Thursday in Cape Town

Today was so full of fascinating conversations, powerful history and inspiring efforts to change the world that I really don’t even know what to write. The first thing I’ll say is that Cape Town is absolutely beautiful. I could live here. Those of you who know me well know what a high complement that really is. The attitude is different here—more laid back, friendlier, less afraid. Maybe that’s in part because people here are surrounded by big craggy mountains and rough coastlines and beautiful blue-green ocean, but also by reminders of everything South Africa has been through and the country’s hope for the future.

But there is also so much poverty here. Soweto was poor, that much was clear, but not in a noticeably abject way, at least not from what I saw. Today Paul (Executive Director of GAA, arrived in SA last night to join me) and I went to Khayelitsha, a large township near Cape Town, basically a shantytown. The poverty there was abject, with a huge sea of shacks topped with metal roofs sinking into sand with mountains on one side and ocean on the other. The disparity between this and the V&A Waterfront in Cape Town was hard to get over.

Paul and I visited a really amazing service program in Khayelitsha. Simelela is a one-stop rape crisis center. This means that when a woman or child has been sexually assaulted, he or she can go to Simelela to have an exam, file a police report, get medicines to prevent HIV, other sexually transmitted diseases and pregnancy, and get a clean change of clothes. Looking at a spare bathroom with chipping tiles and a pair of underwear hanging on the towel bar, I thought for a moment about what it would be like to be in that room, washing up after having had your body violated in a way that can never really be cleaned. I am so thankful that I do not know that pain firsthand—but I know many women who do, and it makes me so angry that our patriarchal society allows such atrocities to continue.

South Africa’s Simelela and Thuthuzela Care Centers (rape crisis units in hospitals and clinics) really are model programs. They follow best practices, making sure the right preventative medicines are on hand and that forensics capacity is available to get any DNA evidence that might remain from the assault. These care centers really need to be scaled up. Our friends at the Treatment Action Campaign (there’s a link to their site at the bottom of this page) are calling for there to be 53 in South Africa ASAP; right now there are only 6.

Despite the fact that these programs are an important step in providing good care to people who are sexually abused, I was concerned at the apparent lack of ongoing psycho-social care. My mother is a social worker who specializes in working with survivors of child sexual abuse. I know how damaging that sort of trauma can be, how it can lead to risky choices, to an inability to ever really love anyone in a healthy way, even to suicide. Earlier today, while we were meeting with folks at the Treatment Action Campaign about their exciting new women’s rights program, we got to talking about how important mental health care is from the perspective of survivors of sexual assault. I know it’s not just in the US that we value good mental health, that we understand the difference between happiness and unhappiness (even if we have different criteria or definitions). I hope that as these one-stop care centers are taken to a national scale that real, sensitive and ongoing mental health care will become part of the package.

After spending the afternoon in Khayelitsha visiting Simelela and chatting with the director of Doctors Without Borders’ TB-HIV clinic across the street, we ended up getting tickets for the day’s last tour of Robben Island, where Nelson Mandela was imprisoned for 18 years. Our guide through the prison was himself a political prisoner there, and he spoke words of kindness, reconciliation, healing and forgiveness. And this was during and after his tale of blinding hatred, brutal torture, and hopelessness. His honesty was incredible. I have heard testimony from torture survivors in the past, so while his story wasn’t shocking to me I was surprised that he would be so public about it without any warning (not that he owed us warning that we were about to be faced with the Truth). I wonder how people reacted…that sort of story can be very traumatizing. But, in fairness, people should be a bit traumatized when confronted with the horror that was apartheid. Just as people should be horrified by the millions of people dying of AIDS as I type; the young women and children being infected with HIV because they don’t know how to use a condom, are being raped, or both; the millions of women and children who will be beaten and violated this year simply for being who they are. We should all be horrified. But the message of our tour guide today was one of hope, of empowerment to make the world a better place. So that’s the take-home message. There are horrible things in this world. But once we see them, it’s up to us to make them end.