Home Visits

Last week our intake was out in the community to do home visits with the care workers. Community Based Organizations, or CBOs, handle home visits differently. Some strictly perform home visits that pertain to vulnerable children. These visits include examining the house, in terms of safety and access to basic needs, as well as examining the emotional well being of the child and how they interact with other members of their household. Some CBOs also perform patient visits. Patient visits are different in that the subject is usually an adult, as opposed to a child, with a medical condition of some sort. This does include people with HIV, TB, but also a number of various other conditions. Later in the week I went on a patient visit to the home of an individual recovering from a stroke to check on his progress. Anyway, I digress..

On this particular day, I was with Dave, Jo-Anne and two care workers on a patient visit. We visited a simple home that was not remarkably different from simple homes in the United States. The living room was centered around the entertainment center, that was also used for basic storage. One end of the entertainment center was used to store ceramic figurines not all that different from pieces I might find in my grandmother's house. There was seating, two matching love seats and two matching chairs, that centered around a simple coffee table. The home obviously had electricity, and there was a small television in the entertainment center and I believe I saw a computer tower. There was a refrigerator with fruit magnets, something else you could find at my grandmother's house. There were two doors on either side of the living room that allowed a cross breeze, quite a luxury compared to most of the homes I have been to thus far. If you ignored the steel roof and the dry wall that was beginning to lose it's integrity, you could easily forget you were in Africa. A single roll of toilet paper and cell phone sat on the coffee table next to the love seat where Martha was laying down.

Martha is 40 years old. The care workers stop in to check her progress and have an idea of her overall well being. This visit was unique in that Martha spoke in her native language and the care workers did not interpret what she was saying for us. I know the conversation, despite being spoken in an African dialect, was peppered with English words and phrases. I know the word 'cancer' was discussed, but not in what context. Other words that stood out included 'abdominal pain', 'pregnancy', months, years, numbers, and reference of HIV status and ARVs. I'm not even sure how long we were there. It might have been twenty minutes, but it easily could have been longer. I just could not escape how thin and frail Martha looked. How bright her eyes were, and how they contrasted with the pain she wore on her face. The pain that could be seen simply by the way she held her hands. I only know Martha was crying. The care worker sitting next to me was crying.

We went on another visit that day to see a woman named Susan. We sat outside her house on crates and wicker chairs. The view from her backyard was absolutely beautiful. It's a strange juxtaposition of so much physical beauty in an area filled with extreme brokenness and heartache. Susan is dealing with TB in addition to being HIV+. She even shared her last lab value of CD4(T-cell) levels, which determine whether or not they need to be placed on ARVs. She suffers from bleeding in her ears and has to walk to the nearest clinic for treatment. She is not working so her only source of income is two grants she receives for her children. She is given 280Rand for each child, which (combined total) provides her just over $60 per month. That is all she has to support her family. Her only prayer request was for healing, so that she would be able to find a job.

The language barrier is a dilemma. We, thankfully, aren't expected to become fluent in these languages immediately. Even so, what do you say to a woman who has just told you she has TB and HIV? They don't understand our language, but even if they do - what do you say? There is the language barrier, but there is also just a word barrier in general. These people that we visit are dealing with so much, and have so little to do so, yet the continue to blow us away with their hospitality towards us and their faith in God. Susan asked for healing because she genuinely knows God has the ability to heal her. It is an awesome faith to be seen. It's also hard for us. There are questions about hospitality. Africans are so given when they have so little - which is a difficult pill for everyone to swallow. How guarded are we with sharing our possessions? You could be the most generous person and you would still come to Africa, only to realize that your generosity pales in comparison! Our Churches are littered with traps of a self-serving mindset, everything comes back to us. Here everything comes back to the greater good. These communities are so social, so group-centered - it is a dramatic contrast from westernized society.

Here we have to accept that we are essentially useless. We cannot 'fix' anything. We cannot provide a solution. We don't have all the right answers, contrary to what we all want to think. All we can do is stop talking and just listen. We can provide support to the care workers by hearing their personal stories, and the stories of the people they care for. We can hold the hands of the families we visit, consoling them as they tell their story, and hug them tightly before we leave. We can pray over them.

In the past I have gone on mission trips where people struggled to allow themselves to entertain the idea that they could have been in that situation. I have experienced people who, more than anything else, want to think that the people we serve are in the situation by their own doing. Because they are less motivated or because they don't have skills or money. That is easier, and quite frankly, more comfortable, than admitting that bad things could happen in our own lives. That they could be beyond our control, and that we could be unprepared to fix them. "If I was in this situation, I'd have insurance which would cover that..." Make no mistake, and I cannot stress this enough: here it is only too obvious that I have the life I do, not because I am better or more deserving, or because of anything I did, but because, by the grace of God, I was born in the United States and not in Africa.