TIK AND TOOTHLESSNESS

(part diary , part reflection, part searching)

TIK AND TOOTHLESSNESS

The community service year took my husband and I to Tygerberg hospital on the Cape Flats.The other side of Cape Town- the side that isn't featured on inflight magazine articles. The Cape Flats refers to that flat part of land on the side of Table Mountain opposite to the ocean. This is the anti-Longstreet, the un-Gardens, allocated to Coloureds and Indians during the apartheid days. It was everything that the Cape Town suburbs weren't: sparse , dry ,sandy and interrupted by industrial plants. Gangsterism reigned proudly, low-grade drugs were rife and teenage pregnancy was common. A suburb in the Flats , Cravenby, has the dubious honour of having the highest incidence of TB - in the the world. It was a place that could suck theadventure out of relocating to Cape Town. If it wasn't for the view of the Table Mountain that I savoured walking to work each morning, I would have sworn that we were living in a run-downsuburb back in Gauteng.The Table Mountain - a living, breathing character she was. Her temperament fluctuated like a pregnant lady. On some days she was warm and receptive as the sun reflected her in a welcoming light and on other days she was broody, melancholic and harsh as the clouds embraced her, subduing her.

To my husband and I the Tygerburg deal sounded like an all-round decent package: a family sized hospital quarters apartment for R700 a month was probably less than the rent charged for a home in the housing projects, and with an opportunity to explore white Cape Town on the weekends - we were sold on the idea.

Tygerburg hospital was at the junction of Coloured Cape Town and Afrikaner Cape Town. It was on the line of the 'Boerewors Curtain'. In Cape Town these racial demarcations seemed very distinct with a cordial but well delineated interaction between races (at most times). If I haven't mentioned Black people, it's because they were clumped together in overcrowded settlementslike Gugulethu and Khayaletsha. Coming from working in the heart of Soweto where informal settlements were a mainstay, I was surprisingly appalled and poured unfettered scorn and self-righteous piety on the concept that was the settlement of Khayaletsha : shacks were stacked on top of each other - something like a mini-version of the Brazilian favellas. The settlement extended for kilometers blocked off from the mainroad by a porous concrete fence - with just enough space to voyeuristically peek inside and just enough security to feel separated from it.

The Tygerburg Hospital building stood as a testament to apartheid's clinical (yet morally depraved) practicality. The hospital stands as two interconnected buildings which are mirror images of each other. Legend has it that during apartheid days one side was used for white patients and the other side was used for the 'others'. But those were just memories now in this post-apartheid South Africa where we are all brothers (as long as everyone knows their place).Racial tensions were more evident to me in Cape Town than in Gauteng. The Afrikaner Specialist dominated : he ( occasionally she) worked with efficiency and commanded the respect of his juniors. Most of the nursing staff were Cape Coloured and rallied around the doctors with reverence that I've never witnessed- before and since. Many of these nurses were harsh in their disrepect towards the Black staff who were often treated as incompetent and bullied. And if thereis anyone that you don't want bullying you, it is a Registered nurse.

I value working in a community different from my own. As a doctor you have the privilege of being let into that private space of an individual - physically and emotionally. Such insight into people and their condition is invaluable. The pulse that I picked up from the community around the Tygerburg hospital was a fatigued resilience. It was truly a tough life. Unemployment was rife and a survivable poverty existed. Working in paediatrics, I found that many of the mothers were young and often single. A fair amount of the babies were born to drug addicted mothers -posing the challenge of drug withdrawal for the newborn. In light of all this, births continued,young boyfriends occasionally came to support their girlfriends who had just delivered their baby and mothers loved their newborns - intensely - almost all of the time.

(more to follow - depending on time and inclination)