Who will live? Who will die?

            The follow day, July 21^st, Taylor and I were invited to observe a multidisciplinary meeting within Grute Skoor’s renal unit.  We met up with the renal unit social worker and two Western Cape university social work interns.  He quickly explained that we were about to observe the meeting held between doctors, staff, social workers, and interns about the status of a patient.  The social worker then ushered us into a small meeting room with about 30 other professionals. 

            As the room filled, the room became quiet and the head doctor requested for the meeting to begin.  One by one the group listened to presentations on the patient’s medical history, current status, and the psycho-social prospective.  After each of the presentations, the group decided whether to accept or deny the patients into the dialysis program and subsequently the transplant list or denied.  As explained, the patients are categorized as either Category 1, 2, or 3.  Depending on whether the patient is category 1, 2, or 3 determines whether or not he or she receives treatment.  Many times the social worker’s assessment is the tiebreaker that determines whether the patient in accepted into the program. 

            By the end of the meeting and debrief with the social worker, Taylor and I reflected on the system of categories and what we had just witnessed.  As we looked at our notes, we realized that two patients were accepted into the program, two were placed on the waiting list, and three were not accepted due to their category 3 status.  We left the hospital with the knowledge that we were apart of the meeting that decided whether seven people were going to live or die. 

A Day in the Life

            The South African government, like most governments, don’ t have enough resources to support all of the programs or people in need.  The South African public health care system is allocated about 25% of the health services budget and the remaining 75% is allocated to the private health care system.  While the private health care system in South Africa is estimated to be one of the best in the world, the public sector struggles to provide life saving services.

 Grote Skoor Hospital

            On July 20^th, I had the opportunity to experience a day in the life of a hospital social worker at Grote Skoor Hospital.  My fellow social work interns and I arranged to meet with the social work department.  The department allowed us to each shadow a social worker.  Stephanie shadowed the Medical social worker and Taylor shadowed the Maternity social work.  I shadowed the Renal and Transplant unit’s social worker. 

            I met the renal unit social worker in a flurry of paper work, nurses, and clients.  After a quick introduction, we delved into his daily work.  I helped him interview and inform patients about their medical situation, grants, and job status.  I also observed an end of treatment discussion with a man whose transplant was failing him.  While we ran from ward to ward to check up on paper work and patients, the social worker explained how the renal until admitted patients. 

            The social worker told me that due to the lack of resources the unit is unable to treat all patients in need of dialysis and a transplant.  Therefore the unit decides who is admitted into the program based on a list of criteria.  The criteria are formed into three categories.  Category 1 patients are young and healthy South African citizens.  They cannot have any medical complication such as obesity, diabetes, or be HIV positive.  These are the patients that are put onto the program immediately.  Category 2 patients are employed South African citizens that may have a few health issues or be older than the recommended age with a family to support.  Category 3 patients are unemployed, have a number health issues, and maybe incompliant to following medical advice.  They are not admitted into the program and are “sent home to die”.   The social worker told me that, “they do the best they can with what they are given”.  I agree.

           

Children’s Act of 2005

            On Tuesday, I lead a discussion around South Africa’s Children’s Act of 2005.  The mission of the Children’s Act is to support and promote children’s rights as outlined in South Africa’s constitution.  A child’s rights as outlined in the constitution are that all children (Under the age of 18) are important.  All children have the right to safe and healthy lives regardless of their gender, problems, cultural or ethnic background, spoken language, ability, religion, or race.  All decisions made in regards to the child have to be in the child’s best interest and the child must be informed.   As defined, the child’s best interest can be defined as thinking about the child’s family (caregiver, siblings, biological parents etc), culture, history, health and well-being.

            Within the act certain terms and processes around serving children are defined and outlined.  The act defines and outlines services around these key areas:

·      Parental responsibilities

·      Child Protection Services including CPS agencies, non-profits, foster care, adoption, international adoption, segregate motherhood,  and cluster foster care.

·      Partial care including schools, crèches, educares, and child and youth care centers (CYCC).

·      Children’s Court

·      The reduction of harm to children from cultural practice such as female virginity testing, circumcision, female genital cutting, and underage marriage. 

·      Children’s Health including access to HIV Testing.

·      Enforcement of the act including visits, stats, delegate’s responsibilities to members of social development etc.

            Though the Children’s act the best intentions, the agencies lack many of the resources and capacity to fulfill many of the outline guidelines.  The act also lacks clarity in many of the key terms such as “best interest”.

Escape

Cheetahs and little boys

            I took the day off on Thursday, July 7^th, to help Stephanie chaperon her boy’s group field trip.  As an intern for Home From Home, Stephanie’s most meaningful project has been working with a group of boys ages 8-11 once a week.  Over the past five weeks she has planned fun activities for them to do as a little escape from the daily routine like school, siblings, and house moms.  Taylor, Stephanie, and I went out to Khayelitsha to the Home From Home office to wait for the boys to show up.

            Once we had all the boys seat belted and happy in the van, we made our way to the Cheetah Sanctuary in Stellanbosch.  Stephanie, like any good community organizer, convinced the sanctuary to give a tour to the boys for free.  We arrived to the preserve after a sunny drive through Khayelitsha and some South African wine land.

            The boys pressed their faces to windows to get a better look at where we were going.  Wonga, our driver, dropped our group off at the front of the entrance.  After entering, we explored the enclosure for a while before our guide came to fetch us.  The Boys, while we waited, took turns taking pictures of the cheetahs on the other sides of the fence.  Each of the boys was chatty, wide eyed, and fascinated by not only the cheetahs, but also the act of taking pictures. 

