When I walk up the steps to Tafelsig Clinic each morning, I pass by a dozen or so people waiting outside the building. Some of them are talking, some of them are eating food purchased from the vendors across the street, but most of them are waiting for TB treatment because they are highly contagious and not supposed to go into the rest of the clinic. As I go inside, I enter the crowded waiting room, where on a typical day I am greeted by nearly 200 faces. I scan the crowd, knowing that some of them will be sitting there for over six hours before they are treated. The primary care clinic, located 7 miles outside the city center in the township of Mitchell’s Plain, provides free health care to about 500 men, women, and children daily. Within the facility are rooms designated for adult care, mental health, child health and immunizations, family planning, TB screening and treatment, and HIV counseling. There is also a pharmacy where patients can pick up medications at no cost and a larger multipurpose room used for dressing wounds, performing EKGs, and, as the nurses say it here, “taking bloods.” Like most primary care centers in South Africa, Tafelsig is largely run by nurses—only two doctors are on duty at a time—and resources are limited. But while the shortage of staff, lack of basic equipment such as blood pressure cuffs and thermometers, and the use of paper files—as far as I have seen the clinic has only a few computers— certainly stood out to me, it has been the people here that have affected me most.
Yesterday I met a 37 year old woman named Rene. She came in with her 6-week old baby because he was due for immunizations and also had a bad cough which at times made him turn blue. After identifying that the baby likely had pneumonia, the nurse went to call for an ambulance to take them to the Red Cross, one of the largest children’s hospitals in the area, where he would be able to receive better care since he was so young. While the nurse was calling, Rene started a conversation with me, and the next twenty minutes were some of my most interesting yet. She told me that the baby was her fifth child; her oldest was my age, turning 21 at the end of the year. Her children were from three separate fathers and lived in three separate homes, and from what I could gather, she had been divorced at least once. Rene had lived in Mitchell’s Plain her whole life, just down the road from the clinic, she said. Her story was not uncommon; many women I have met so far in this community started having children in their teens, are unmarried, and have lived here from when they were born. But what Rene said next baffled me. “Hey, this baby doesn’t have a name yet, what do you think I should name him?” she asked, almost casually. I was stunned. Until this point, I had been surprised enough that patients at the clinic trusted me with simple tasks such as taking their blood pressures and giving them medicine. Now this woman was asking me to give her suggestions for a name for her child, something that could last a lifetime. Smiling, I said I didn’t know and would have to think about it. The conversation shifted and at one point she gave me Baby to hold, but she soon brought it back to the name—I was almost sure she was not going to leave without me saying at least something. Knowing my name was Indian, she asked for a Hindu name; I gave the first one that came to mind, my dad’s. “Krishna,” she said, “I could call him that.” As we continued our conversation, she would occasionally refer to the baby as Krishna, and I thought to myself how strange yet fascinating this all was. When the nurse finally returned, Rene and I exchanged goodbyes and in a matter of minutes, after possibly naming her newest son, she was out the door. I realized I would probably never see her or Baby Krishna again, but even though this was the case, I was thankful for the conversation we shared that cloudy Tuesday afternoon.
Tafelsig has taught me many things so far. I have learned how to give an HIV test, how to feel for the head of a baby in a pregnant woman, and how to treat a child with the flu. Above all, though, I have learned about communicating with people. Even though I didn’t provide Rene or her baby with any medical care, I think that being there to speak with her and listen to her was important. For me, Tafelsig has been a prime example that even in communities with very little, patient care can go a long way with both patience and love.