Vegetable Gardens

Drew Wallace, a volunteer from the US posts his final blog before going back home...

Time goes by way to fast. It feels like I just got here in South Africa, and already its three weeks later and I’m leaving. I’ve learned so much while here, it’s been an experience completely unlike anything I have ever done before. My whole life has been spent inside the U.S. and this is the first time I have ever been outside that shell of American middle class comfort. As much as Project HOPE and South Africa has given me in terms of experience and unfailing hospitality, I hope I was able to give back just as much of my time and effort to help get the HOPE center ready to see patients, and start to make a positive impact in this community.

While here, I was able to finish up a few different types of gardens, and make instruction booklets for each one. With luck and a little sunshine, the plants will take root and grow, and start producing healthy foods, and maybe inspire some of the HOPE center’s patients to try making their own gardens, and be able to eat a little healthier, and manage their conditions a little better. I wish I could stay around just a few weeks longer, and get to see the fruits of our labor here in South Africa, see the first patients walk through the doors of the clinic, hopefully see the first vegetable gardens start to pop up in the township, but life and school gets in the way, as it so often does.

Anyways, so long South Africa, I hardly knew ya but you taught me so much, I hope I was able to give a little back. Maybe someday I can return, time willing. I know I certainly want to.

 Project HOPE is an amazing organization, and I’m proud and ever grateful that I got the opportunity to volunteer with them. I’m certain that they will make a gigantic impact for the better in this community and I wish them all the best in the future operations of the HOPE center.        

Thanks Drew for all your hard work! If anyone would like to come and volunteer with Project HOPE here in South Africa please contact me on slawson@projecthope.org

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Cosmo City Screening Day

Drew Wallace, a volunteer from the US, blogs about his first screening event in Cosmo City...

 One of the biggest problems with chronic disease care in Africa is the lack of diagnosis. Most people with diabetes don’t know they have it until they start to develop acute symptoms, blindness, foot ulcers, etc. What we are trying to accomplish with screening days is to identify people who are diabetic and pre-diabetic before they start to exhibit symptoms, so that they can then manage their condition, and never develop some of the problems that arise when diabetes and high blood pressure go too long undetected. At the screening day, people take about 5 minutes to get tested, and if their results show they have diabetes or high blood pressure, we can refer them to a free government clinic to receive treatment or to our  own HOPE Centre Clinic, which ever is closer for them to get to.

                                                                  

One of the great things about South African health care is that medicine is provided free by the government, but the diagnosis and management system is woefully underdeveloped. To highlight this of the 110 people we screened in Cosmo City we found over 50% of people were either overweight or obese which increases their risk of developing diabetes, and 70% of people had hypertension. We also were able to diagnose 7 people with diabetes who came to us with dangerously high blood glucose levels.

Hopefully, through screening events like this we can get more people to be aware of their conditions, and encourage them to stick with their treatment plans, to live healthy and full lives.

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First Impressions - Blog from Volunteer Drew Wallace

Drew Wallace, a volunteer from Virginia, USA is here in South Africa for the first time helping Project HOPE South Africa set up its nutrition program as part of the HOPE Centre project. Here is a blog about his first impressions....

So I guess it would be appropriate to start off with a bit about me. This August, I’m going to be a sophomore at The College of William and Mary (Go Tribe!), majoring in International Relations, with a minor in premed focused kinesiology.  I have always been interested in global health and wellness around the world, but in all my 19 years of life, I have never been outside of the continental United States. Sooner or later, this would need to change if I wanted to pursue my dream of helping people around the world lead healthy lives, so I jumped at the opportunity to volunteer with Project HOPE South Africa.

When people think of health problems in Africa, they generally think of infectious diseases, HIV, Malaria, etc. but in actuality, Africa, most specifically South Africa, has the world’s fastest growing diabetic population, and diabetes, as well as the heart conditions associated with diabetes and an unhealthy lifestyle, is the leading cause of death in South Africa. What Project HOPE South Africa is trying to do is establish comprehensive, across the board care for diabetic and hypertensive patients in Johannesburg’s poorest neighborhoods. My role more specifically, is to help develop a nutrition and exercise program, trying to get more people to grow their own vegetables to supplement their diet, and replace fried meats and starches, as well as get out and exercise in the very limited space they have.

Getting off the plane after a 15 hour flight, your mind really doesn’t register that you are now in South Africa, the airport could be in any metropolitan area in the United States, there are no giraffes, no zebras, no lions, just a typical airport terminal. Large parts of Johannesburg would fit in most anywhere in the first world, if not for the ever-present security fences and armed response signs, a constant reminder to this isn’t the suburban Virginia I’m so used to. The contrast becomes even more apparent when you get into the townships, informal settlements like the one the Project HOPE office is located in. South Africa, especially Johannesburg is a country with intense dichotomy, on one side of the road you could have a first world shopping center or a beautiful golf course, on the other side, a village of corrugated metal shacks crammed together along narrow unpaved allies.

The challenge now is to show families how they can grow healthy food in the limited space they have, in order to manage their diabetes. To do this we will be building a variety of demo gardens, and putting together instructions on how to build them, so that diabetic patients can better manage their condition with proper exercise and nutrition. I’m really excited for this opportunity to help out, and hope the new clinic can make a great positive impact on the community!   

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When is it OK for Chronic Illness to be normal?

