Africa Study Tour Journal (web article)

Students Yong Chen, Lynn Huynh, Tong Jen Lo and Jennifer Gray in Cape Town, South Africa

January 1-13, 2007

Four Johns Hopkins Bloomberg School of Public Health students have traveled to Africa to experience firsthand how communities in South Africa and Botswana are responding to the HIV epidemic. Yong Chen, Jennifer Gray, Lynn Huynh and Tong Jen Lo, all Sommer Scholars, will visit hospitals, clinics and facilities in both countries, which offer different perspectives and approaches to dealing with HIV/AIDS.

Named in honor of Alfred Sommer, Dean Emeritus of the School, the Hopkins Sommer Scholars program is training the next generation of leaders in global health issues.

You can follow their two-week journey below.

January 11, 2007

Jennifer Gray

This morning we met with Dr. Neil Martinson, the deputy director of the Perinatal HIV Research Unit (PHRU) of the University of Witwatersrand, which is located at the Chris Hani Baragwanath Hospital in Soweto. It is one of the largest hospitals in the world. Dr. Martinson explained many of the research projects that PHRU is currently undertaking, such as mother-to- child HIV prevention and tuberculosis prevention. After meeting with Dr. Martinson we went to a local orphanage in Soweto, an area where many of the cardboard and aluminum sided “houses” still don’t have electricity, running water or sewage.

January 9

Tong Jen Lo

Our second day in Gaborone was packed with activities. We visited the Botswana-Harvard AIDS Institute where we were briefed on the HIV research and education conducted at the institute This was followed by a visit to African Comprehensive HIV/AIDS partnership (ACHAP) where we learned how effective partnerships between government and private organizations can support the fight against HIV. In the afternoon, we visited the Botswana-Baylor Children’s Clinical Center for Excellence. There we witnessed the delivery of family-based HIV care for children. Our last stop for the day was at Botswana Network of People Living with HIV/AIDS (BONEPWA+) where we saw how the community can be mobilized to provide social support for HIV patients and to remove the stigma associated with HIV. We were exhausted at the end of the day, but were glad that it had been fruitful, having witnessed first-hand how government, private sector, NGOs and the community can work together to combat the HIV epidemic.

January 8

Yong Chen

Today we visited BOTUSA, a partnership between the Botswana and U.S. governments to fight HIV/AIDS. We met Dr. Doug Fleming, the associate director of science, who gave us an overview of the mission of BOTUSA.

Later we went to the SOS Children’s Village. It was founded about 20 years ago and currently has 258 children. The director, Motshwari Kitso, who has dedicated the last 10 years to working in this orphanage, introduced us to the organization of the orphanage and showed us around the village.

Jennifer Gray

Dr. Mpho Mododi, a friend of our fellow student Chuka Anude, has been a real help to us since arriving in Botswana. Not only did she arrange for her nephew, Joel, to pick us up from the bus station last night, she also helped arrange our accommodations and provided transportation to our meeting with Dr. Doug Flemming.

After visiting BOTUSA we arranged a last minute visit to the SOS Children’s Village. It was clear to see the impact that the AIDS epidemic has had in the orphanage. Many of the children were orphaned by AIDS. There were a number of children there with HIV as well. Mr. Kitso informed us that for the first time in the orphanages 20 year history, they will have to turn away children because they have reached their capacity.

January 7

Lynn Huynh

Today we set out for our cross country journey from Cape Town to Gaborone, Botswana via bus. We drove through the vineyards and saw the mountain ranges. This road trip was a good opportunity for us to witness first-hand the beauty and richness South Africa possess, as well as some of the poverty.

The bus took us into the small towns that bordered Botswana. One interesting aspect of this trip is the beautiful houses that are aligned on the mountain roads following rows of shacks. I couldn’t quite figure out whether these beautiful homes belonged to the locals or to the foreigners. We approached the border after sunset and, surprisingly, Botswana officials did not stamp my passport and quickly admitted us across the borderline.

Yong Chen

After our 18 hour trip, we arrived at the bus station in Johannesburg from Cape Town early in the morning. In the afternoon, we took the bus to Gaborone, the capital of Botswana. Botswana, which has one of the fastest growth rates in the world in per capita income, was hit very hard by the AIDS epidemic. Approximately, one-in-three women in the reproductive age group has HIV. The government showed strong leadership in the fight against HIV epidemic. I am interested in how organizations cooperate with government in this campaign, and how the methodologies in biostatistics fit into the public health studies in Botswana.

January 5

Tong Jen Lo

Today we visited the Desmond Tutu HIV Center (DTHC) at the University of Cape Town. Dr Linda-Gail Bekker gave us an overview of the main roles of the Center, which included treatment and care of patients with HIV, the prevention of HIV transmission and training of healthcare professionals to care for patients with HIV. The Center is active in research on adherence strategies, HIV and tuberculosis interaction, point of care monitoring and pharmacy accountability. We also had an opportunity to visit the Hannan Crusaid clinic in Gugulethu, as well as some of the surrounding township. I was very heartened by what DTHC is doing for patients with HIV.

