Rachel Miller's reflections on volunteering and VSL in Zandspruit

It’s hard for me to believe that my two weeks in South Africa have come to a close so quickly. The saying “Find a job you love and you’ll never work a day in your life” has never seemed more valid.

This trip has made me think very soulfully about life and our purpose on earth. Life is a blessing; it is a confusing gift we must all sort out. At the end of the day, I always return to a phrase I was raised with: tikkun olam (pronounced tee-koon oh-lohm). It is a Hebrew saying, meaning “repairing the world” or “making the world a better place”. My experience in South Africa has reinforced my passion for acting on this central belief.

Acts of kindness and a common HOPE for a brighter tomorrow can make all the difference in the world. As Americans, we get so caught up in our “first world problems”. I, myself, have been known to complain when the air conditioning is broken or a restaurant has overcooked my steak. In Zandspruit, a place where most homes are simple tin shacks and the bulk of families cannot afford to eat three meals a day, people hold their heads up high and walk with smiles stretching across their faces. These people laugh often and relish in the beauty of the little things.

Children playing at Emthonjeni

 

 

 

 

 

 

 

 

This past Thursday, Tsholofelo (our field officer)and I hosted an interest meeting to introduce *VSL to the community. One particular attendee was David Nesengani. He is a pastor from Healing World Ministries here in Zandspruit.  His stoic presence was heart-warming as he sat through our meeting, front and centre, expressing his gratitude in careful English:

“Your work here truly makes a difference in people's lives. This is what is important. It is about people coming together and working together to better ourselves. Project HOPE is a very fine organization and the people will be very grateful for your work. I encourage you to have more one-on-one sessions about VSL with people because it is such a good thing.”

Another person named Solomon attended with his wife, Dorah. He spoke of forming a VSL group comprised of pensioners to help them manage their money, since they only get paid once a month. He told Tsholofelo in Sepedi, “thank you for bringing such a program to Zandspruit. It will help us pensioners to manage our money.”

A few of the attendees of the VSL meeting. David is on the far right. Solomon
and Dorah are behind him.

 

This, my friends, is what it is all about! Project HOPE touches lives. We bring HOPE and opportunity to places where it is difficult to find. I have never felt more proud to be a Hopie.

Sincerely,

Rachel

*My reason for coming to SA is to introduce a new program to the HOPE Centre: VSL, which stands for Village Savings and Loans. VSL is an economic strengthening methodology that helps people save money, make profit on their savings, and take out  loans. Groups of 8-15 people are formed and HOPE trains them on the methodology throughout a cycle (about 1 year). Each group also elects a Health Activist we train on varying applicable health matters (ex: diabetes, nutrition, diarrhea, HIV, etc). They, in return, provide the newly learned health education to their group. At the end of the cycle, the group’s money is shared out proportionally,  based on how much each person saved, and they then have the opportunity to continue with a new cycle in which they will be able to operate independently. VSL offers a form of insurance in  places where people often do not have money stored away for a rainy day,. We hope the program will complement our existing ambitions of improving people’s health and access to healthcare, thus continuing to increase their standard of living.

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VSL in South Africa - Rachel Miller's Blog

I arrived in this picturesque country on Saturday February 2^nd. Ten days later, I am thrilled to report on the work I came here to accomplish.

 

The Setting

Rachel and Tsholofelo at the Hope Centre

A township called Zandspruit, about 30 minutes from Joburg. Currently, Stefan is running a wonderful program focusing on diabetes and hypertension. The staff here are incredibly hard workers and it is evident they are proud to be Hopies. *Our Project HOPE t-shirts are the envy of the community!* The office here is part of Emthonjeni Community Centre which consists of: our HOPE office, a community bakery, a crèche (nursery school), and of course the clinic. The middle ground has beautiful trees-some that explode with exquisite pink flowers- and lots of green grass. The best part is: in the afternoon the lawn fills with giggles and songs from the little ones just out of crèche. Even though we sit in a poverty-stricken community where most structures are tin shacks, the HOPE Centre offers an atmosphere of beauty and (fittingly) …hope.

 

VSL

Rachel training local nurses and community screeners about VSL

My reason for coming here is to introduce a new program to the HOPE Centre: VSL, which stands for Village Savings and Loans. VSL is an economic strengthening methodology that helps people save money, make profit on their savings, and take loans. Groups of 8-15 people are formed and HOPE trains them on the methodology throughout a cycle (about 1 year). Each group also elects a Health Activist which we train on applicable health matters (ex: diabetes, nutrition, diarrhea, HIV, etc). They, in return, provide this health education to their group. At the end of the cycle, the group’s money is shared out proportionally based on how much each person saved, and they then have the opportunity to continue with a new cycle in which they operate independently. In a place where people often do not have money stored away for a rainy day, VSL offers a form of insurance. We hope the program will complement our existing ambitions of improving people’s health and access to healthcare.

