Africa 2001, Week 5 (or so): Cape Town health clinics, Gay Goth Night, and Tim's sudden goodbye

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Cape Town was the reason we went to South Africa in the first place. Tim had gone to Wharton for grad school and he signed up to join alumni and students of their healthcare management program for a volunteer stint at the city's medical clinics. We built the trip around that. Only later did we learn people call Cape Town the best city on earth.

I’m not sure what all the fuss is about. At the risk of sounding jaded or elitist, what I saw was a hybrid of places I’d already been. Table Mountain, looming over the city like a blockade against the rest of Africa, is like Anchorage’s Flat Top. The gargantuan mall at Victoria & Alfred Waterfront is New York’s South Street Seaport with more escalators. Long Street, the heart of the famed night life, is a bunch of anycity, anywhere bars. They’ve even got seals in the harbor, just like San Francisco. We ate Mexican food, went to a Scottish pub, watched American movies.

Of course, that makes it the best city in Africa.


With Tim’s help, the encouragement of other volunteers, and the hesitant cooperation of the group leaders, I weaseled my way onto the Wharton team. I wanted to meet new people and see areas that tourists fear.

The experience was fascinating. Everyday we went to another clinic in another bad part of town. We heard stories about staff members stepping outside for cell phone reception and getting mugged. Gun shots right outside the door. Even a young mother having her baby stolen.

Patients would begin waiting when the sun came up. The clinics' lobbies were full as soon as the doors opened. Expectant mothers came for medicine to keep their fetus from contracting HIV. New mothers came to get babies weighed, inoculated, and evaluated. Tuberculosis patients came for daily treatment -- the full treatment required them to be there every day for 3-5 months. AIDS victims came for counseling and check-ups until they were sick enough for the hospital.

We monitored patient flow and kept an eye on how much break time the nurses took -- the doctors only come by once or twice a week and only saw the most serious cases. I got called "Doctor" by patients who assumed guys from out of town helping out in the clinics must be MDs (it was about hemisphere and accents, not race -- a black Wharton student was also called "Doctor."). The nurses were all called "Sister," a holdover from work done by missionary Nuns many years ago.

The director of our program had warned us that the scenes would be bleak. Poverty ran very, very deep. AIDS infection rates reached 40%. The surrounding areas were dirty, desperate, and dangerous. The director also told us many of these folks were immigrants who'd come to Cape Town because the situation was even worse where they came from. That was eye-opening.

I spent most of my time monitoring the tuberculosis treatments. Medicinally, it was the same care you would get in the United States, made more complicated by the fact that most of the TB cases stemmed from AIDS. At the time, every patient I watched take a pill or get a shot was likely to die pretty soon. The many alcoholics among them died sooner, because they got too drunk to make it in for treatment every day.

The only patient face I remember was an old lady who was hesitant to drop her drawers for a butt shot in front of me. I looked away and heard her screaming in pain. The nurse told me she screams every time, but only for attention. The shot doesn't hurt much.

The lobbies that were so full first thing usually emptied out by around noon, so we went home. The end goal was to recommend improvements. One example: implement a scheduling system to reduce wait times and fill the whole day with work. That seemed obvious and good, except that none of the patients had watches.

It began to feel academic -- the Wharton students were actually getting course credits for being there -- and I began to question the value of my input. Worse still, it began to feel like work. The second week we were going to prepare a presentation of our findings and ideas. There was no way I was spending a week in Africa doing Powerpoint.

I sincerely thanked the Wharton folks for letting me participate and announced my departure. Nobody seemed to mind. I think the program leader was pleased that I wouldn’t be around to jeopardize the school’s name anymore. The students were envious of my impending freedom. I was upset that I would miss their scheduled dinner with Desmond Tutu (I heard later they all got to meet him, and it was a bit like meeting Santa at the mall).

Right around the time I made my decision to leave, Tim got word that his cousin had lost a long, one-sided battle with testicular cancer. He briefly pondered what to do – should he stay, could he stay, could he get home in time. It wasn’t much of a debate. Family wins. He booked a flight back for the next morning and we set out for one last great night.

There was dinner with the Wharton crew, and several hours of drinking and amusement listening to an all-percussion band at a bar/restaurant called Mama Africa. We bumped into folks we’d met earlier in the summer. We chatted with new people. The band stopped, the women went back to the hotel, and Tim and I joined three other Whartonites on a quest for the legendary late life of Cape Town.

I suggested a bar called the Purple Turtle, though I don't know where I heard about it. Everyone there wore black and had long hair and pale skin. Men in leather pants had no shirts. People on the dance floor swayed slowly, heads bowed, arms dangling, to thrashing heavy metal. There were few, if any, women. We got out of Gay Goth night quickly.

On the hunt for somewhere better, a street kid led us to a bar he promised would have women. The line was long and filled with men, and the cover was high so the kid took us to a place with no cover, no line, and a whole lot of young, attractive women in tight clothes and heavy make-up. It didn't take long for us to realize it was a whorehouse. We called it a night, fearing the pending hangover.

Tim left for the airport at 8AM. Within 30 hours he was giving his cousin's eulogy.

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