My heart broke as I gazed into the 10-year old boys eyes from Kenville Primary school, who described his experiences over the past few months to me, Jenna (Cue child’s possible mindset: ‘A western, white girl, wearing scrubs, who probably wouldn’t understand the realities of his world’). Hugging the boy I asked, “You aren’t escaping school for no reason, why have you been absent for 12 days? I am here to help you”. The pupil would not open up to the principal and his teachers. I began asking yes or no questions as his teary-eyed face would shake yes or no. My mind flooded with options as I realized what it was. Are you being forced to do bad things? Head nods. Do these high school boys beat you up if you refuse to climb through the window and steal? Head nods, as he lifts up his chin to reveal the scar from their forceful hands clawing him down on the tar road. THIS IS THE REALITY OF SOUTH AFRICA – this 10 year old little boy. Not the well-kept, strict and highly academic, model C schools that I’ve come from. This leads me to the important topic of positionality and how it can affect our occupational therapy community-based practise.
At first when I looked at the topic for this blog, I will be honest and state that I cringed and rolled my eyes. It is a very subjective topic, which would call on me to reflect deeply. Positionality can be defined by the experiences you’ve had which shape you as well as your opinions on social situations. (Witmitz, 2015) I then started to recall the realities of this topic and delve further into the impact it has on my community occupational therapy practise. I’ve decided to compare the truths of what I’ve experienced during the community block to my own reality.
I am currently sitting on the veranda overlooking the Mount Edgecombe golf course, at sunset, as I write. Yes, the place where the Carona Virus is suspected. Of course, as only the well-off would have been able to afford to travel to these affected places. I have this yearning for all of these people to experience what I finally have. How their worlds are currently shaped, their minds formed, and their hearts moulded based on inauthentic realities of their own country. And of course, our generation doesn’t quite grasp it, as we weren’t born in the era of apartheid. We sit on our comfy couches, understanding that there are extremely hungry children and homeless people a couple km’s away, or even under our nearest bridge, begging. But do we really understand it???
Subjectivity is deeply connected to the social and political structures in our lives that outline our behaviour and experiences. (Thomas, 2014) Let me introduce myself: My name is Jenna Sutton and I am 21 years old. I am a female who has grown up in a middle class, white family. I have had the privilege to be raised by a wonderful caring family, with strong values. However, every large extended family has their possible conflicts and complications. I understand that the ability for families to live up to such values can be greatly inhibited by unequal access to power and resources. I have been going to church since the young age of 5 and find comfort in the understanding of the gospel and Jesus’ unconditional love. I have been extremely fortunate to complete my matric and go on to study. I am currently in my final year of occupational therapy at UKZN. I have been in a relationship with my boyfriend for 5 years. South Africa, Durban, has formed my home my entire life, and I have travelled overseas on two occasions, to New York and England. Now that I have stated my own positionality, I would like to take you all into the world I have currently been journeying through, whilst describing why it’s important to consider positionality when assessing conditions and creating programmes for the people of these communities.
Working in the community has exposed me to the truths behind poverty. An example of my experience in this situation is going on home visits and walking alone in the community. I entered my stroke client’s home hesitantly, not knowing what to expect. A shack - not even the size of my bedroom. With multiple gaps, allowing the rain to sweep through. Their two year old child stays with her grandmother as a result of their poor living conditions. They get to see her during occasional holidays, such as Easter. His wife had significant burns after their paraffin stove burnt her. The family sometimes chooses to not use the broken, disgusting communal toilet and rather find a bush. Although, these realities weren’t what opened my mind the most. My walk back to the clinic took me at least 20 minutes and there were multiple steep hills I had to climb. My stroke client has to do this walk every few days to get to the clinic. This was a new experience of truly understanding context. The difference between asking the patient to draw their house for you in order to suggest adaptations etc, was insignificant in comparison to viewing it with my eyes and commuting the way they have to. This truly exposed me to delving deeper into understanding one’s context before treating the patient.
