or two (Black Label is favorite SA brew) at the Sani Pass Lodge, billed as the 'Highest Pub in Africa' - at an elevation of more that 2,800 meters.

After coming back down the pass, we spent the rest of the afternoon swimming in the nearby river, watching Sharks - the the local Durban rugby team; Go Sharks! - beat the Bloemfontein Cheetahs and take possession of first place in the Super 14, and having a delicious, home cooked dinner in the beautiful farmhouse located just next to our lodgings.

The next day was spent on a wonderful hike to several waterfalls and then up to one of the rocky bluffs overlooking the Drakensberg Valley.



All told, it was a wonderful weekend and I was sad to have to head back to Durban. However, I certainly plan to check out other sites in the 'berg in the coming months and I am personally of the opinion that it's never a bad thing to leave 'em wanting more.

And that's exactly what I aim to do. As always, the rest of my photos can be found on my Flickr stream. Hope you all had wonderful weekends as well, and I'll be back soon with some more posts.

Into thin air

Sorry I’ve been slacking on the posts; things have gotten crazybusy here over the past few days, and I haven’t found myself with the time to respond to the flood of birthday e-mails (thanks for all of those, by the way!) let alone collect my thoughts and put them into an acceptable post form. The projects that I’m working on at the hospital and the clinic have really started gearing up, and there has been a steady stream of VIPs from Harvard and Partners coming through the hospital over the past few days – and while I don’t think I should name names, I definitely went out drinking with a cadre of them on my birthday Monday night (sweet!).

This weekend I’m headed up into the southern Drakensberg Mountains via the Sani Pass (there's a picture nice of it up at the top of this post), a well–known entry point into Lesotho from South Africa’s Natal Drakensberg Park. It’s apparently a very steep drive up – requiring a 4x4 to get through the pass – but exceedingly beautiful once you get there; I’ve heard the plateau referred to as the “Roof of Africa.” The intermarry for the weekend includes a stop in a traditional Basotho Village, hiking, swimming in mountain streams, an hour or two on an ATV (quad bikes they’re called here) and a drink at ‘the highest pub in Africa.’ Hopefully it will be as much fun as it sounds – and I might even need to wear a sweatshirt (*gasp*) for the first time since I arrived in Africa six weeks ago. Pictures of the excursion will follow, I’m sure.

Hope you’ve all been well, and hopefully I’ll get a chance to post again soon. Happy Friday.

We are the champions

I leave my left hand up in the air as I watch the ball snap through the net. I have just put my team up by 10 points in the closing minutes of the citywide basketball final, virtually sealing the championship for my team. A small smile grows on my face, equal parts excitement and relief. The crowd is cheering surprisingly loudly, and all I can do is shrug my shoulders and backpedal down the court.

This is a childhood dream of mine – the sort that so many little boys have while shooting around in local parks/schoolyards/driveways as dusk gently settles across the sky, blurring lines between fantasy and reality. It is also, incidentally, exactly what happened on this past Saturday afternoon while playing in the eThekwini District Basketball Tournament.

On Saturday morning I got up early to help the Peace Players International (PPI) guys run another basketball clinic out in Chatsworth, as has become our weekly custom. After we finished cleaning up the balls and cones at the Chatsworth Youth Center and were back on the road back into downtown Durban, they invited me to be the fifth man on their team for a basketball tournament that they heard was being held down at the Durban Institute of Technology. Excited at the prospect of some good hoops and an interesting experience, I quickly said Yes.

Four games and three hours in the hot Durban summer sun later, the final whistle sounded, and we were crowned champions of this (annual?) tournament. And while I wasn’t entirely happy with my individual performance, we played some fantastic team basketball and had come out on top. We were each given individual medals and a big trophy for the team to share; don’t worry I have already put in my request to have the hardware at my house one day each week. It was an amazing experience – a dream-come-true in the purest sense – and one hell of an early birthday present.

You wanna see how happy I was?:



And, just because I'm sure you're wondering, my birthday was lots of fun as well.

Birfday!

In celebration of my impending birthday, I have invited a whole cadre of semi-acquaintances, demi-friends, and co-workers out for dinner and drinks on Saturday night at a restaurant/bar called Bean Bag Bohemia on Florida Road – one of the most happening strips in Durban. Usually, I’m a bit nervous before any party I throw; I find it a bit nerve-wracking to wonder if my friends will show up, will they show up on time, is someone else throwing a better party, &c. However, in this instance, I don’t really know these people all that well – and this is liberating in a particular way. Sure, I’d love it if they came out, but it wouldn’t really faze me if they didn’t, as I’m not all that friendly with them. It’s an interesting experience having a birthday far away from home, surrounded by those you don’t feel all that close with; I’m reminded of those people who had birthdays that fell in the first few weeks of college, when we hadn’t yet formed any long-standing connections with our classmates.

This isn’t to say that I haven’t been meeting loads of interesting people. In fact, I’ve encountered a whole new set of exciting people this week. And some of them have invited me for a braii at their house tonight. And I’ve found out the exact date that I’m picking up my new (to me) car. And I think I’ve found the apartment that I’m going to me moving into come April. So, all in all this has been quite a nice week – and quite a relief after the difficulties of this past weekend.

Alright, I’m done for the day. I hope you all have wonderful weekends, and I’ll catch you on the flip side. Peace.

De la Rey, De la Rey / Will you come to lead the Boers?

“De la Rey”, a song about a famous Afrikaner general during the Boer War of the same name has been making headlines both here and abroad over the past few months. The song - penned by Louis Pepler and most famously performed by Bok van Blerk, both Afrikaans musicians – has rapidly become an Afrikaner anthem here in South Africa. In the music video, which I’ve posted below, a blooded and beleaguered Afrikaner soldier sings of "a handful of us against a whole big force" and "a nation that will rise again." This has tended to bring to a boil the always-simmering racial tensions in SA, as it was the Afrikaans-led National Party who institutionalized Apartheid in the 1950’s.

The most pertinent questions that have been posited by the national and international press are the following: Should the Afrikaans people be entitled to celebrate their cultural history, even if it evokes an appalling past of White Supremacy? Does this song functioning as a subversive Call-to-Arms for Afrikaners? And should the artist be held responsible if the South African Right Wing parties use this song as a metaphor for the overthrowing of the democratically elected – and currently African National Congress-led – government.

It’s a very interesting Freedom of Speech issue, and one that you guys might be interested in reading more about. Here are a couple of links to articles in several different newspapers. Please take a look, and I would love to hear any feedback you guys might have.

(A big Thanks to Sue and my dad who alerted me to the fact that this issue has made it all the way to the hallowed pages of the New York Times.)

From the New York Times

From the Mail & Guardian

From the Sunday Times

And, as promised, here's the music video: