What I Did On My Summer Vacation: The Second Installment of My African Journal

It's been just about a month since returning from a trip to Europe and South Africa--a family odyssey that we'd talked about for many years that, through a trick of synchrony, finally happened. I'm a big believer in the concept Karl Jung developed and every day find some hope and comfort in little coincidences that come together in such a way that I see as the puzzle pieces of the universe snapping together. Not so much in the time frame we'd like to see it happening, but happening nonetheless.

Since my days at the Columbia University School of Public Health, where I worked with some of the great leaders in international public health including the late Dr. Allan Rosenfield, I've wanted to spend time working abroad in maternal-child health, which is my specialty. But with young children, the time just never seemed right to leave them behind for even a short stint, and burden my husband with the role of  a single working parent.

It was our last full day in Cape Town, and efforts to get to Robben Island, the site of Nelson Mandela's political imprisonment, had been complicated by wind and weather that kept the ferry from running. This was  our last chance, and we went to the V & A Waterfront in spite of the fact all departures for the day were sold out. After being turned away, the voice with a lovely British accent stopped us. "I think I can help."

My husband and I looked at each other--scalpers are everywhere in NYC and we'd had our New York radar up for the entire trip. But the woman speaking explained that her youth organization had 65 tickets paid for but only 50 kids from the township on the excursion. Their mission: To show the teens and young adults more than shanties and rubble, and that there is a life outside and they can and should enter it. Sounded great, and the tickets looked real so we turned over the rand and rode the ferry three hours later with a very excited and well-mannered group of kids in green t shirts. Before we got off the boat on Robben Island, Ingrid and I had exchanged cards and agreed to communicate. Some of their needs include dental care services, education for the parents about the dangers of drinking during pregnancy (migrant workers in the vineyards are paid with wine), healthy eating and living in general--all simple projects for a program like the one I work in that does this in the medically underserved areas of The Bronx, using teams of professionals and paraprofessionals in conjunction with community health organizers.

So, now the time is right and after our trip, my whole family wants to get involved in a project to help out in the South African townships.  My daughter and I will be doing a Girl Scout project this year to get backpacks and school supplies to Langa, the township we toured.

Dr. David Appel, the director of the Montefiore School Health Program, anticipated what I was proposing when we met last week and said the magic words, "Let's do it." Now comes the long process of finding linkages, which will likely include the CUSPH, MMC, and some of the contacts I made on my journey, narrowing down the project to a manageable scope, finding funding, and finally, organizing the trip. I estimate it will take about two years to happen, which seems like a long time but one which has been even longer in coming. In the words of my beloved Yoga teacher Ronnie, "What time is it? The time is now."

Cry, the Beloved Country: The First Installment of My African Journal

I've been back a little over two weeks from what I've dubbed my family's three weeks, three continents tour. The latter half of the trip we spent in Cape Town, visiting my son who is doing a study abroad semester at the University of Cape Town.  He's an English major, minoring in International Education and  Education Policy--loving the literature like Alan Paton's famous novel and the work he's doing in class and in the townships.

I've seen poverty right here in America. And in Peru, where people were living out of puddles on highway medians. But something about the gestalt of Cape Town remains inherently disturbing--clearly the after effects of apartheid and its devastating effect on the Blacks and Coloreds (those are terms used in South Africa, not mine) who were uprooted from their homes and tribal lands and plopped down in townships that still exist today. And in those townships, one of which we spent an afternoon touring, there are many people living in overcrowded tin shanties, with dirt floors, little if any running water let alone hot water for sanitation. One woman recounted that when it rains hard, snakes get washed into the house along with the mud, slithering across the same floor her kids put their mattresses down to sleep on every night.

What makes this so disturbing is the curious juxtaposition with million dollar homes, wine estates (that have in the past paid their migrant workers with wine, leading to an epidemic of alcoholism and fetal alcohol syndrome), luxury beachfront resorts with high rise buildings that destroyed the natural landscape,  and upscale shopping malls. Poetic justice that the gorillas are wreaking havoc along the Cape of Good Hope, breaking into homes and cars, venting fury that their natural habitat is gone along with the now extinct black lions, and the waning populations of Cape zebras.

