The Abortion Entry

If you know me well, you knew this was coming. Maybe you didn't know it was coming. This post isn't meant to be controversial in anyway or start up moral debates.

On Tuesday we had a lecture on abortion in South Africa in my Gender and Health course. Prior to the class, we read two studies that the guest speaker, Jane Harries, had conducted: one on health workers' attitudes on abortion and the other on delays in seeking abortion until the second trimester. She also recently did another study but is having trouble finding a publisher. As one might imagine, it can be difficult for researchers to receive support in examining abortion.

It's impossible to cover everything that I learned in one entry, so I'll try to summarize my thoughts (all of the info is coming from her presentation and studies. Email me if you want more detailed info). First of all, South Africa has some of the most liberal abortion legislation in the world. This is a recent development that occurred in 1996; prior to that it was very restricted. Most of the rest of African nations still have very restrictive laws on abortion, which leads to unsafe, illegal abortions. Approximately 68,000 women die every year from illegal abortion and many more are injured, often permanently. Keep in mind that abortion is an extremely safe procedure when done in a legitimate medical setting, so the liberal laws in South Africa have saved thousands of lives. Abortion is available on demand in the first trimester of pregnancy, though it is more restricted in the second trimester (only for pregnancies resulting from rape or incest, fetal abnormality, life threat to the woman carrying, or if the woman can prove low income status). Abortions are also FREE in the public sector. Yes, free! In the U.S, first trimester abortions cost about $300-$700 depending on where you are, and second trimester procedures can be $2000-3000. Something else exciting is that "mid-level" providers, such as midwives, are allowed to perform first trimester abortions here with MVA. (By the way, abortion rights are increasingly under attack in the U.S. If you'd like to learn more and support abortion access in the U.S., please click here).

Something surprising was the high percentage of South African abortions that occur in the second trimester. Later term abortions are relatively rare in the States, but here they account for 20+% of all abortions. Harries' study on delays in seeking abortion covered most of the same issues I've heard from women back home, so I haven't drawn a conclusion myself for why there are more delays here.

Probably the biggest shock for me was that medication abortion is very commonly used for second trimester procedures. Back home, it was offered to nine weeks at the latest, and to seven weeks in the FDA approved version. Here, a woman in the second trimester can be admitted to a hospital, administered medication, and then waits it out until she passes the pregnancy. To me, I can only imagine that that is a very difficult, painful (physically and emotionally) process for the woman. I would really love to see a study on women's experiences of second trimester medication abortion (I believe that is what Harries' latest study examines, so I am going to try and get my hands on it!).

Overall, despite the liberal legislation, there are certainly problems with the implementation. When the most recent legislation came out in the nineties, very few doctors were trained or prepared to offer abortion services. Also, the stigma of abortion often keeps providers from getting training even when they are seeking it out. Most disheartening to me was to hear that there isn't much pre or post abortion counseling being given to clients, and that includes contraceptive counseling. I wish there were some type of organization to offer these services, even outside of the clinic setting, like CHOICE or Exhale back home. Giving women safe spaces to discuss their health, particularly with a professional, is something that I am very passionate about. I wish I could find away to be involved with such initiatives here.

I'm going to leave the abortion portion of this entry there. But if you have questions or want more info, leave it in the comments or email me (disrespectful anti comments will be removed, so please show courtesy!).

Some updates in addition to all of that...we now have home internet (thank you, Thomas)! Schedule your skype call with me when you have time!

I've been a bit of a hermit this weekend after a bunch of classmates and I went out on Thursday to celebrate handing in our first paper. Tonight, I am going with my friends Bob and Ozie to some type of church gala dinner thingy. I have no idea what religion it's for, so it could be interesting! But it should be fun. Tomorrow night, Thomas gets home for a couple of days (yay!), so we're planning on possibly going to beach and also going out with the MPHers on Monday. I'm also going to try to persuade him that we should buy our couch this week!

Missing y'all!

Thar She Blows!