When is it ok for chronic illness to be normal? This is something that I have been pondering for the last few days, but it first came up when I used to live in Mozambique. There are certain chronic illnesses which unfortunately result in people suffering pain and other disabilities with very little that can be done. However, there are other conditions where this does not have to be the case.

When I lived in Mozambique, I stayed in a Malaria endemic area, and over the course of a couple of years suffered from multiple bouts of the disease. The first time I got it I remember the crippling headache, fever, lethargy like an extreme case of the flu. After I had taken my medication for about a week I felt much better and continued on with life as normal. Yet I clearly remember the subsequent bouts of malaria were often not as crippling - yes there was a fever and a headache, but because of work and other commitments I often couldn't take time off and I would soldier on through. Then it began to hit me. What if everyone was feeling like this? What if the many people who had malaria, had a constant headache, felt tired, but because of pressures to just survive,  pushed on through without taking time off to go to a clinic and queue for a test and rest at home. Would this feeling over time become the new "normal" forgetting what it was like to live pre-malaria?

Fast forward almost 9 years and I am sitting in Zandspruit, South Africa wondering exactly the same thing. We are screening people of diabetes and hypertension. We've come across some patients with blood glucose of 37 mmol/l or 666mg/dl, another patient with 27 mmol/l or 486 mg/dl. Many patients had blood pressure of over 160/100 mmHg. In fact over 35% of patients have had an abnormally high blood sugar reading.  One of my first questions I ask these patients is, "How are you feeling?" Often the response is tired, headache, blurry vision, sweating a lot, having to use the bathroom frequently. My next question is "Are you aware that you have high blood or high blood sugar?" Some patients say yes, whilst others say no.

This one patient situation typifies most. He had a very high blood sugar and blood pressure level. He knows that he is diabetic and has high blood pressure. He used to take the tablets, but he doesn't anymore because he didn't think they worked, they ran out, and he couldn't take time off work to go to the clinic and queue all day to get another prescription.

So, when is ok for chronic illness to be normal? Have patients simply forgotten what it was like to "feel" energetic and headache free? Do people soldier on feeling like this because in their minds there is no other option, or is it because they don't know any better?

The answer is NEVER. It should not be acceptable. You and I would most likely do everything we possibly could to feel better again. But we are the lucky few, where barriers to quality healthcare are few and far between. 

 I suspect for the patients that I met in Zandspruit, the reason that chronic illness has become 'normal'  is a combination of living on the bread line trying to make end's meat, and the absurd inefficiencies, lack of care, education and other barriers that they face at government clinics that leads to a sense of hopelessness and acceptance of feeling ill.

My hope is that as we slowly break down the barriers in the community, reducing wait times at clinics, improving patient self care, reducing blood pressure and blood sugars to a manageable point, these patients will feel so much better, more productive, able to do things they haven't been able to do for years, that they will advocate for improved quality, improved access to preventative screenings like the ones we are doing.

Over the coming weeks Project HOPE in partnership with Eli Lilly, The University of Pretoria, Empilweni Nursing College, and other community stakeholders will continue to hold screening days to make people aware of these conditions, and then will be able to refer them to our HOPE Centre clinic where they will receive  proper care and attention and hopefully very quickly begin to see drastic improvements in their health.

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Diabetes and Hypertension Screening Day in Zandspruit

Setting up our testing station

Project HOPE South Africa as part of the HOPE Centre project, funded through the Lilly NCD partnership held its first diabetes and hypertension screening event in Zandspruit on Saturday 16th June 2012. Despite a freezing cold day and recent service protests in the community which shut down everything, we managed to screen over 150 people and generated a lot of interest in our project in Zandspruit. 

Nurses registering patients

Screening events like this one are part of our strategy to sensitize and make communities aware of the growing problem of (pre)diabetes, (pre)hypertension in these urbanising areas. In sub-Saharan Africa only 15% of people with diabetes have been diagnosed, meaning the vast majority of people are living with the disease and only presenting at the clinics when complications have set in. By offering free screening opportunities like this one, we are able to catch the diseases sooner, get people onto treatment when necessary quicker and improve patients quality of life.

Our team of volunteer nurses

We were supported by a wonderful team of 13 volunteer nurses provided to us by Empilweni Nursing College in Randburg who helped us weigh and measure patients so we could take their  BMI, prick fingers to get a random blood glucose value, take blood pressure and then provide counselling and referral services at the end. Teams of nurses from the college will be a regular part of these screening days ensuring that we can screen as many people as possible at one go

Patients queuing for the various tests

Homemed, a medical diagnostics company donated all our glucometers, strips and lancets and provided training to the nurses on how to use the glucometers.

Getting a finger pricked!

All the patients that we saw, received education material about the risks of diabetes and hypertension, were educated about their results, and where necessary were referred either to the government clinic for an immediate follow up, or to Project HOPE's clinic for a re-test in 3-6 months time. This is  a really important piece of the puzzle. Many times patients receive tests, but because nursing staff are over stretched they do not have the time to sit down with the patient and explain thoroughly what the numbers mean. Project HOPE is using a very simple, yet effective stop light system approach so the patients were able to see if they were in the 'Red' or danger zone, 'Yellow' or warning zone, and 'Green' or healthy zone. 

Project HOPE will be screening in Cosmo City this Saturday the 23rd June, and then again in Zandspruit in August. Over the next couple of years we will be repeating this on an regular basis.

Check back next week for pictures of our screening event in Cosmo City!

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