At times I could have been in London, Paris,  New York City or Montreal, with the fusion cuisines and ubiquitous British, French and West African influence until I looked up and saw Table Mountain, The Twelve Apostles, Devils Peak and Signal Hill--then turned a corner to find groups of men hanging out, begging, hawking souveniers. or screaming out windows of mini vans promising us the cab ride of a life to city center or back to the suburb of Mowbray, where we were staying.

Needless to say, Americans are not blameless when it comes to our past treatment of minorities and Native Americans. And parts of our country have pockets of poverty as well. But I'm still struggling to reconcile my feelings about being a "have" as opposed to a "have not" in a land where there are three classes: rich, poor, and destitute.

On a chilly, gray winter day, the residents of Langa welcomed us into their township, their home and their schools-and yes, a shabeen where I drank beer from a communal bucket (even though I hate beer) to show solidarity. And we sprang for the entire tab R20.00, which is about $2.00 US for enough home made brew (it wasn't bad) to intoxicate about fifteen adults.

No one knows what will happen to this fragile, lopsided democracy when Nelson Mandela dies. There is conjecture, fear, and resignation that, without the moral compass that he and other political prisoners and exiles set will be spinning aimlessly when he is not lying in that hospital bed and the daily prayer services and tributes have ended. They're trying hard to build houses on top of the rubble of shanties at townships like Langa, just outside of Cape Town, but more spring up, tacking themselves onto every spare piece of land even if a dirty river with pigs  and chickens wading through it laps at the sides.

My daughter and I will be starting a Girl Scout project to send book bags and school supplies to the children of Langa, so stay tuned. And, as if I don't have enough to do, I'm going to try and organize some sort of nursing, dental, and medical team to go down to a township for a special project focused on women's and children's health needs.

We did spend some time in Europe (Italy, Vienna, and Amsterdam) en route to Africa and on the long road back--hence the three continent reference. And from Johannesburg to the Numbi Gate to Kruger National Park. It was an incredible family journey with multiple flights, train, bus and van rides, reminiscent of the TV show The Wild Thornberries. When we cleared customs at Kennedy, the officer asked how long we'd been away surveying bags full of dirty laundry and souveniers,  including four bottles of wine and an African drum from Mamanapusa.

"Three weeks." I said at 9 p.m. EDT in North America  in our 36th hour of travel, at what felt like 3 a.m. in Africa.

He stamped our passports, each in turn, then pushed them across the counter with a smile. "Welcome home."

Indeed.

The Un-Answerable Question

            Last week at this time, I was hunkered down finishing a mid term assignment for my ongoing doctoral studies on a real life quality management project. Buried deep in abstract organizational and management theory, I struggled surprisingly hard to pull real life quality metrics and benchmarks out of the literature and a myriad of government and accreditation agency publications. Got it done. On time. Over the page limit (as usual). Irritated.

            The next day, the real-life process of quality improvement continued at a late afternoon meeting. Anxious to get home, get my head out of academia and work related problems, I flipped on the radio for a traffic report and instead heard breaking news about the bombs at the Boston Marathon. Zap. Back to 9/11/01 with my heart racing, my mind struggling to comprehend the reality, listening for every tidbit that would indicate it wasn't as bad as it sounded. My mind wandered back to what it was like on 9/11/01 working in the hospital, waiting for the casualties that never came because there were no survivors. The fear, the grief, the helplessness, the anguish. The big question-Why?

            I, along with a lot of my colleagues, have PTSD related to the events of that day. We go into health care to be heroes, to save people, to run toward the screams and the danger—not away from it. But that theoretical desire collides with reality big time in disasters—and my heart goes out to the first responders, doctors and nurses in the Boston emergency rooms who had to deal with all that—plus their own grief and horror as they pronounced the dead and made life and death. decisions in minutes on whose leg needed to be amputated and who got to go to the OR first.