Hello folks,

Oh what a day. This morning, while the Telecom guy was here to install our internet (hooray! however, we won’t be totally up and running for at least a couple more days), the wind blew one of our balcony doors open (which were locked, by the way) and shattered the glass in one of the four doors. At the time, I was downstairs letting the guy out to check the box. At the sound of broken glass, I went upstairs to discover it!

The wind has been very, very strong since last night. I was loving it since we finally had a nice, cool evening, but obviously this is the downside. I have to say, our landlord was amazing about it—it’s already repaired. Phew. I couldn’t figure out what actually broke the glass, but the repair guy said very likely it was just a direct result of the wind. Geez.

Otherwise, it’s been an uneventful week. Studying, catching up on laundry, etc.

 I finally started that dreaded history paper and have a decent chunk complete. To prep, I read some of our professor’s (Howard Phillips) book UCT: The Formative Years. It was actually a really interesting read, especially as a student. When UCT first started training doctors, they were only able to provide the first year of medical school and then students would travel overseas to complete their studies. In 1920, they were able to offer the full program for the first time. It was soon evident that class rooms and clinical space were too limited for the amount of students training, so in the late ‘20s, they moved to a new Health Sciences campus in Observatory, which is where I take classes now! They also built Groote Schuur Hospital specially to be a University hospital, which I didn’t know. It was finished in 1938. I had thought the hospital was older than that.

Something else really interesting (and horrifying) was that originally Indian and Colored (people of mixed race) medical students were forced to complete clinical trainings abroad, as they were not to work in white wards. No one in the faculty really spoke up about it, because it was thought breaking that rule would place the medical program in jeopardy. Because of WWII, in 1943 Indian and Colored students were allowed to do clinical in Groote Schuur, but they weren’t allowed to see White patients—even if they were deceased! Seriously?! Seriously. And even that policy was thought of as liberal! His book says the policy continued until the 1960s, but I’m not sure what changes were put in place then.

Another interesting thing we learned in class was how the outbreak of the bubonic plague at the beginning of the twentieth century followed by the flu outbreak of 1918 (which was devastating…dead bodies in the streets, etc.) led to some of the first racially segregated living. The plague was blamed on dock workers (of color) for bringing it in with their cargo and they were driven out of Cape Town. A similar thing happened in 1918, especially because more and more Black residents were arriving.

I should totally get an A in this class, right? J

I’m working on some Epidemiology right now, since I had to miss class today for the repairs (thankfully this professor had made it very clear that it’s okay to miss class if we need to). Hopefully I’ll be posting this in an hour or so since my plan is to head to Sidewalk Café for dinner and internet! (actually, Sidewalk's internet cut out while I was there, probably due to the wind? So I'm posting this a day late, from another Vredehoek cafe with free internet that I recently discovered).

I’ve been spending so much time alone, it’s strange. Definitely missing my friends and family back home. <3

Saturday Fun

Hello friends!

Apologies for not updating for over a week--it seems that time got away from me! My internet availability is a little patchy as well. This week I won't have much access, but Thomas is working on getting us a home connection so I should be a little more available to y'all soon.

Block classes are officially over! Last week was Introduction to Epidemiology, during which we focused on research study designs. I personally found this extremely helpful since I haven't actually done research before. I think I'll learn a lot from Epi and am excited to work more on the course. For my other classes, I have a couple of assignments come up, some of which I'm more excited about than others. Overall, I am still really enjoying the program and feel it is a good fit for me. School wise, this will probably be my busiest semester as I am taking four courses. Next semester I am planning on taking three and then I'll have to complete three more plus my dissertation over the following two semesters.

I've had more opportunities to spend time with some of my classmates. We're really blessed to have such an enthusiastic, fun group of people. Yesterday, a group of us went on a hike. If you're like Thomas, right now you are saying, "You went on a WHAT?" Okay guys, I know I'm not the most athletic person out there, but I figured the naturally beauty paired with being with the MPHers would make for a good time. And it did!

We went to Crystal Pools, which is near Gordon's Bay, about 45 minutes or so from the city. I got a ride from Eben (South Africa), along with his wife, Aldi and my friend Eliana (US). We left early, which turned out to be a good idea. The morning hike was nice and cool and we seemed to beat a lot of the crowds.