Lynn Huynh

After our meeting Dr. Bekkar, we visited Hanan Crusaid Clinic in Guguletu and toured of the township of Langa with our guide from the Desmond Tutu HIV Foundation. One man we visited was preparing a feast for his nephew. Several dead sheep laid out on the fence to dry out in preparation. We were told the boys in this area were sent to the bush for 5 to 6 weeks to learn about manhood and to get circumcised without anesthetic. The feast was an opportunity to celebrate the nephew’s coming of a new age with food and drinks for everyone in the neighborhood. This visit into the township vividly illustrates “the haves” and “the have nots.” Those who were well-off lived in houses made out of concrete with barbed wire fences, while those with fewer resources lived in homemade from metal containers or scraps hammered together.

The Desmond Tutu HIV Foundation is planning to build a youth center to intervene in adolescent sexual behavior. It is great to hear about the work and see the projects in action.

January 4

Jennifer Gray

Our group visited the GF Jooste Clinic. Although it is called a clinic, it really runs more like a hospital. It is also the site where Dr. Jean Nachega and Mandy Selin are conducting their clinical trial. We rented a car for the day to explore Cape Town and visited Cape Point and the Cape of Good Hope. It was my first time driving a car on the left side of the road, but thankfully, we all made it back safe that night.

January 3

Yong Chen
Today we visited Groote Schuur Hospital, which is famous for being the hospital where Christiaan Barnard performed the first human heart transplant in 1967. The hospital is located at the foot of the Table Mountain and shares the same building with the University of Cape Town Hospital, a private academic institution. We were able to compare these two hospitals side-by-side. Both of them are facilities for the internships and residencies of students at the University of Cape Town.

Jennifer Gray
Today has been busy. Our group was lucky enough to meet with Paul Roux, a pediatric physician at the Groote Shuur Hospital and University of Cape Town Hospital. Dr. Roux is also the chair of the Kidzpositive Family Fund and one of the founders of Pediatric AIDS Treatment for Africa (PATA.) Roux, a leader in the fight against HIV/AIDS, is a strong believer in private-public partnerships. He spent over an hour talking with us about some of the projects that he is overseeing, including a bead-working project, which is able to support over 130 families living with AIDS in the Cape Town area. Through the project, women are able to support their families by making beaded crafts which are sold around the world. The bead work was beautiful and I think everyone in the group ended up buying something. Dr. Roux also talked to the group about PATA, which is a collaboration among physicians, nurses, pharmacists and counselors that deals with issues concerning pediatric AIDS.

After our visit with Dr. Roux we had a bus tour of the University of Cape Town and then went into town and visited the Robben Island Museum. We then were able to meet up with two current Johns Hopkins students who are doing internships in Cape Town. Marissa Mika is working with TAC (Treatment Action Campaign) and Mandy Selin is working with Dr. Jean Nachega on a trial study. Both Marissa and Mandy shared their experiences working in Cape Town. They gave us tips on places to see while in Cape Town. With their encouragement, we set up a tour of an AIDS orphanage in Khayelitsha (a township outside of Cape Town).

Even though I've only been in Cape Town for a day, I really like this city. The weather, land and people are all beautiful.

January 2

Lynn Huynh
We arrived in Johannesburg at 3:30 pm. and then boarded a domestic flight to Cape Town. From the little I have seen so far, the neighborhoods in Cape Town remind me of Miami, with stucco buildings. The temperature reminds me of San Francisco; the weather for the summer is very mild and windy. It is definitely not what I expected.

Jennifer Gray
After traveling for close to 20 hours we finally arrived in Cape Town. It’s hard to believe I am finally here. My first impression was how much cooler (temperature) it is here than I had expected, and my second impression is the diversity of the country. The area in which we are staying in Cape Town is called Observatory.The many cultures were apparent as we walked down the street to find dinner. Our options included: Greek, Mexican, Chinese, Italian and a deli.

January 1

Lynn Huynh
On New Year's Day, Jennifer, Tong and I departed from Dulles Airport to start our journey to South Africa. I have three objectives in mind: 1.) learn strategies to combat HIV/AIDS in Africa, 2.) promote higher awareness of African organizations fighting HIV/AIDS when we return to Johns Hopkins, and 3.) bridge a connection between Johns Hopkins students and the organizations in Africa. The direct flight was approximately 15 hours to Johannesburg. On the flight, I watched Beat the Drum, the story of an 11-year old boy who leaves his village for Cape Town to find his uncle and to buy back his grandmother’s precious cow.

The highlight of this movie is its portrayal of the HIV/AIDS problem plaguing South Africa, which has more people living with the disease than any other country. Over the next two weeks, I hope to hear the voices of the people involved in eradicating and preventing HIV/AIDS in South Africa and Botswana and learn why there are so many people infected in this country. I also hope to experience firsthand some of the solutions to this deadly pandemic.