            After the guide came, we were escorted into a classroom.  The boys sat cross-legged on the wood floor.  The guide presented all of the amazing facts about cheetahs and wild life conservation.  The boys sat in awe listening intensely to every fact for about 45 minutes.  After the presentation, the guide took all of us around to the different animal habitats.  The boys eagerly moved from habitat to habitat taking pictures. 

            By the end of the day, the boys were tired, but happy.  It was a good day.  Stephanie could see that she was giving the boys a taste of adventure and dropping them safely back home. 

Surf's Up

False Bay & Surfing           

            On June 25, after a long week, our group went on a search for adventure and stress relief.  Taylor, Stephanie, Kristen, and I made our way to the Rose Bank train station to catch a train to False Bay.  We hopped on the afternoon train to Muizenburg.  I had made arrangements for surfing lessons at 2:00 with the Surf Shack.  We arrived at the Muizenburg beach with our towels, swimsuits, and spirits of adventure in tow.  I was eager to meet our instructors and get into the water.  I couldn’t wait to touch the ocean and attempt to catch a wave. 

            Up until the surfing lesson, I had never had the opportunity to swim in the ocean.  I had, of course, walked along beaches and let the water come up to my calves, but I had never swam in the ocean.  The instructor thought I was joking when I asked if I should be worried that this was my first ocean experience.  As I squished in a wet suit, I wondered if I should be concerned about swimming in the ocean, but adrenaline and my friend’s encouragement quickly erased all my fears.

            After a short discussion about shark safety (False Bay hold a large portion of the Great White population), we grabbed our boards and followed our instructors into the great blue.  The ocean was freezing, salty, and beautiful.  I don’t think I have ever felt so amazing in all my life. 

            For over an hour, Kristen and I met wave after wave with no fear.  I pushed myself up on my board time after time riding the wave for a few seconds before falling off.  By the end of the day, my feet were numb, my abs were sore, and I was incredibly happy. 

A Little Glimpse of Hell

“For a minute there, I lost myself”-Radio Head

            The last two weeks of June, I lost myself.  I did not intend to lose myself.  I intended to support Safe Line and help a few families in the process.  I wanted to help children on the Safe Line’s waiting list obtain therapeutic services while continuing to participate in community work.  I knew that many of the children had been waiting over a year.  As forensic interviews and case files began to pile on my non-existent workspace, I began to lose sight of myself and the reason why.

            I began seeing up to four clients a day for up to an hour and a half each.  During one week I saw twelve clients, attempted to organize a parent support group, struggled to write client reports to be allocated, and managed to set up follow up appointments for other clients.  I also connected certain clients with resources from local hospitals and Rape Crisis.  I was clearly making an impact on the caregivers’ lives, Safe Line’s waiting list, and building my understanding of forensic interviews. 

            Though I was connecting clients to services and providing a little relief to families waiting to be seen, I was leaving the office exhausted and disturbed.  I was not being debriefed or supervised by anyone at the office.  It was difficult to get answers to any of my questions.  It was also difficult to obtain information about how the allocation process worked and how to set up appointments.  I had to track down key forms and appointment conflict information that no one bothered to tell me about.  Some days I would show up to work only to be handed four new files and told I was seeing a client in the next five minutes. 

            With so much weighing down on my own shoulders, I couldn’t help but wonder about all of the other social workers in the office.  Who was supporting them?  How was each of them dealing with the stress of forensic interviews and play therapy session with traumatized individuals?  How could a service agency like Safe Line provide sustainable services without supervision for their staff?   

            I saw myself drowning…..and I could see everyone else right there with me. 

Secondary Trauma

            Secondary trauma is a phenomenon that is being discussed among helping professionals.  Secondary trauma is a set of symptoms related to post traumatic stress disorder (PTSD) in which a therapist or helper begins to change his or her behavior due to the stress or empathetic response to hearing a client’s story or trauma.  The symptoms vary in each person but can include sleeplessness, unsubstantiated fear, nightmares, depression, bursts of anger, and a lose of connection to people in one’s life. 

             Until my time with Safe Line, I had never read about or discussed the impact of secondary trauma on helping professionals.  I had recently learned how to accept and work through my own trauma and grief, but I had little understanding of how I could absorb someone else’s fears, anger, and sadness.  When I began having nightmares, outbursts, and gripping anxiety, I realized that I was not coping well.  My normal positive outlook and behavior was quickly over shadowed by darkness.  Day after day of listening to stories and pleas from parents, aunts, and grandmothers to help his or her child or grandchild cope with surviving rape or sexual abuse, left me hollow.   I began questioning my self as a social worker, the people around me, and the world I lived in.

            It took my support group (Stephanie, Scott, Kristen, and Taylor) and my CCS supervisors to push me to acknowledge that I needed help.  After an uncomfortably public break down, I discussed ways I could reduce my stress and why supervision is key to taking on interpersonal practice. 

The Plan

            My experience these past few weeks have challenged me to think about my lack of a self-care plan.  I was hit hard by working with traumatized caregivers.  I needed to think about what that means for my future work with individuals and communities. 

            My current thoughts are that I need to schedule in time to talk about my feelings around my work.  I can’t hide from the fact that I am working in a difficult field.  I also can’t hide the fact that I need to work through my guilt around having these feelings.  I need to think through these reflections and build up my own protective practices instead of preaching to others about self care. 

            Some stress relieving activities I need to build into my daily life are my yoga practice, journaling, cooking, and spending time with friends.  For years, I have placed these beloved practices on hold for the sake of “education” or “being too busy”.  Now, it is time I start giving myself some time to grow and leave work for the work day. 

