Monday, October 12, 2009

Man at the Side of the Road

I have finally started work at the Desmond Tutu HIV Foundation and am really enjoying it. I'm working under Dr. Katharina Kranzer on a study of undiagnosed TB among HIV positive people. She is in the early stages of data collection, and my duties are basically to manage the data flow. This includes going into the field and assisting with interviews,  overseeing data entry staff, and managing and validating the database. The Tutu Tester is a mobile voluntary testing and counseling unit that goes into the townships. People can come to the tester and meet with nurses who test them for hypertension, diabetes, and HIV and counselors who provide pre and posttest counseling. All people who are either known to be HIV positive or newly diagnosed on the Tutu Tester are invited to participate in the study and are asked to give a sputum sample which is used to test for TB.

My first day out with the Tutu Tester crew was a memorable one to say the least. The day I went out, they were testing for a program called Man at the Side of the Road (MSR). If you drive out of the city, it's not uncommon to see groups of men sitting at corners. At first glance, it looks like they are just hanging out. What they are actually doing is hoping for work. Men gather and sit on the sides of the road and at intersections and wait for someone to come hire them. For instance, if you were moving, you could pull up, grab a few of the men to move your things, and then pay them whatever you see fit. It's not the most stable or reliable source of income, but it's something.

We traveled quite a ways to the outskirts of a township called Philipi. I wasn't really sure what to expect and pretty much nothing could have prepared me for what I was about to experience. We pulled up literally on the side of the road in the middle of nowhere. There was sand for miles and a few small dunes with some weeds, but that was pretty much it. Once we pulled up, about 50 men seemed to appear from nowhere. We could only serve about 40 of them, so unfortunately there were some men who were turned away. As part of the MSR program, the men receive R75 ($10.71 USD) once they have completed their posttest counseling. The purpose of the incentive is to compensate them for their time and basically pay them slightly more than what they would have made if they had worked for the day. Off in the distance, I noticed a group of four women walking down the road. As the afternoon went on, two of the women actually came over to the testing van and said something in Xosha. All the men laughed, and the women walked away. Once they were gone, one of the testing crew explained to me that the women were prostitutes, and they told the men that they would be up the road but the men must show their papers stating that they tested negative before they could purchase! Talk about being where the action is!

I sat in with one of the nurses and helped with a few of the tests, but I didn't last very long. The day didn't go as well for me as I had hoped. I'll spare you the details, but out of nowhere I got very sick. It would be just my luck to be sick, in the middle of nowhere, with no bathroom in sight! One of the nurses was really sweet and walked with me down the road where there was a security shack. After some pleading, the guard let me use her bathroom but wasn't happy when I asked for toilet paper. Oh well… luckily I made it through the day and was fully recovered after about 2 days :o) For many reasons, this is not an experience that I will soon forget!

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