            Coincidently, I am working on a Moth Storytelling based event about my experiences on 9/11 to commemorate National Nurses Week. And I made my home in Boston during my residency, not far from the big Citgo sign I see on all the pictures of Kenmore Square, deserted while the good people huddled in their basements and maniacs lobbed a bomb out their car window and shot anything that was moving. I've always said if there was another city I could live in besides New York it's Boston—and now both have their own sad legacy of terror and its aftermath.

            This has infused even more emotion and reality into my oral re-telling but it re-opened the wounds. It's hard to concentrate, focus, complete anything. I refused to make my son an airline reservation for his European trip that goes through Moscow, wishing he wasn't going at all. I'll pay more, much more, for what seems like a less risky itinerary but who would have thought watching a running race was risky? Who would have thought going to work one day in the Twin Towers would have involved mortal peril?

            One tidbit I do remember from the chapter on management of complex systems is to make some changes, no matter how small. So, I got on the subway yesterday to go to ballet class. The trains were packed with weekend construction disrupting several train lines and routes. I read my book, moved like a robot across the platform from the local to express, one eye on all the bags and backpacks around me. Walked from 86^th and Lexington up to 93^rd instead of from 96^th and Lexington down. No choice—the Number 6 was bypassing my usual stop.

            I danced till my legs hurt more than my heart and got back on the train, sipping water from a bottle, scanning the faces, the bundles, the baggy clothes, the hoodies, looking for anything amiss. Got home and went to see "42" with my family and munched popcorn (loved the movie).

            Meanwhile, Bostonians held vigils for the dead and injured, celebrated the capture of the surviving suspect, and the death of the supposed mastermind. They took back their civilized and cultured city. They will recover. We will all recover. But we will never forget. We can't. We'll keep asking the un-answerable question: Why?

Not Your Mothers Book and Other News From The Nonfiction Front

I've just gotten word that the opening story of my mommy memoir, Karma, Kickbacks and Kids, which bears the same title in on the table of contents for Not Your Mother's Book: On Parenting. This brings the total of stories contracted for this updated and  irreverent and humorous take on the Chicken Soup for the Soul series to two, and I have six other stories on submission there.

This is exciting, coming on the heels of the rave reviews for Not Your Mother's Book: On Being a Woman, which was released in October. Hurricane Sandy nixed my plans to coordinate readings and book signings before the holidays with other local authors represented therein, but hopefully something will work out this spring when NYMB: On Parenting has it's currently scheduled release in April.

Unless, of course, we have a spring Nor easter blow through shattering the already tenuous control we have on the cleanup and recovery and the streets go through their usual springtime collapse after frigid temperatures, snow, tons of salt and the sheer volume of New York City traffic.

But let's be optimistic.

I am in Week 9 of 12, with an intentional capitalization, of a killer semester in my doctoral program, deeply immersed (and often befuddled) with statistical methods and trying to stay on top of the latest health information technology issues for the second course. I live with the realities of HIT daily, interfacing-or facing off-with no fewer than four electronic medical record applications in the throes of interoperability and meaningful use compliance while trying to focus on my real mission: patient care.

To that end, course work has complemented my workplace realities and I hope that my current project will benefit my employer, so generously reimbursing my tuition as well as advance my progress toward the DNP. But I have to write the papers, due in two weeks, first and therein lies the challenge as I have finally succumbed to the virus afflicting so many of my patients and my daughter's classmates--including her.

It will happen because I will make it--and look forward to a long rest after a few all nighters. But I'm looking forward to a brief rest and an easier next semester with only one course to allow me to put the finishing touches on my research proposal. It felt like I'd never finish graduate school either but I did and look at me now.

My fiction writing is on a serious hold, of course, but if anyone wants an update click over to my fiction blog. There are stories in the making, appearances planned in Westchester at the Hilton Rye Town with signings (my nonfiction will be on sale as well) for the weekend of March 15-17. Hope to see some of you there.

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