The concept of Crystal Pools is wonderful. You hike about 45 minutes on fairly flat terrain (save some spots where you make climbs up or down) until you reach the first pool. The pools are natural bodies of water and there are about six of them throughout the trail. So, once you finish a portion of your hike and are feeling hot, tired, and sweaty, you get to go for a refreshing swim in a beautiful place. That's my kind of hike!

We stopped at the third pool first. Once you reach the first pool, the next two are not very far, about fifteen minutes more for each. However, the hiking changes to be more steep. This made me nervous, but it turned out it wasn't actually too difficult. Katrine (who is from Denmark, but spent many years growing up in Princeton, as it turns out!), is a seasoned hiker and was really cool about explaining to me that it would actually be a lot easier to come back down the steeper areas than it looked (and she was right!). I was pretty exhausted when we reached the third pool but by the time we decided to hike to one of the higher ones, I was very refreshed and, perhaps the adreneline was kicking in, because I felt fantastic during that portion of the hike. I must've been channeling my dear friend Tamra, because suddenly the climbing and hiking felt wonderful instead of tiring. We had trouble finding the next pool, but I didn't mind. We climbed fairly high up into the mountain, which was probably my favorite part of the hike. Eventually we found our way over to what was either the fourth or fifth pond and we ate lunch and had another swim. Some people were climbing up the rock formations to jump or dive into the pools. Honestly, the pools were pretty deep, so it didn't seem too dangerous...but I'd rather just watch that part. :)

The hike back out was a little less fun, because we knew there was no refreshing pool at the end, haha. However, we made it! We were on the trails either hiking or swimming for about 8 hours and it felt pretty good to have done that. I won't lie, I'm feeling the burn today though!

That night was my friend Bob's (Zambia) birthday, so we went out to a little bar on Long Street. It was a good speed after a long day. We hung out on the large balcony which was very conducive to talking, although there was a live band inside. I got to chat more with Whitney (US) about the time she spent living in Liberia! I can't wait to hear even more about it. I love hearing about places other people have been. Vicarious traveling! I also met some of Bob's friends from outside of the MPH program, and they were just as warm and friendly as he is. Bob is one of those people you can't help but smile around and he brings a great energy to our group. After midnight I decided to make an early night of it and caught a cab home.

This week should be fairly relaxed. Right now I am enjoying a glorious breakfast at the Sidewalk Cafe, which is basically around the corner from our place. Not only is the food delicious, but the presentation is always gorgeous--today, my platter had a huge flower on it which was just lovely. I'm planning on trying to catch a taxi down to a nearby mall, just to browse and pick up a few needed things. Not sure how regularly the taxis run on Sundays, so if that doesn't work out, I'll probably skip the mall (the burn is making me not want to walk too much right now!) and relax at home. I only have Epi this week for two hours, so on the other days I'll be working on assignments and sending out my resume for part time jobs. On Tuesday we also have a meet and greet for graduate students and faculty.

Friday Thomas will fly home so that we can U2 in the World Cup stadium--very exciting!

Lastly, I would really like to know if there is anything in particular you would like to hear about in this blog. Although this is my first time living in Cape Town, it's a place I'm somewhat familiar with. So if there is something you'd like to know more about, please let me know and I will be more than happy to write about it!

Sending y'all love back home.

Pictures!

...are up on facebook! If you don't use facebook, click here. Please let me know if it does not work!

A Day in the Life of a Commuter

I’ve realized that I was awfully distracted a couple of weeks ago when I wasn’t feeling well. Time to take a step back and talk a little bit about living in Cape Town, specifically, Vredehoek. One of these days, I’ll hopefully find a way to upload pictures, but until then, I’ll do my best to describe what I see. I've also talked about some of this before but figured I'd go into more detail.

I wake up pretty early for my block courses—not a problem, since it’s about the same time I used to get up for work. Also, the sun helps wake me up when I sleep with the blinds open. We have a very large window looking down on the city center, or “town,” as I’ve come to call it. In our living room there are glass doors that lead out to a small balcony with a similar view to our bedroom. It’s neat to look out at the city in the morning and know that’s where I’m headed.

