Back Row: Carrie Graham, Alyssa Hughes, Daniella Abelard, Cindy Bravo, Cynthia Tetteh, Maeve Maloney, Zuleika Candelaria;
Front Row: Chivelle Blissett, Leslie Rivera, Deborah Delianne, Eddie Woollacot

Welcome . . .

On May 10, 2013 ten eager students and their director Carrie Graham arrived in Cape Town to begin what is sure to be an amazing four weeks. The University of Connecticut’s Service Learning Study Abroad in Cape Town is designed to facilitate greater understanding of South Africa’s troubled past while providing opportunities to witness its vibrant hope for the future. While living, learning, and working in one of most beautiful settings in the world, students are placed at various service learning sites while participating in classes intended to help contextualize their experiences, expand their horizons and develop a deeper appreciation of what it means to be a global citizen.

As anyone who has been to Cape Town can attest, there are no words or pictures that can begin to adequately capture the beauty of the scenery or hospitality of the people here. Therefore, this blog is merely intended to provide an overview of the program and a glimpse at some experiences of students participating in this first ever 4 week "summer" program. Once again it is a privilege and honor to accompany a wonderful group of UConn students to a place I have come to know and love.

In peace, with hope, Marita McComiskey

Tuesday, June 4, 2013

Maeve's invaluable experience at Tafelsig Clinic

My service learning site is the Tafelsig Health Clinic in the township of Mitchell’s Plain, the largest colored community in Cape Town. The clinic sees over 500 patients a day for tablets, BANC, club dates, family planning, psychiatry, TB clinic and any general complaints (and I do mean any). On an average day, patients start queuing outside the clinic around 6:00 am. The clinic opens at 7:30 am and madness ensues. Club patients are those who have an appointment with the doctor. All patients see the doctor every 6 months for a full checkup and to have their medicine adjusted if need be. There are specific days for certain chronic illnesses such as diabetes and hypertension. While the patients wait to see the doctor, the nurses or students (us!) give a talk about risk factors for these diseases and prevention methods with an emphasis on exercise and healthy eating. When patients are done with the doctor, they bring their script to the pharmacy/chemist. They join the long lines of people waiting for their tablets. This line includes patients who are there only for tablets who give their card to the pharmacy and wait while their pills are counted and bagged. For most patients they have a date once a month when they pick up their tablets and the pharmacist initials to indicate that the patient hasn’t defaulted. BANC patients are those in maternity care or young child care. Family planning is the sister who sees patients for birth control, condoms and HIV testing.

Anyone tested for HIV will also be tested for TB because of the high incidence of the two together. (The same is true if someone comes in for a TB test; they will also be tested for HIV) TB testing is done in the TB clinic where patients will give a sputum or spit sample to be sent away for analysis. For every patient, two samples are taken an hour apart. The two samples have to be stapled together in order to be sent for the new TB testing which can tell if someone has TB or is susceptible before they even feel some of the symptoms. To confirm TB diagnosis, an x-ray will also be performed at the day hospital. On the x-ray the doctor looks for white patches in the lungs which can be signs of the disease progressing. There are two types of tuberculosis: pulmonary and multi-drug resistant (MDR). MDR TB occurs if someone comes in contact with someone else who has MDR TB or if they default on their medication from their first round of pulmonary TB. What impressed me the most with the TB clinic was the in-depth counseling for every suspected TB case and confirmed case. There is a flip chart presentation which describes what TB is, how TB can be transmitted, what the treatment plan involves and the importance of healthy eating while on the medication and beyond. For the first patient I sat in on Sheena, the TB counselor, told me to give the talk on healthy eating because she noticed I’m always eating healthy at tea time and lunch time. (Turns out all of the nurses have taken note of this)

The standard TB treatment cycle is 6 months: 2 in the intensive phase and 4 in the continuation phase if the sputum comes back negative after two months. The important factors in changing to the continuation phase are weight, compliance with treatment and sputum results. One of the main symptoms of TB is weight loss so the patient’s weight is closely monitored to ensure weight gain while on treatment. Compliance is a big part of the decision because the patient must continue medication even if they feel better. During the first two weeks of treatment, the patient must come in every morning to take their medication so the doctor can sign off. If the patient completes this then they are given medication in two week intervals and must initial their card saying they took their medication. At the two month mark the patient must bring in a buddy who vouches to handle the medication and administer it each morning. Throughout this time a community care worker goes to the patient’s house to do a pill count, ensure the patient is taking their medication and that the living environment is safe. This integrated treatment is key to their success at curing TB patients and was something I’m very grateful I had the chance to experience.


There’s something so powerful about knowing how to help someone with anything and solving people’s problems to give them peace of mind. They leave knowing they’re being sent somewhere to be helped or were given something to help them. And the doctor is the person with the knowledge to do this. What I appreciate most about the doctor’s, however, is their humility. They acknowledge when they don’t have all the answers and sometimes they ask for advice from clinic members considered beneath them or are taught a new procedure from a sister. And the patient trusts the doctor with their health anyway. In the US, doctors don’t falter on their diagnoses and their opinion is presented as fact. Because of this, asking for a second opinion can be seen as an insult to the first doctor who may have showed signs of incompetence. Medicine is always changing and you might not be as caught up on a new policy as someone else, but the willingness and openness to learn is so much more powerful than ego. Something else I really like is the bluntness of the doctors and sisters. There are no excuses allowed and they tell the patients exactly what they’re thinking. In the US doctors are concerned with hurting feelings and are sure to be delicate when talking to patients for fear of offending someone which could get them sued. Here, if the patient smokes they’re given a stern looking and a scolding with “shame” used at least three times. If the patient is diabetic and had 6 sugars in their tea this morning, “shame, shame, shame, why would you do that when you know you’re coming to the clinic today?” If the patient has hypertension and is overweight they’re told to lose a certain amount of weight before their next visit because being fat is affecting their health. Patients have been told they’re killing themselves with their current lifestyle, they’re going to have a heart attack or a stroke, or they’re a walking target for health problems. There’s no sugarcoating in this clinic; clean up your life or something bad is going to happen, end of story. Honestly, it’s a refreshing attitude that I am not accustomed to hearing and I still chuckle a little when the doctor scolds a patient. Overall, we’re getting invaluable experience that we wouldn’t come close to having access to in the US. My days at Tafelsig will stay with me for the rest of my life and maybe, I’ll be back here some day in the future after I’ve completed my schooling and have the confidence to really make a difference down here.

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