‘I wish a long life to my enemies so they may see all my successes.’
These framed words hang on threadbare cloth, the only insulation covering corrugated walls of a tin shanty in a township outside of Cape Town, South Africa. Sprawling Kayelitsha, a million people strong, is a frightening place. Plastic bags cram undulating crevices where ‘wall’ meets roof, inadequate protection from the icy winds that rush from the South pole. There’s no running water, nor sanitation. The door, while appearing sturdy, has no lock. Men enter randomly staring with flat hostility, assessing, tension rising like a brittle stick bent too tightly – you anticipate the break, before it happens. Into the lull, the slow, quiet voice of the Mentor Mother, guiding the woman breastfeeding, ignoring the male filling the doorway, belligerence ricocheting off the walls. I drop my gaze, waiting. He leaves.
The women talk in soft Xhosa clicks. A bed – the only seating – dominates, fitting snugly against three of the hut’s walls. The young mother at the head, at the foot, her pre-school daughter, legs tucked away, unmoving, but for huge litchi-pip eyes, tracking her mother, the two Mentor Mothers, and the baby. I’m the fifth female. I have no task. I feel fierce and hopeless. Inadequate. So I mirror the little girl’s stillness, willing myself invisible, an interloper in a private moment.
The mother is learning to breastfeed. Her baby so small that when the infants many layers of clothing and swollen diaper, long past-due for changing, are removed, the skeletal body is shocking. The howling neonate is placed on a quickly constructed scale. Wearing scarf, gloves, leather jacket – I’m chilled to the bone. The babe screeches its resentment – but the nakedness is necessary to assess weight gain – a positive sign of thriving. Thandeka, Senior Program Manager, encourages the mother. Despite the emaciated body, the baby prospers, gaining weight steadily since the Mentor Mother first encouraged the mother to switch from formula to breastfeeding. Since women are ranked so low in Africa, the mother doesn’t believe she has anything worthwhile to give her child. Newborns are believed to have the best chance of survival if fed formula – a falsehood. While in the West, babies thrive on formula, it can be a death sentence in Africa, where clean water is scarce. Formula when mixed with un-sanitized water, leads to diarrhea. For low weight babies, that often means death. Diarrhea is the highest cause of infant death in South Africa.
As we inch over the potholed roads teaming with loitering, unemployed men, laughing children spill from school. The streets appear nameless, making it hard to tell one from another, the huts having a numbing similarity that’s endlessly replicated, districts incongruously called Miami, Beverly Hills, New York. The contrast of the monotonous tin ‘neighborhoods’, to their namesakes, heart breaking, indicating aspirations and optimism of people with few reasons to be.
A rapid-fire disagreement breaks out in Xhosa, resolved by retracing our route. I recognize children playing tag, so query the reversal. “Areas have given way to drug dealers,” Thandeka explained. “Since you are not African, it’s not safe for you. Its faster to go through, but I don’t want to endanger you, so we’ll bypass it.” “Why aren’t you endangered?””Everyone gets ill sometimes,” She shrugs, “even drug dealers. When they do, they know we’ll help them. They leave us alone.”
Raising my iPhone to tweet as we park, she cautions. “Don’t. It makes you a target.” We traverse paths so narrow, my hands touch shanties on either side. Soon there’s nothing but corrugated iron walls in front and behind. I walk faster, passing the first woman, and am called back. “Stay between us,” comes the advice. We burst into an intersection, people lounging, doors open, chatting – springing upright – startled at the tall skinny caucasian looping past their homes.
Drugs are administered at the home of an HIV mother, to combat the disease, and protect her breastfed infant from infection. The mother’s immunities in such depressed conditions, are invaluable. When Mentor Mothers first encounter HIV+ women, trust is an issue. “Stigma causes fear. We show we are here to help, not judge.” Malnourished children are visited weekly, then monthly, as the child improves. Monitoring continues until government schooling begins at age six.
The Philani Maternal Program believes every child and mother has a right to access good nutrition, health and education. For 30 years it’s offered clinic based services to women and children, empowering women to initiate income-generating projects, and provides early childhood education. 70% of women are unemployed and often single mothers. Fewer than 20% of the children have an opportunity to attend pre-school. Of the malnourished children Philani reaches, 50% are rehabilitated within six months.
Philani’s task is not to take on the problem of a family, but to help them find their own solutions by sharing knowledge and skills. Once invited into a community-in-need, they recognize ‘positive deviants’, women who despite their poverty, have raised healthy children, an invaluable skill they teach their peers. After a six week course Mentor-Mothers conduct hands-on in-field training with coordinates who map a neighborhood, identifying resources like schools, clinics, playgrounds and social services, which equips them to assist those under their care. Training includes generalist healthcare and practical skills like weighing babies, plotting growth charts, mixing oral dehydration solution, and intervention. After a written test they are paired with supervisors and enter the community, often gaining access under the auspices of weighing the baby, they assess homes for physical, sexual, and drug abuse, besides malnutrition. Mentor Mothers graduate to coordinators, providing self worth and empowerment, but need debriefing due to the intensity of the poverty, illness, abuse, neglect and addiction they encounter.
Mentor Mothers teach socialization, encouraging play and bonding. Young, alone, uneducated, and unprepared for parenthood, teaching a mother to show love is one of the most basic and rewarding tasks. Nonqaba Melani explains, “I tell them they don’t have to buy love, they can give it, then children won’t seek love elsewhere – falling pregnant, or contracting HIV.”
Playgroups develop vocabulary in their native tongue and English. Improvisation of toys – footballs made of rags, or plastic bottle caps as educational tools, allows a richer experience in one void of opportunity.
A study on the effects of Mentor Mothers by UCLA and Stellenbosch University, show women benefitting from the program were more likely to use condoms, breastfeed exclusively for 6 months, adhere to protocols for prevention of maternal-to-child transmission of HIV, and correctly administer ARV treatment during, and after birth. Alcohol consumption by pregnant mothers was reduced. In impoverished areas like Kayelitsha, these achievements are crucial in ameliorating Society’s health care costs, giving children a chance to compete, by providing nutrition during the most important time of brain development; empowering women on micro and macro scales.
Inside the neat turquoise walls of Philani, I lay next to the slumbering children who had an advantage, merely by being part of Philani, and met women whose cottage industry produces simple jewelry, (that gets queries of admiration from the entertainment crowd at premieres), aprons, table clothes, and bags.
Departing Philani in the darkening sky and icy rain, I felt such optimism at the will of humanity. On a continent where women often lack power, here was a grass roots enterprise that was for women, run by women, empowering women. They didn’t need to be told to ‘lean in’. They were living it. Overcoming their obstacles, taking charge, self actualizing, benefitting society, and setting up the next generation for a greater chance at success.
Published: 03/18/2015. By Margaret Gardiner
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