The Garden Route

Stephanie at the Cango Caves.

The crew at Cango Caves

Conservation Safari-A family of Giraffes.

The Garden Route.....

For the long weekend, I will be taking some time to enjoy the sites of the Western and Eastern Cape.  Stay tuned for more exciting details.......or at least amusing stories.

The Load

Role Play

            On Thursday, I finished my forensic assessment training.  After going through the schedule for the office, several of my co-workers and I crammed into a small office to practice our in-take skills.  One co-worker pretended to be a caregiver while each of us facilitated a forensic interview. 

            Overall, my interview captured the needed information from the pseudo-client.  I went through the confidentiality agreement and gathered information on the family and abuse.  I was nervous at first, but I became more comfortable as I asked the questions.  The more practice I can get the better.    

Casework

            Today, June 15, I was handed my caseload.  I spent the day familiarizing myself with twelve different client files.  I set up appointments with each of the client’s caregivers for next week.  It took all day to make appointments.  I contacted the caregivers by phone or by sending out letters.  My calendar is filled with meetings, events, and forensic interviews.  Now, I just need to find time to debrief….

All I can say is thank the world for Stephanie, Kristen, and Taylor.  My helping professional support group.  Without your support and our round robin debrief, I would not be sane right now.  

Finding a Balance

            It is difficult to find a balance between work and a personal life.  Many young people I have met seem to easily understand where the line between workaholic and human being is drawn.  I have yet to find this elusive balance.  Like many social workers or helping professionals, I find myself giving more to others than to myself. 

            During my time in the Masters of Social Work program at University of Michigan, I was placed with the Detroit Initiative.  Though I learned a lot about community work, grant writing, and teamwork, I found myself isolated.  Sometimes I would get lost in my work, but other times I found myself dealing with heavy experiences alone. 

            I continue to struggle understand what it means to live a balanced life.  Currently, I am beginning to realize that I need more than a career, exercise and healthy eating.  I am beginning to realize I need to find and tap into my own support system.

Forensic Assessment Training

            Safe Line has recently received an increased number of referrals from hospitals, the police, and schools.  With so many new cases, I have been asked to begun conducting Forensic Assessments with the client’s caregiver before referring the client to a staff therapist.  Continuing to follow my mantra of “going with the flow even when it’s bumpy”, I agreed to help.  Today, the director hosted training on Forensic Assessments.  The training was similar to other trainings I have attended, but I was thankful for the refresher before I start taking on my own caseload.  We reviewed interview techniques, the Children’s Act of 2005, person in environment maps, kinship charts, and SWOT analyses. The training could have been more in depth, but I felt that it reviewed needed information and answered all my questions.  Hopefully tomorrow, I can practice my in-take skills before my first client on Wednesday. 

            Though I am content to learn in-take skills and therapy methods, I wonder what part of my placement connects to my professional development as a community organizer?

           

The Politics of Language

        South Africa is a nation that is considered to have one of the most progressive constitutions.  The constitution was formed post-apartheid during 1996.  As the citizens rushed to find their place, the many different political parties came together to write a constitution that everyone could stand behind.  After a long year of debate, the new constitution took affect in 1997.  The constitutions recognized children’s rights, defined human rights, and approved 12 official national languages.  Children even sing the national anthem in three different languages.  South Africa’s constitution has been raved as being clear, fair, inclusive, and pushing for a culturally pluralistic society.  Unfortunately, implementing the constitution has not been as successful as making it.

            At my own work place, I can see the everyday tension between groups due to language, socio-economic status, or power.  I see a divide between the IsiXhosa speakers and Afrikaans speakers within Safe Line’s office.  Every worker has devoted her or him self to working with or for children who have been sexually abused, but find it difficult to connect to coworkers outside their ethnic group.  I find myself observing and playing a part in the larger social issues pushing down on each South African.  Yes, the constitution preaches pluralism and human rights, but implementing those ideas into action and into social structures takes time.  The fight for equity and acceptance is going to be a long struggle in South Africa and everywhere else. 

           

Working for Others

ACVV- Visiting a Child protective Service Agency

            On Friday morning, June 10^th, Tahira took Stephanie, Taylor, and I to visit a Child Protective Service agency that serves inner Cape Town.  We arrived at the agency around 9:00 am to meet with a social worker.  The agency’s office was above an inner city educare.  Jonathan, the community social worker, met us in the lobby and took us to his office.   Jonathan described his job responsibilities as conducting community work through programming, receiving in-take calls and conducting intake interviews.  He told us he receives 15 to 20 calls a week that require a follow up interview.  One of his co-workers said that her caseload is between 100-150.  With so many cases, I was surprised that one social worker would have so many job tasks.  After his introduction, we discussed the roles of a social worker and the misconceptions of social work.  In a room of American and South African social workers we came to the conclusion that we are in a highly needed, skilled, and under appreciated profession. 

Workshop

            After meeting with the ACVV intake and community worker, I returned to Safe Line to conduct my rescheduled workshop.   With my bag full of crafts supplies and examples, I convinced several of my co-workers to attend the workshop.  I set up a table with my supplies in the lounge and arranged biscuits on platters for the attendees.  As everyone settle into a seat, I began the workshop with the “Who am I?” Flower activity.  My co-workers each created picture of a flower with one identity written inside each petal.  For example, I might write my name in the middle of the flower with the identities of Social Worker, Peterson Family member, American, Woman and Student on the petals.  The staff finished their flowers and presented their identities to the group.    Then I lead them through a few activities and crafts.  The group particularly enjoyed the “Make your own city” activity.  I was happily surprised by how the staff engaged in my workshop.  Each of my co-workers jumped into the craft and activities with open hearts.  They were all interested in learning from me and I was excited to gain their feedback.  After reviewing my evaluation forms, I determined that the workshop was successful and the only thing that would have made it better was more time. 

