Helping the Sick in South Africa

February 1

As I write this, it’s eight days almost to the minute until I step on the plane to Africa. For me, who has barely been to a place without a flushing toilet, it’s a big step.

Paul Gertsmann in KwaZulu-Natal

Last February, five classmates from Evergreen’s America Abroad program headed to South Africa to volunteer with local non-governmental organizations (NGOs) and do research related to their community involvement. Faculty member Sam Schrager accompanied them, spending time with each of the organizations where his students worked.

One student, Paul Gerstmann ’08, spent three months as an intern with the Strelitzia Trust AIDS Hospice. South Africa has the highest number of HIV-positive people in the world. Out of a population of 47 million, an estimated 5.7 million are living with the virus that causes AIDS. Nearly a thousand South Africans—both young and old—die each day from the disease. More than a million of the country’s children have been orphaned by the pandemic, which has profoundly impacted virtually every facet of South African society.

The hospice is a small rural clinic nestled in the foothills of the Drakensberg Mountains in KwaZulu-Natal, a predominantly Zulu province, which has been hit hardest by HIV/AIDS, with at least 40 percent of adults infected. Gerstmann has a simple answer for what motivated him to go to the hospice, which attends to the orphans, the sick, and the dying from surrounding villages: “I wanted to do worthwhile work.”

February 7

As an advocate, my job will be to basically help out the AIDS Hospice by ferrying supplies and patients from the little township I’m staying in to the big city of Johannesburg. One day a week, I’ll don a pair of slacks and a button-down shirt and spend a few hours in the local school, teaching kids English. I’m told I’ll also teach some basic sex education. But my biggest role sounds a little peculiar: I’m helping AIDS patients get birth certificates.

Paul Gertsmann with scientific beaker

Not surprisingly, the internship proved to be “a huge challenge.” Gerstmann’s main job was to help patients get through the often-daunting bureaucratic process necessary for obtaining identification documents like birth certificates, which are required to receive life-saving treatments and support. Medical care in the region is substandard and the logistical and socioeconomic hurdles to combating the deadly disease are high. He also faced the additional difficulty of not being fluent in the native tongue. “I learned Zulu on my feet,” he says.

March 9

For three weeks now I’ve been reading about AIDS and the Zulus, and I’ve been working with AIDS patients. I’ve seen enough sick people for a crack team of medical anthropologists.

Sofi Ntshalintshali, the founder and director of the hospice, praised Gerstmann’s efforts. “He learned how to negotiate in often difficult and delicate situations to attain the information, documents or health care required,” she wrote in his evaluation. “He was present to the individual’s need in any moment, putting the needs of others before self. He has shown great courage in walking into a variety of situations without the knowledge, language and often support to achieve an outcome, with confidence and enthusiasm.”

March 12

I spent today in and out of schools. I met a principal who’s terrified that if his school shows students how to use condoms, they will start having sex with everyone they can find. Then he complained to me about teen pregnancy rates.

Schools here would get more done if the teachers demonstrated how to unroll a condom. Teen pregnancy and transmission of HIV would both drop. There. Now everyone knows my politics.

It just occurred to me that I’ve chosen the least sexy way to study sex.

Drakensberg Mountains

During his internship, Gerstmann lived at Cosmos Farm, which accommodates the hospice’s foreign volunteers. When he could spare the time—and get Internet access—he posted to his “Greener in the Bush” blog, and completed his final project analyzing the ways that AIDS has damaged not only the Zulus’ health, but their community and culture. Gerstmann “went about his fieldwork with care and compassion” Schrager notes, and conducted “a remarkably insightful ethnographic investigation of the cultural dynamics of the AIDS epidemic in this rural area, using the experience and relationships he developed in the community.”