There are many neighborhoods in Cape Town (Gardens, Observatory, Mowbray, Green Point, just to name a few) that comprise the city as a whole.  Vredehoek is ours, and it is lovely. We live in a residential area with a suburban feel; when I walk outside I don’t feel like I’m in a “city.” However, only a few blocks away is a Spar (convenience store/supermarket), a bottle store (liquor store), several restaurants, and of course, Natalie the hairdresser. When traveling, the Spar is an extremely helpful landmark—all taxi and cab drivers seem to know it. Pointing out my new home to friends is also easy. When you look up at Table Mountain from town you can see three towers in front of it. We live across the street from the middle tower.

It’s not difficult to catch a taxi in the morning, probably because we live along the route to Spar. I usually wait no more than five minutes for one to come. If you catch a taxi in Vredehoek, they are all headed into town eventually. Their last stop is Grand Parade, which is where I get off, so it’s a stress free ride. Occasionally I’m lucky and we head right into town, but far more often we take a zigzag route looking for more riders. Even with the circuitous route, it typically is no more than a ten minute ride to Grand Parade. GP is an open square in town with some stands selling various wares across the street from City Hall. Across the square is the bus station and another block up is the train station. There are several buses that will get me to Groote Schuur Hospital from where I have about a seven minute walk to the Health Sciences Campus of UCT, where all of my classes are held. The ride from town to UCT (which is in Observatory aka Obs or Obz) on Main Rd reminds me a little bit of my brief experience in the Bronx—lots and lots of shops along main road, all with loud, slightly dirty signs, but none looking terribly inviting.

The Health Sciences Campus is small with only a few buildings. It felt confusing at first, but I find my way easily now. We have our own library with computer labs, including a special room for grad students with wireless internet (haven’t tried that yet!). At lunch, there is a cafeteria which is so-so and a little stand selling Indian food. I tried today and it was quite delicious, although I’m disappointed with the portion size in comparison to what the wonderful woman at UKZN would sell. Anyway, most of the time I bring peanut butter and jelly.

 I’ve pretty much decided on taking taxis all the way home. I usually have someone to ride with and if not, at least it’s bright and sunny out. Main Rd is busy territory for taxis—it seems they pass constantly! I can catch a taxi from school to what I like to personally call Taxi Land. It’s only a few blocks walk from Grand Parade and it is an enormous lot FULL of taxis, parked, coming and going. I could probably also take a taxi from there in the morning, but for only a rand more I can take a bus which is calmer and I can read. These days it’s getting dark late, around 8 or 8:30 and I finish school at 4, so I still have a few hours of daylight when I get home. In a week, my commuting habits will further adjust since block classes will be over and I’ll only have class a few hours per week.

Meanwhile, back at the ranch, Thomas and I are doing swell. He’s not working this week so we’ve had lots of time together and have been cooking dinner together every night. Cooking is a lot more fun when you’re with someone and not eating alone! I look forward to that when I’m done school.

Tomorrow is my final block day of biostatistics. It’s going well, but by the end of today, my brain felt to full to absorb anymore! I’ll be glad when the sessions are shorter.

Hope everything is well back home!

The Life!

Things are looking even more up since last I wrote!

Firstly, Thomas is home! He is in the other room doing his ironing as I type this. I get a weird joy out of doing normal things with him. Cooking and eating dinner, watching TV, being here when he gets home (or vice versa) is a beautiful kind of normal that we've never had before. Yesterday we went shopping and got some much needed things for our kitchen. Today's task is trying to figure out space for our (ahem, his) clothing. A pretty lazy Sunday before I begin Biostatistics tomorrow!

Last week was a good one at school. Monday began the block of Public Health and Society. This was a course I wasn't too interested in taking initially, but it's required, and I'm glad that it is! The three days we had were taught by health historian, so we studied definitions of public health from different time periods and also important health documents from South Africa. It really helped to contextualized where we are coming from and where we are going. Our first assignment is to do a comparison of different syllabuses of different time periods for public health at UCT. Hmm should be interesting!