A (Half) Day at the Beach

Planning & Community Work

            On Wednesday, June 8^th, I spent the early morning planning for my upcoming Parent Support Group and re-working my rescheduled workshop.  I also attempted to assist the community workers in hosting a Parenting Program in Bontiville, but no parents attended.  The workers and I waited at the identified church for two hours with only one attendee.  The community member that recruits women for the program reported that no one was coming.  On Thursday, June 9^th, the community workers and I returned to Bontiville to host the Parenting Program.  Patiently, we waited for the parents from the community to arrive.  Eventually we began the group with around 15 women.  I introduced the program and facilitated an icebreaker before beginning the group activities.  After a few days of parenting programs, I am beginning to wonder if Safe Line has a place for me.  Almost half way through with my internship and I feel stuck.  I want to be professionally challenged. 

Cape of Good Hope

            For our last day with Scott, we took a day trip to Cape Point after placement on Wednesday.  On the drive, we jammed out to Scott’s garden route mix of classic rock and old school rap.  Kristen, Scott, and I sang the lyrics loudly as our van drove through the ocean side towns of the Western Cape.   We eventually arrived at Cape Point.  I took in the breath taking scenery before beginning the hike to a mini piece of paradise.  Kristen, Stephanie, Becky, Scott, Bethany, and I made our way down the trail to the aqua water and sandy beach.  For the rest of our short time on the beach we ran around, took pictures, and took a moment to appreciate each other and the connection we all had. 

            With each joke and conversation, I thought about how much I was going to miss Scott.  How much I was going to miss everyone. I also thought about how rare it is to find people who understand my sense of humor, my frustrations, and everything else in between.  I hope that my family and my friends know how much I appreciate the validation and support they give me.  I also hope they know how much I miss them when I am gone.  There are days where I wish I could carry you all with me, but in a way I guess I already do. 

PS. See you later, Panda. Safe Travels.

           

Reflections on being a Social Worker

Social Work

            My favorite part of being a social worker, particularly a community organizer, is never having the same day twice.  Everyday, I have something new to think about, plan for, or implement.  The work challenges me everyday to think in a different way. It is a profession that allows me to work with others towards positive social change on an individual, community, and policy level.  It also relies upon my own strengths of creative critical thinking, reliability, kindness, and patience.   I know that many times I can find myself writing and reflecting on the difficulties that come with working with other humans, but I can’t see myself being anything other than a social worker. 

            As a young social worker learning in both the national and international field, I would like to share some of the lessons I have learned.

Flexibility

            Flexibility is one of the most important aspects of social work.  As a social worker, I am responsible for supporting and empowering individuals and communities on their own terms.  Of course to do this you have to have time, money, support, and consensus.  Therefore, I work to balance the roles of accountant, therapist, planner, administrator, and advocate.  I have to jump into to any role at anytime to meet others needs.  I strive to meet organizational and community needs in Detroit and in Cape Town.  But where is the line drawn between being flexible and being taking advantage of? 

            Within many of my conversations with Stephanie and other social workers, we talk about where the line is between flexibility and inefficiency.  At my placement, I have worked hard to support Safe Line’s programs and meet their requests in a timely manner.  In contrast, I have run into difficulties finding the same support from Safe Line.  I do not expect to be lead by the hand, but I do expect to be informed of events or meetings like any other staff member.  Through self-initiated communication, I have navigated a schedule for the next week and laid out my expectations for clear communication. 

Communication

            Communication is another key aspect to social work.  Whether working with clients, co-workers, or other agencies with out communication nothing can move forward. 

            For example, Safe Line requested a full day work shop on Group Work this past Monday.  I planned an in depth work shop on creating a group work logic model, using icebreakers, and incorporating art and music therapy into groups for the staff.  On Monday, I set up my workshop and ushered people into the meeting room to begin.  A few moments later, I was told that the staff was going to start the morning off with devotionals.  An hour later, the staff had finished with devotionals and the director had called a staff meeting.  I left the day having lead only 40 minutes of my full day workshop. 

Professionalism

            Professionalism is another aspect of social work that I have found meaning in during my time in Cape Town.  In the few weeks I have been challenged by my own and others cultural view of professionalism.  Though cultural difference is an asset, I find myself frustrated by the South African work ethic.   With so much need, when is it ok to expect staff members to finish paper work, attend meetings, and arrive on time?

 Just some thoughts. 

Recovery

Brunch at Cocoa Chai

            After a long Saturday, our remaining group members needed a break from the hectic house. We met up with Scott (aka Panda), another volunteer staying in Cape Town for a few extra days, to sooth our stress over brunch. Cocoa Chai, located in Observatory, is a sunny café that offers a delicious brunch for cheap.  My two favorite eaters, Scott and Kristen, joined me in trying various options on the menu.  After fulfilling our appetites, our load felt a little lighter and our heads were better able to take in the day. 

Holistic Fair

            Following brunch, we headed off to a Holistic Fair held at the Observatory Community Center every month.  We walked in the sunshine until we came upon a small grassy park filled with vendors, food, and children’s games.  I wondered around the fair commenting vendors to my friends.  While my friends wondered, I found a woman who was creating intricate Henna tattoos.  After watching her squeeze the dark paste-y dye into beautiful designs, I asked her to choose a design for me.  Kristen and Scott watched happily as she delicately covered my arm with winding flowers and leaves.  As she created, she told me about her sons and about Deaf culture and education in Cape Town.  I eagerly listened to her story about how her son was not allowed to sign in school and the lack of resources for children who are deaf.  I also shared with her more about Deaf culture in the United States and the push for sign language to be considered a valid language.  As she finished my arm, she handed me her card and I thanked her. 