 The Work

Children of Zandspruit

My first full week here I spent my days working in the office 8-5, eating a quick dinner, and working from home into the night. There is quite a bit of planning and preparation that goes into launching a successful VSL program. I had fun creating colourful flyers to hang around the community and hand-outs to promote our public interest meeting. A slew of other documents were important in the preparation phase. We interviewed several people for the job of Field Officer (the person that will train the groups and supervise after I leave). We hired a spunky young woman named Tsholofelo Mathebula. She laughs often, works hard, and is proving to be an excellent promoter of VSL. This week, I am spending my days in the field (yay!)- trekking around the slums with Tsholofelo and talking to community members about VSL. Although my arms look like lobsters from sunburn, I am loving every second. Responses have been quite positive- people are very interested in making the most of their money. I often receive stares, because it’s weird for a white person to be walking around the township, but I have only been met with welcoming arms. The children love to have their pictures taken and are a big fan of the fruit snacks that Cheryl Smallwood sent them. 

 

The Next Step

The “next big thing” is the public community meeting which we are holding this Thursday. In addition to Tsholofelo and I promoting on foot, I also trained the group of community screeners who are attempting to screen 1,000 people for diabetes and hypertension this week. Now, they have a basic understanding of VSL and a handful of hand-outs to give out to their recipients. We hope a nice gathering of people will show up on Thursday to learn more about VSL and form groups. After that, I will head home and leave the groups in the capable hands of Tsholofelo and Carol Diplock (another spectacular HOPE employee here).

Tsholofelo talking to commuinity members about VSL 

Conclusion

There are a million more things I could talk about, but I am amazed you have even read this far! I will conclude. I have been involved at headquarters for over three years and am impassioned every time I learn something new about a field program. I feel so privileged to play a role in one of these special programs. It is a glorious confirmation of HOPE’s outreach and impact. I am grateful for this opportunity and so thankful to every person who made it possible for me to be here. Here’s to hoping the VSL program will see great success!

Cheers from a proud Hopie,

Rachel

Rachel training Tsholofelo on evaluations

 

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Day 1 - Orientation in Zandspruit

Jo Burt and Dottie Newsome, volunteer nurses from Utah, USA are here in South Africa for two months to help with the HOPE Centre Program. They will be posting frequent blogs about their adventures...

Dottie Newsome and Jo Burt arrived in Johannesburg from the U.S. on Saturday January 19 ready to embark on their two month volunteer placement with Project Hope, South Africa. After a weekend of acclimatizing to Johannesburg and a warm welcome from Stefan Lawson, Country Director for Project Hope & his family, the real work for Dot and Jo began:

Monday morning came very early with the time change and jet lag, but we were excited to begin our adventure!  We travelled to the Project Hope offices and Hope Centre Clinic where we met the staff and the new Community Health Workers (CHW’s) who were beginning the latest Health Screening Project with us.  The staff are great and Lebo who is the trainer for the CHW’s is fabulous.  We spent the morning with the teams and did orientation with them.  There are 10 CHW’s and they are extremely excited to be working with Project Hope. 

We spent time with Stefan learning more about the project and what our specific responsibilities would be and then we met with Carol , the Operations Manager, H.R. Director and ‘jack of all trades’ who further oriented us to the community. She was a wealth of knowledge and made us feel very welcome and helped us understand roles and details about our stay. 

For the afternoon, we verified screening competency of the CHW’s.  Competencies included measuring for: height, weight, abdominal circumference, BMI, random blood glucose, and Blood Pressure in each arm.  The staff were great and passed off the skills learned with confidence.  We divided in to our teams and each team was assigned an area of the community to conduct the screenings in.

Then home to our apartment.  We were pretty tired and glad to get home, but took advantage of the beautiful weather and went walking around our neighborhood for a while.  I am afraid that we were in bed fairly early.

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Time to take a dose of my own medicine!

So I have a confession to make. The past few weeks I haven’t been feeling particularly well. Lots of headaches, dizziness; in particular when working out at the gym; sometimes feeling like my heart is going to explode out of my chest.

To put this into some sort of context I run a large scale, community based diabetes and hypertension program on the outskirts of Johannesburg for Project HOPE. As the boss of a team of ten staff, I try to be a role model to them and to the hundreds of patients we see monthly. Part of my role is to educate patients on the signs and symptoms of chronic diseases such as diabetes and hypertension, tell them how they can improve their lifestyles which will in turn improve their health and either reduce their risk of getting one of these diseases, of help improve their control of the disease.

I know what range your blood pressure should be in, what it does to your body when its too high, what uncontrolled sugar in your bloodstream can do to your eyes, nerves, and kidneys. I’m no expert, no doctor, but pretty well versed in these things as its my job.

So maybe you can see where this is going? After lots of putting it off I  make an appointment to see our doctor at our local private clinic. I go and explain to the doc my symptoms, thinking that its low blood sugar as its happening at the gym (I don’t eat before working out). She knows what I do for a living so we talk, she takes some blood and then I go lie on her couch for my blood pressure reading. “Stefan”, she says, “your blood pressure is 160/110!” “Ahhh,” I say, putting all the pieces of the puzzle together in my head. She tells me that we will wait for the blood results, not to exercise for the next couple of days and see her a few days later for a repeat blood pressure reading.