On Wednesday, I went out to lunch with a few people from class: Kim and Whitney from the States, Yas from Swaziland (now a South African permanent resident through marriage), Federico from Colombia, and Bob from Swaziland. They're some of my favorite people I've met so far, so it was nice to spend more time with them. We also had a delicious lunch at a health food place. I had the most amazing mushroom and potato pie and fruit smoothie.

I also broke down Wednesday and finally started an antibiotic for my sickness. It seems to have done the trick, I'm feeling better everyday!

As I mentioned before, I was without internet for a week, but I should be more available in the coming week. Thomas and I are also talking about getting a different type of internet so that I will have it at home all of the time. Hopefully coming soon!

My days off (Thursday and Friday) were eaten by necessary repairs to our apartment. However, I now have a working front gate and no hole in the bedroom ceiling! It also gave me a chance to read. I just finished A Widow For One Year by John Irving, which Jennifer recommended to me. A wonderful book, I highly recommend it if you're looking for some well told fiction! I did also attempt to open my bank account on Friday, but they weren't happy with my proof of address. Hopefully I'll have it sorted out by the end of this week.

Excited for the coming week: intrigued to see what biostat is like (I'm thinking I will enjoy it, but eight hours a day for three days might be a bit much), and then Thomas, his sister Louise, and I are going to see Imogen Heap on Saturday! Absolutely cannot wait. Her music has been a part of our relationship for a long time (we bought and listened to her first solo album together in 2007) and I love her music. Check it out.

Time to get back to organizing. Hope to hear from y'all soon. Love!

January 23, 2011

Hi folks!

Unfortunately, I have been without internet for a week now! I wrote this last week but am only able to post now. Enjoy!

I have made it through my first week of block classes and am preparing for my second tomorrow. I am still surviving off of Sudafed, though on the whole I am feeling largely better besides a pesky cough that crops up here and there. 

Once I was feeling better, I immensely enjoyed my Gender and Health course! We had several guest lecturers which helped the long days go by more quickly. For a few years now, I have been on the 60percent listserv, which is based out of UCT and provides information about women and HIV (the name comes from the disproportionate ratio of women who have HIV vs men). Some of the guest lecturers were names I have seen before on that listserv that I am now finally meeting in person!  I also received a lecture on rape in South Africa by a woman whose book I own. Very exciting!

I am hoping to possibly intern with one of the organizations that provided guest lecturers. One is the Ivan Toms (health4men.co.za) health clinic, which works predominantly with men who have sex with men (MSM) and the other is Sonke Gender Justice, which is a larger organization working mostly changing the attitudes and understandings of men to achieve gender equality. I’ve really been on a kick lately for working with men and masculinities, so I’m thrilled there might be some opportunities with these organizations.

I have also been trying to make friends with my classmates. The Americans are nice, but I am also getting to know some of the South African (and other international students) as well. No bosom friends yet, but these things take time.

Getting home from school continues to be interesting. I have three different options, all of which are fine for now. The difficulty will be determining which is safest once the days are longer and I finish class when it is dark.

This weekend I had a visit from Thomas’ dad, Walter, as he was kind enough to drive Thomas’ car down after it was serviced in Durban. Overall, we had a good time. Last night we went out with some of his friends from the UK and we got home later than I normally would—those party animals! Today we went up to Signal Hill (which I am currently looking at out my window) to take some pictures of the City Bowl and harbor and then went to his Godfather’s son’s, Hans, home for tea. He and his wife Julia had a beautiful home. It was just stunning!

Tomorrow, Thomas will be home for a couple of hours before leaving for another job (fingers crossed that he will be able to pick me up from class so we can have a few minutes together!). However, I will have him home for about a week starting on Saturday. Monday-Wednesday I will have block class days of my next course, Public Health and Society, which is a compulsory course. My biggest goal for Thursday is to open a local bank account and then I will begin applying for jobs.

Home is beginning to feel further away. I can’t say that I’m sad here, but I am missing you all!