Table Mountain

            With beautiful weather and a need for some stress relief, Kristen, Scott, and I decided to climb Table Mountain.  We switch backed our way up the two to three hour trail in one and half hours.  We stopped from time to time to catch our breath on the up mountain trail and appreciate the view.  As we found our way through the fog or “table clothe”, we reached the top of Table Mountain.  As the fog cleared, we made our way across the table to view Cape Town.  The view was breath taking and indescribable.   I stood with Scott and Kristen and watched the sun set on Cape Town. 

How do you say goodbye?

A Bittersweet Experience

            One of the most bittersweet realities of the Cross Cultural Solutions program is that you will have to say goodbye.  You will have to say goodbye to everyone at your placement, the CCS staff, and your fellow volunteers.

            At first, I thought that I wouldn’t fit in with the volunteers because of one thing or another, but two days into the program we had all bonded.  I found myself wanted to play games after dinner, going to others for support during difficult times at my placement, and looking forward to group adventures.  As a person who lives alone and could be labeled as a “workaholic” for a majority of the year, I began to feel a sense of balance seep back into my life.  I had formed deep attachments with the people I lived with for only three weeks. 

            As with any CCS program, it must come to an end and you have to say goodbye to the people you have only begun to know.  Of course, you have their contact information and promises to see one another again, but you also know you’ll never have this feeling again or this experience.  The first group of five was set to leave on Saturday. 

            To honor our last night together, we devoured Miss K’s  delicious marshmallow cupcakes and went out together.  We went to Mama Africa’s restaurant to enjoy the live band and each other’s company.  After Evelyn’s dance off with the house band’s lead singer, great conversation with Cal and an over all amazing night, I ordered taxis to bring us home.  On the way home, while listening to Carlos talk up our driver, I looked out at the city lights.  The pricks of light covered the cape as far as the Atlantic.  I imagined crossing the Atlantic to where my family is and where my friends would soon be. 

 I imagined my own last night in Cape Town two months from now. 

Saying Goodbye

            On Saturday morning, our crew dragged each other out of bed to have one last meal with one another.  We all piled in two different taxis and went out to the Old Biscuit Mill for a 9:00 am breakfast.  Kristen, Scott, and I enjoyed our usual smorgasbord. We each tried bites and sips of veg pies, lassis, smoothies, and an unbelievable made to order peach crepe.  With full stomachs, we wondered around the over priced shops and avoided any discussion about saying goodbye.   

            When we returned from Biscuit Mill, we greeted the new volunteers arriving from the airport.  Overwhelmed, our group, along with their luggage, found refuge in Stephanie and my room.  Piled on bunk beds and beanbags, we spent our last few hours together.  One by one the group staying behind said goodbye to the five people leaving.  With sad hearts, I hugged Cal, Carlos, Meghan, Evelyn, and Kelsey goodbye. 

           

Repeated Loss

            At the end of a long emotionally taxing day, my roommate, Stephanie and I laid quietly in our beds thinking about the friends that left or would be leaving.  As we listened to the sounds of the new arrivals wondering the halls, she turned to me and said, “We are going to have to do this every three weeks?  We are going to experience this repeated loss?” 

Context

Group Planning Work Shop & Planning for a Care Giver Group

            Over the past few weeks, Safe Line has grown more confident in my abilities as a social worker and community worker.  I am fluttering around the office planning a children’s group, caregiver group, activities booklet, updated their brochure, and a staff work shop.  Though I feel stretched, I am really enjoying the opportunity to incorporate my own ideas into the group work. 

The District 6 Museum

            The District 6 Museum is located on the edge of the almost barren former location of the sixth district of Cape Town.  The museum was formed to commemorate the destruction of an under served, but well connected community under the apartheid government.  The policies passed under the apartheid government lead to the destruction and displacement of a historically connected community based on skin color and hair texture.  These families were moved miles out of Cape Town to various Town Ships or informal settlements. 

            The goal of the museum is to attempt to capture what has been lost as well as give those families the opportunity to share their experiences both good and bad.  When you first step into the museum your eyes go to the canvas map of the community on the floor.  On the edges and streets of the map there are family names, addresses, poems written by former community members.

            Around the community map, the walls of the former church are covered with aging snap shots of families and friends who lived in District 6.  The photographs, street signs, and artifacts depict a vibrant and real community.  There are photos of women cooking together in kitchens, a bride, a man shaving, and other captured pieces of daily life in lost community. 

            As I wondered, I came upon a photograph of a family who lived in District Six in the 1950’s.  In the photo, each of the members holds a content smile and stand in a cobble stone street.  Under the photograph the capture reads, “The Petersen Family”.  

Quotes of the Day

 "It's like a bungy jump in my mouth."
"Licking through the pain to euphoria"
- Scott on the Charley's Bakery's cupcake & brownie. 

Carlos:  "That's Qaitlin-y"
Me:  "How would you define me in verb form?"
Carlos:  "Ummm...I don't know kind of like a cute, artsy, hippy thing?"

Umntu Ngumintu Ngabantu: A person is a person through other people

A Young Life Lost

            Today a little boy died.  He was five years old.  He was found in the township of Nyanga by a health worker and brought to the public hospital.  For about a week, he was treated for severe malnutrition, AIDS, and all the other symptoms that come from being neglected.  He was marked by the hospital social worker as  “without family”.  He was placed in a bed in the Peds section of the hospital.  His limbs were grossly under weight and he was unable to keep food down the first few days.  The CCS intern, placed at the hospital, was shocked by the little boy’s condition. 