Viewing the poor creches and the lack of stimulation for the children, crammed in the small shack, from the ages of 6 months to 6 years deeply saddened me. It in fact, almost, made me a bit angry. I had to reflect on this and remember the realities of poverty in Kenville. The wonderful ladies running the creche are most likely not well educated, they definitely don’t have a teaching degree and they are more than likely volunteering to look after these children. My positionality and degree in OT evoked my emotions and I needed to remind myself of the truth behind the matter.
Another significant situation of the Kenville community includes substance abuse. I have never been exposed or offered any significant drug my entire life. The realities of the community are that they are exposed to drugs at an extremely young age. Alcohol abuse is considered a norm and broken bottles litter the dusty streets. My colleague and I are currently working with a grade 11 class promoting health promotion through dramatic pieces. We have noticed a few children (even only within this class) who were not in the right mind frame and had definitely been taking a substance that morning or between classes. Please click on the following link if you would like to read more on drug use amoung the youth of South Africa: https://citizen.co.za/news/south-africa/1179509/drug-abuse-is-growing-in-sa/ I finally understand the true reflection of drug abuse. I never understood it completely until now. This leads me to my next eye-opener topic: The experiences of the homeless. Please find attached the link to the Denis Hurley Centre, a foundation which provides many services to the homeless to which you would be able to donate food to, if you wish: http://www.denishurleycentre.org/?AspxAutoDetectCookieSupport=1
United States Conference of Mayors, 2008 asked 25 cities for their top three causes of homelessness. Substance abuse was the single largest cause of homelessness for single adults (reported by 68% of cities). Drugs consume people’s lives and easily destroy them. I only recently learnt that it’s not just about being addicted to the substance, but it is more importantly the withdrawal symptoms which cause the substance to sabotage their lives. Without the substance they go crazy, and therefore have to take it daily. This is a main cause for the crime as they need to get money to consume the substance. Without understanding this and the context behind it, I would have treated the clients in an insignificant and meaningless way. Another understanding of context include their experiences. One of my homeless clients stayed in prison for four moths after the police planted heroin on his bag, in order to arrest someone for the day. After engaging with homeless people and understanding their poor circumstances and the reason behind their lack of support, I have a new found respect for them. A type of respect that only they deserve. I have witnessed a man protecting his disabled wife by placing her in a safe shelter, so that she was no longer on the dangerous streets of our city centre. He cares for her on a level I cannot explain. An incredible artist, an amazing song writer and a beautiful poet all form part of them. They don’t want this life. Many people think they do. It’s extremely difficult to escape. Please find attached a link which further describes the lives of the homeless living in Durban if you would like to understand this extremely vulnerable population more: https://www.groundup.org.za/article/homeless-durban-dumped-outside-city/
I have realised that I need to ensure the values, assumptions and beliefs which I have inherited don’t affect the work I do in assessing clients and formulating programmes for the communities which I work with. I need to constantly be mindful of how I am constructing myself, which influences my decision-making for the community and I must understand how others might choose to construct me. I would like to conclude my blog with this quote, as it exposes the mindfulness that needs to be inherited, despite being 25 years post-apartheid.
References:
Mcintosh, P. (2020). Picture Quotes. Retrieved on the 6th of March 2020 from http://www.picturequotes.com/olusegun-obasanjo-quotes
Thomas, A. (2014). Exploring my Identity through my social context. Retrireved on the 5th of March from https://www.youtube.com/watch?v=Sz3RPZeqGFk
United States Conference of Mayors. “Hunger and Homelessness Survey: A Status Report on Hunger and Homelessness in America's Cities.” 2008. Available from http://www.usmayors.org/uscm/home.asp.
Witmitz, B. (2015). Positionality. Retrieved on the 6th of March 2020 from https://otmakingyousmile.blogspot.com/2015/04/positionality.html
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