The next couple of days bothered me. I was wondering why me? I exercise 4-5 times per week. I am not obese, but ok, could stand to lose a few pounds if I am honest. I may drink 2-3 beers per week. Have no immediate family history of high blood pressure. Sure like my food, but love fruit, eat veg and if I am honest have a fondness for MacDonald Big Mac burgers! I also started to think about epigenetics – was there an environmental occurrence in-utero that could have impacted my kidneys which predisposes me to greater risk of high blood pressure? I then start thinking about what my blood test results will be – what will my fasting sugar be like – please God, its got to be preferably below 5.6 mmol/l and definitely below 7.0 mmol/l.

I go back to the doctor with a splitting headache – probably more stress than anything. We go through my blood results – I recognize most of them as we carry them out on our patients at our clinic. They are all normal. I go lie on the couch at she takes my blood pressure again at its still 160/100. So, to my surprise I have been diagnosed with stage 2 hypertension.

We go sit back at her desk and talk about drug options. Hypertension has been classed as a chronic disease, and if you look at all the literature, the majority of people who start medication for hypertension don’t come off of it. We settle for a combination drug – HCTZ and a beta blocker and a check up in three months time to see if I can come off the medication.

So you might be wondering what the big deal about all this is? Its not like I am going to die, have a really serious illness that’s going to kill me soon. In fact many people in my situation would just and do, resign to the fact that they have high blood pressure, take their medicine and continue with their lives.

Well for me, being an educator I want to see if it is actually realistically possible for me to follow the advice that we give our patients and see if I can improve my health. There is nothing like a dose of my own medicine.

After some research, I decide that it would be good to lose 10kg to begin with. That will take me from 100kg down to 90kg – a 10% weight loss which according to the American Diabetes Association should see improvements in my health. I will follow the DASH (Dietary Approaches to Stop Hypertension) diet – voted in the US for being the healthiest diet to follow by the National Institutes of Health. The basic premise of the diet is to reduce the amount of sugar that you eat – simple carbs, eat healthy fats, lots of starchy vegetables, some fruit and lean protein. If you eat carbs it should be complex carbs – brown rice, whole wheat bread – but still in limited amounts.

Will I make it? I am not sure, but I will give it a good try? Are you in a similar position to me? Would you like to make some lifestyle changes that will see improvements in your health in 2013? Let me know, maybe we can go down this road together - slawson@projecthope.org

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Project HOPE US Board Visit and Dinner

A couple of weeks ago now we had the privilege of hosting a delegation from our Project HOPE HQ in Millwood, VA as well as representatives from the Project HOPE Board.

This team led by Dr John Howe, President & CEO of Project HOPE did a three country two week intense visit with the aim of getting to understand the various programs that Project HOPE runs on the Africancontinent.

We had the privilege of hosting the delegation for a couple of days here in Johannesburg where they were able to come out to Zandspruit and visit our program, get to know our staff, take a tour of Zandspruit on foot to appreciate the complexities of township life as well and to meet with some of our patients at the HOPE Centre clinic. They were also able to visit the City of Joburg Masakane clinic and see some of the challenges that are faced there on a daily basis

The day was a wonderful success with the delegation leaving having a much better understanding of the scope and size of the program and the immense need for Project HOPE to work in Zandspruit and the surrounding area.

After a long day in the baking sun, we all went back to the Hyatt Hotel in Rosebank where Project HOPE hosted a dinner event attended by 100 senior executives who represented all but a couple of  international pharmaceutical companies working in South Africa, government, the NGO sector and academia. The aim of the evening was to highlight the work that Project HOPE is doing around the world in non communicable diseases as well as to specifically talk about our baseline survey findings from the HOPE Centre program here in South Africa.

Very rarely does an event like this occur, and as the diabetes world is fairly small and people usually move from one company to another it was like a big reunion for many attendees!

Dr Howe gave the opening address where he talked about our long history with working together with corporate organisations to improve the health of disadvantaged communities - some of those relationships are over 50 years old.

Ms. Sandhya Singh the Director for Chronic Diseases, disabilities and geriatrics at the National Department of Health shared with us the governments strategy for how they will go about tackling this growing problem of NCDs here in South Africa.

Professor Rheeder then came up and shared our baseline findings from our initial community survey and screening days. If you would like a copy of this then please contact me and I will be happy to post a copy to you.

I then closed off the evening sharing some of the real challenges that diabetic and hypertensive patients face living in a township like Zandspruit.

The dinner was a roaring success with many opportunities now to follow up with companies who would like to come and see our work in Zandspruit and potentially partner with us in the future.

If you would like to come and visit our site please do not hesitate to contact me at slawson@projecthope.org

Thanks for reading!

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