            She shared her experience with our close-knit group.  Last week, we all pulled together to lend her support when the boy was brought in.  She elegantly coped with witnessing the pain of this young human being.  With each day, she pushed to comfort him and encourage him to keep some food down.  By the weekend, she was reporting that he was keeping food down and able to keep his eyes open.  She asked me to look into activities that might help him feel more comfortable.  With hope, she and I researched art therapy techniques for children with terminal disease and unique mobility needs.  We were both working on creating a list of activities that might make this little boy feel loved and hopeful, but no amount of planning can prepare you for heart break. 

            After picking her up from the hospital today, she informed us that the little boy had passed away.  I could see the tears in her eyes.  She had worked so hard to be more than a doctor in training.  She had worked to give the little one a sense of belonging.  Even now, as I write, I can feel a pain in my own chest.  A pain that makes me remember other young people that have died.  A pain that leaves me wishing that I did believe in an after life. The sort of pain that comes from loss….the loss of a unfinished life. 

Reflection on Difficult Moments

            Though I have had many successes this week, there have difficult moments.  Many of the people in the house faced challenges at their placements this week including witnessing a child dying of AIDS and neglect.  I, myself, have been haunted by stories of incest, rape and the atrocities faced by humans around the globe.  Our group had to come together this week to process these unbearable realities.  With the help of our supervisors and one another, some of us were able to talk about our experiences at placement.  Though I was quiet during the session, I reflected on how in the past few weeks I have been pushed and challenged by statistics, accounts, and my duel identity of tourist/social worker. 

            As a young person, I knew I wanted to work with people.  I wanted to help all young people have the opportunity to have happy safe lives.  With this ideal, I have aimed to become an effective social worker.  But many times, my own beliefs about human kindness are faced with darkness.  The sort of darkness that wakes you up at night when you see it in others or in yourself.  When I am faced with this darkness, I find myself standing in a gray area that stretched farther than I can see. 

            When I find myself in the gray abyss, I think about my challenges and my strengths:

            I am challenged by each account of pain.

            I am challenged each account of betrayal. 

            I am challenged by my own memories. 

            I find strength in the little wins.

            I find strength in running it off.

            I find strength in talking with others and journaling.

            By the end of the day after long talks and take out Sticky Toffee Pudding, our group pushed through a horrible day to a pretty good night. 

The Week End

Rhode’s Monument and a winding walk

            Our quartet headed to brunch on Saturday morning at the Rhode’s Monument Café.  After a beautiful, but rainy hike, we shared an amazing meal.  Over Eggs Benedict, Scones with clotted cream, Cappuccinos, and my lone espresso, our group shared intense ghost stories.  With each bite, sip, and story I began to see the complexity hidden behind the beautiful faces of my newfound friends. The sadness of our stories and the warmth of each other left me with an aching feeling in my chest.  The type of ache that leaves you with the feeling of being both hopeful and sad.  After leaving brunch, the sun broke through the cloudy sky of Cape Town lighting our trail down. 

            We hiked down Devil’s Peak to the University of Cape Town’s School of Dance fundraiser.   Unfortunately, we stood in line only to find out that the fundraiser performance of the Black Swan was sold out.  After our group disappointment we strolled through Rondebosch and stopped by a used bookstore.  I happily perused the poetry section and found two collections of South African poets for 43 Rand ($ 6.14).  Maybe I should facilitate a poetry session with my 13-year-old youth group? 

             With my new treasures in hand, we went back to home base. 

Professional Development

Professional Development

            As usual, the Safe Line office was buzzing with clients, office chatter, and the ring of incoming phone calls.  Through the ringing and conversations in both Afrikaans and Xhosa, I researched, planned, and discussed group activity ideas with the staff social workers.  After a week of planning, I completed my children’s group plan on Thursday afternoon.  My plan was divided by session and theme.  Under each session I included the outline for the session including activity descriptions, a supply list, and the purpose or goal that session. 

            I printed off a copy of my plan and handed it to Safe Line’s director.  The director slowly sipped her tea and looked over the plan.  As she flipped through all ten pages, she asked me to explain certain activities or crafts.  At the end of the plan, she looked over at me and told me that she loved my plan.  She said that she was interested in how I wrote my plan and asked me to host a staff training session for this coming week about group planning and using art therapy.  I left the short meeting with a feeling of pride and a very very long “to do” list.

            After the staff meeting on Friday and throughout this weekend, I have worked on planning a quick workshop on creating a group plan using a logic model.  I have also worked on making examples of the crafts I am hoping to work on with the children.  I can feel the weekend and time slipping through my fingers, but I can also see a clearer picture of the “Social Worker” me forming.

            Please see attached copy of the Children’s Group Plan. 

                

Sushi & White Wine

            After Friday’s lunch, the CCS home base was quiet.  Most of the crew left that afternoon for a weekend trip around the Western Cape of South Africa.  The remaining three interns and I had stood at the gate to wave goodbye to our friends as their white van sped off.  I knew I would miss the busyness of the group, but I also knew that soon the group would be gone.  Within the next week, all of the group except the remaining four interns would be back in their home countries.  I turned to head back in the quiet house. 

            With an almost empty house, the four of us decided to plan a relaxing weekend together.  For our first “night of bonding” we headed out to dinner.   After our group “foodie” debate on the sunny porch, we decided that we all wanted some good sushi.  We headed out to the small, but posh Wakame. 

