An introduction to Epukiro Pos 3
Thursday, April 30, 2009 at 4:26PM Day four in Epukiro dawned with two hours of torrential rain and a sky that hung low and grey as I sat out on the step of the porch eating my toast and watching the two dogs, Choppy and Trixie, play. There has been very little to write about since I arrived. The nurse, Anna, was not here when we arrived on Monday afternoon and nobody seemed to know where she was. In the end she was tracked down to Windhoek which is where we had just come from. She arrived on Tuesday early evening and so two days were wasted with nothing to do but hang around the house or take a walk around the ‘town’. I wandered into the small general store on one side of the main street (there are only two streets, but one has the main services and facilities) and found its shelves empty apart from the most basic commodities. Imagine the shop in 'Open all Hours' minus 90% of the stock and the same grumpy owner and that would be about right. The other general store across the road was a replica of the first. Apart from bag upon bag of sugar, a meritable supply of cheap cigarettes and various dried commodities there appeared to be little else. No fresh fruit or vegetables, no fresh milk and no bread. Both the bottle-shops were closed (which had been the main purpose of my stroll) and had also been closed the day we arrived so this didn’t help my humour much either. If I was to be stranded in this out of the way place and giving my time for free, I at least expected to be able to have a beer in the evening while shaking my booty (at a distance) to the music coming from the local shabeens (bars). But even that modest expectation seemed to be eluding me.
There are about one hundred and eighty buildings in Pos 3, all mostly small and single storey and in the main residential though the community does have one or two council offices and there is a sizeable state medical clinic just two buildings up from the Lifeline Clinic. The community is poor, that much is immediately evident and there is little work so during the day there are lots of individuals, male and female, just hanging around on the street chatting and passing the time of day in whatever shade they can find. As I wander up and down the two main streets I am clearly an object of interest and I feel the gaze of groups of people following me down the road and children run up to touch me then run away screaming or laughing. The two roads which make up the town run parallel for about 200 meters and then loop around. I stroll along, taking in the surroundings and buildings. Litter is strew across the roads, trapped in the wire fences and even hanging in the trees and I wonder how the townspeople can just sit and look at it with no apparent desire to clear it up. A few of the homes are well looked after and painted in jolly colours and some effort has been put into keeping a few flowers or plants in the garden. But you don’t have to walk much further until you hit the ‘wrong’ end of town and the buildings become dilapidated, windows are broken or cracked and gardens are overgrown and unkempt. This is the area with the loudest shabeen and as I walk past it, at 3pm, it is already busy and the music pounds away in the background. I feel slightly nervous as I get nearer and I have a chance to turn around and go back the same way I have come, but I keep my nerve and continue on round the loop and whilst I get some curious glances and various people go out of their way to pass me and say hello, there is no particularly overwhelming sense of threat. I’m not sure I would walk this way in the dark though.
It’s interesting that in such a tiny community that there is still a ‘bad’ side of town. There are about four shabeens and they compete with each other for a cut of the very small population which probably accounts for the level of music which they pump out all through the day and into the early hours of the morning. On the evening of day two, bored and fed up, I was sorely tempted to take a stroll down and grab a beer at one of them, the novelty of watching TV again having worn off. But living in Pos 3 is a little like living in a mini SA township and we’ve had clear instructions not to go out at night and always to lock the compound gate after us so I decided that common sense has to prevail and I remain in the accommodation dreaming of all the things I was going to do in Swakop – eat an icecream sundae, get a manicure and not have to hang around for hours waiting for something to happen or for someone to be ready to take me somewhere.
The clinic is in the same compound as the accommodation and Kat (the volunteer doctor) and I have been wistfully gazing at it from the volunteer house and have even walked up and stood with our foreheads pressed to the door peering through the glass to see what was inside. We finally got into the clinic on day 3 and as we wandered around it looking in all the rooms and cupboards there were cries of oh and ah as we came upon things we didn’t expect to see – a better than expected pharmacy and clean and tidy treatment rooms. A small admin office and two examination rooms run along the left hand side of the building and then in the centre is the reception where patients register before they sit and wait their turn to see the doctor. Behind the reception area is a family planning area (not used), a dressing room (for dressing wounds that is) and the pharmacy. An eye centre appears to have plenty of equipment but isn’t used though I note that a report done by an earlier volunteer on the visual acuity of the population makes a number of recommendations, none of which appear to have been implemented or at least aren’t currently.
The clinic has not been manned since the 6 April and so patients start to arrive early, in groups of 2 or 3 and from all around the district. The Bushman don’t do anything alone it seems and so everyone who arrives seems to have with them various friends and family to support them or it appears just to gossip or laugh with while they wait their turn. Most of them are women and have various children with them, either in a sling on their back, on their hip or trailing along behind them. The women are small and slim, too slim which is down to the lack of food than any fashionista desire. The children are not badly ill and they get seen in turn by Kat who reports that respiratory and gastro problems seem to be the most common. The differences between the Herero people in the town (big, confident, well dressed) and the Bushman who appear to be fairly marginalised and live on the periphery (small, thin, uneducated, badly dressed) is marked – you can tell straight away which is which – and this is useful because the Bushman get their medication free and the Herero and Ovanga need to pay a (nominal) fee. The Bushman women wear eclectic outfits. They wear whatever they have which can be any combination of colours, patterns and fabrics and they always have a wrap of some kind on their heads. Some of the younger girls – aged 14/15/16 have a fun dress sense which is a marvel given how sparse their wardrobes seem to be but they make up for it with creativity and sass and have spent time on their hair and sport some wacky and individual styles. They also wear lots of the beadwork that they make and which is one of their few trades and they aren’t afraid to wear it in profusion around their necks, wrists and ankles. It really does look very exotic against their black skin and I have made a note to buy some before I go back though I am not sure it will look quite so exotic on me, especially once I have lost my tan.
But in reality there is very little for me to do here and my time is too valuable to spend ten days as a receptionist, especially when I think about the opportunity cost of being out of my business. The clinic is not very busy – we only saw 19 patients on day 1 - and so the reception duties can easily be handled by Anna. Not having more medical experience and any formal qualifications really works against me here and there are not enough patients and they are not ill or injured enough for the need to do triage or take first stage patient histories. I find myself therefore kicking my heels, getting bored and trying to find useful things to occupy myself but which require the need for at least some level of nouse.
I’ve been asked to conduct some research while I am here on the understanding and knowledge of contraception, HIV and Aids within the community using the clinic patients as the sample. This requires questions to be translated from English into either Afrikaans or Bushman and so I have been allocated Elsie, the young Bushman cleaner as my help. She is twenty two though looks and acts much younger but her English is good enough and she can pick up things reasonably well. But her temperament is not quite right , I am not always convinced that her translation of the answers is right and when I query what she is saying - she tells me that a 54 year old woman post menopausal women still uses contraception - she just looks at me and shrugs and she appears and disappears like a ghost so I am always having to walk around the clinic or look outside to try and find her. But she has rather been thrown in at the deep end in helping me and normally just cleans the floor in the clinic. She has been chosen because she speaks some English and also Afrikaans and Bushman and I sense that she wants to help and is enjoying learning and having some sense that there is more to life than living in a plastic house and sweeping floors in a clinic but her lack of formal schooling and her culture impacts on her reliability and I have to keep reminding myself to be patient and to work around her idiosyncracies, afterall, I have plenty enough of my own.