            Over white wine and “fashion” sushi, our quartet laughed, shared, and talked until late into the evening.  Back at home we fell asleep piled on bunk beds and bean bags as Julie & Julia played in the background.

Plan, Plan, Plan

Planning for Group Work

            Growing up, I can remember acting in children’s plays, attending drama camp, and being apart of many extra curricular activities.  In all of these activities, the person in charge would guide us through fun games and ice breakers.  As a young person, I had no idea what an important role those seemingly meaningless games played in my development.  The skills and understanding I gained from simple games have given me the ability to work effectively with others. 

            Now, I am shedding the role of participant observer and moving onto the role of facilitator.  Yesterday and today, I have spent my time planning out my children’s group’s sessions.  After going through a pile of examples and literature, picking out and adjusting themes and activities.  As of right now, with little information on the identified children, I have planned for 10 sessions and one final event.  The purpose of the group is to present the identified children with the opportunity to gain and practice coping skills, self-motivation, and relationship building.

            I have planned the sessions around these 10 themes:

1.     Trust and Group Building

2.     Understanding Yourself and Others

3.     Team Work and Relationship Building

4.     Feelings and Stress Relief

5.     Expression Yourself

6.     Your Support System

7.     Self Esteem and Self Image

8.     Supporting Yourself and Others

9.     Your Future

10.  Presentation to Families and Community Members (EVENT!)

11.   Message in a Bottle & Evaluation

            Each session will follow a similar outline including a Check-In, Activity, Short Discussion, Theme Activity, Feed back, and Closing.  The outline will be adjusted according to age group and theme.  My goal is to have all 10 of my hand written outlines processed by tomorrow.  Until then, does anyone have any more suggestions?    

           

Hot Cross Nuns

         On Tuesday night, after a long day of planning and meetings, the crew made our way to University of Cape Town’s Baxter Theater to see Hot Cross Nuns.   Not Your Midnight Mass is a famous South African A Cappella group.  Our crew sat down in the black box theater expecting to see a comedy about nuns.  Well, turns out, that the performance was hilarious, but had nothing to do with nuns.  The group performed songs like Nature Boy, Cannon in D, and Working Class Hero using only their voices.  The group and myself left the theater pleasantly surprised and sore from laughing.

            Throughout the performance, I thought of how brave performers are to put themselves out in front of the world.  I also thought about all of the performers I have known in my life.   To one particular performer and friend I want to say:  Happy Birthday, Nick. 

"Go with the flow even when it is bumby"- Scott, CCS volunteer

 I was back in the field today.  The community team did the child education program or biblio. at Hugueriot Primary in Mitchell’s Plain.  Our team presented the biblio to about 150 children in Grade 2 and Grade 3.  For each presentation, I took minutes, pictures, and helped present on South Africa’s Emergency number: 107.  The lead community worker is beginning to trust in my ability to present information. 

            After our presentation, our group had to wait a long time before being picked up by another worker near Mitchell’s Plain. Once we returned to Safe Line’s Athlone office I had a quick discussion with the director about the children’s groups I will be conducting.  She talked about how the office is still waiting for the school in Mitchell’s Plain to confirm the number of children and the dates, but she wants me to begin to work out my group work outline.  There was discussion that I would be hosting up to five different groups for 10 sessions each.  Though I have already begun to plan the sessions, I am concerned about planning for some many children with a range of behavioral and abuse histories.  I feel that I can’t plan an effective group without talking with the school, building relationships with the children, and conducting a needs assessment.   I sincerely hope that I can gather more information about the youth before I implement my groups.

Weekend Adventures

I visited the Cape of Good Hope.

Cape Point:  Where the Indian Ocean and the Atlantic Ocean meet.

Robben Island: Nelson Mandela's cell is an example of one of many cells on Robben Island that held political prisoners that fought for basic human rights. 

Play Therapy

Play Therapy

            Today, I continued to research and plan for the upcoming children groups.  I found several articles and training manuals that discussed play therapy with children who have been sexually abused.  Play therapy is therapy that recognizes that playing is how children learn about their world, concepts, and learn how to problem solve.  Play therapy empowers children by giving them choices and control through toys, role-play, creativity, and story telling. 

The principles of play therapy are:

1.     Develop rapport

2.     Accept child completely

3.     Free to express

4.     Alert to recognize feelings

5.     Therapist maintains a deep respect for child’ problem solving abilities

6.     Child leads the way

7.     No hurrying the therapy along

8.     Therapists anchors everything in reality

            I also have begun compiling lists of activities and exercises that help individuals build strengths.  Trauma leaves children leaves children with emotions they are not also equipped to express or understand.  Many children withdraw, act out, regress or behave in a variety of ways that are inappropriate for their developmental stage.  Play therapy can help a child feel safe while they relearn or learn for the first time to enjoy being a child. 

The Importance of Knowing the Numbers

The Office

            The day started slow on Thursday.  The director explained that I will receive intake training next week and will begin managing several children’s groups.  In preparation for taking on these responsibilities, I began to review policies and refresh my memory on Play therapy techniques, definitions, and group planning.  I sat in the Auxiliary Social Work room with my colleagues and sipped bad instant coffee from my giraffe mug.  My colleagues enjoy teasing me about how I take my coffee black and how I pronounce their names with my “hard vowel” American accent.  I can tell that they like having me around.    

            While my colleagues chat in Afrikaans and work around me, I go through binder after binder of Play Therapy material, Safe Line Policies, and articles about working with traumatized individuals.  I review key definitions for the various types of abuse: physical, emotional, sexual, neglect, child labor, human trafficking, and structural abuse.  I also review the key physical, behavioral, and psychological signs of Rape Trauma Syndrome. 

Human Trafficking

            Slowly, I work my way through the binders.  I came across one article by Susan S. Creston about human trafficking in South Africa from 2007.  The article compiles statistics from organizations such as UNICEF, IOM (International Office of Migration), and Molo Songololo.  The article states that 12.3 Million people are trafficked worldwide.  About 1.2 million of the humans that are trafficked are children (under 18 years old).  The majority of the people trafficked through coercion, force, and false promises are forced into commercial sexual exploration.  South Africa, like many countries (including the United States), is a hub for human trafficking.  It is estimated that South Africa, trafficked up to 38,000 people in and out of the country in 2007.  I filled up page after page of my Choco Cat notebook with information, stats, advice, and activities until my hand hurts and the bus arrives to pick me up.

HIV/AIDS Workshop

            In the afternoon, our group sat down with the program director to discuss HIV/AIDS in South Africa.  The program director has a background in public health, working with HIV/AIDS organizations, and handling international aide for HIV/AIDS organizations.  Her presentation went over the stats, definitions, and her own experiences. 

            To begin, The Human Immuno-deficiency Virus (HIV) is a virus that invades a human’s cells through blood to blood contact through sex, child birth, and any other blood to blood interaction.   Once infected with the HIV virus, one can live in Stage 2 for years without any symptoms after the Window period.  Eventually, HIV wears down your immune system leaving your body open to infections and disease leading to Acquired Immune Deficiency Syndrome (AIDS).

Here are some quick stats about HIV in South Africa:

·      70 % of the world’s HIV + population live in southern Africa (including countries such as Namibia, Zimbabwe, South Africa, and many more) due to poverty, strain of HIV, migrant work, gender power relations, and high levels of sexual violence.

·      There are 6 million people out of 48 million are HIV + in South Africa.

·      Only 600,000 people are receiving Anti-retroviral Therapy (ART) with 1.7 million in need of ART.  

·      There are 1.4 Million children who are AIDS related orphans living in South Africa.

            The information and statistics above were an important part in helping me to understand what an integral role HIV/AIDS has played in shaping South African people’s lives. With so many middle aged and young people dead or dying from AIDS, the elder generation is taking on the responsibility of taking care of young children and the government is taking on the responsibility of caring for orphaned children.  As our program director said, “The truth is that this is a story of loss”.

           

 

           

Election Day

 Local Election Day

            Today, South Africa hosted its local elections.  All week the news blared and people talked about the election.  Who would win?  The DA or the ANC?  Some people discussed how they would vote other discussed that they refused to vote.  It should be interesting to see who will win Cape Town.    As a result of elections, all work places were closed including all intern placements. 

Table Mountain…..oh wait….

            With no placement, several volunteers and I decided to climb Table Mountain.  Excited about seeing the view of the towering mountain surrounding Cape Town, my partners in crime cabbed it to the specified trail and started our climb.  Some where between gasping at breath taking views, snapping pictures, and talking our group lost our way to Table Mountain.  As far as we can tell, the specified trail was not for Table Mountain, but for Devil’s Peak.  The climb was steep, amazingly beautiful, and about 6 hours long (we originally expected a 2 hour hike).  After a while our group thought we were lost, but found our way back to the main road.  Even with our mix of possibly three trails and sore legs, we had a great time together.  We climbed boulders, took time to enjoy the view, and had a picnic with Auntie Lynn’s sandwiches.  By the end of the day, my feet are sore, but I had a great time.  I guess I will save Table Mountain for another time. 

Take-out

            With elections, the house manager gave our group money to buy ordered in take out food from Mr. Delivery.  We each carefully wrote down our orders, Stephanie tallied the cost, and I called the service with our order.  Of course, after talking with the attendant, I found out that we couldn’t order from that restaurant anymore.  The house exploded in laughter and frustration as we struggled to find current menu and order food.  By 8:00 pm, we had a new list of orders.  I dialed the number and crossed my fingers that this would work……  The attendant picked up and I began our order.  From the start, I had to navigate the list and ask people to change orders after the attendant informed me the restaurant did not serve certain dishes.  After many thank you’s, order changes, and hurried page flipping (Thank you to all that made that happen!) we ordered our food!!!  About 30 minutes later, we enjoyed our feast of Indian, Thai, and Chinese food with only a few order mistakes (my order and one others).  Overall, out food adventure was a good show of team work and what we will all do for good food!

Jump in

Leisbeck Primary

            The community outreach team headed out to Mitchell’s Plain again.  The team had set up a line of presentations from Grades R-3 at Leisbeck Primary.  I was assigned to take minutes and take pictures for Safe Line.  Victoria and another community worker presented the children with information about their bodies, health, and a little about what Safe Line does though activities and songs.   The children sing and follow along. 

            The second graders come into the classroom for their presentation.  The other community worker and I switch places.  She begins taking minute while I sing along to Victoria’s songs and help answer the children’s questions.  Even though I am still learning the words to the songs, I jump and sing along with the kids.  The session goes very well.  I am so happy to finally start participating in the educational outreach program! 

            After we returned to the office, I quickly meet with the director of Safe Line.  She is working on a calendar for me and told me I will be running four youth groups with children identified as having been sexually abused by a school in Mitchell’s Plain.  I am beginning to compile activities and icebreakers to plan a 10 session group for four specific age groups. 

The Water Front

            I had a lovely dinner with several volunteers at the Water Front.  We walked around the bay, went in shops, and had a nice dinner out on the deck.  I eyed a beautiful Ferris Wheel on the board walk as we searched for dinner.  After deciding on a restaurant, I tried some Springbok appetizer and enjoyed some good conversation.