So Yana and I have been working in Mmopane (a nearby village) to make home care visits with the community health volunteers. The volunteers explained that home visits involve going into homes and consulting with the family to assess the patient’s needs. First they start by greeting and praying with the patient. Then the volunteers will ask the family if the patient has eaten. If water is needed, they will fetch it. If food is needed, they will go and buy food to cook for the patient. They will also do physical labor that the patient cannot such as cleaning the yard and making sure the patient’s home environment is in order. The volunteers and the nurses play a pivotal role in this community. If there is no caregiver in the family, the volunteers and nurses become the primary caregivers. This care concept is almost unheard of in the United States; the selfless, compassionate nature of these volunteer caregivers is insurmountable. Due to the work of these caregivers, the acuity of the patients has significantly decreased making it easier for the caregivers to provide care and see outcomes. These volunteers earn a meager 100 pula/month (about 16 US dollars). Some of this money may even be used to buy food for the most impoverished of families. Needless to say, we have come to find that those who have the least give the most.

Since Yana and I are making home visits with the volunteers, they've somewhat modified their approach. Our visits are more focused on disease-related issues rather than the ADL-focused care that volunteers provide. It has been a very humbling experience and what is more astonishing to me is that the volunteers and patients have trusted us to provide care. I have never been in a patient care situation where I was the sole provider. So home visits involve assessment, diagnosis, and treatment! This concept is fairly new to many of us because in our undergraduate nursing education, we're not necessarily responsible for dx and tx (obviously, this is more in the NP or doctor realm of practice). Nonetheless, it has been a very challenging and interesting experience.

Perceptions

So the UB nursing department suggested we attend international student orientation. One of our cultural events was a traditional Setswana meal at a local woman’s house. As we drove to the site of our traditional dinner, I anticipated the sights and sounds of village culture that are so vividly displayed in many media-produced images of Africa. The almost heart-wrenching outward compassion one feels for the people of Africa, the suffering, the dying, the forgotten, and the oppressed upon viewing the grotesque images of starvation and poverty is unfortunately characteristic of many parts of Africa. However, what we’ve found in Botswana, much to my surprise is that widespread poverty and its effects on the population cannot really be seen much in proper Gaborone. Much of it is hidden in small, surrounding communities and villages. I perceive Gaborone to be a wealthy capitol city; however, when I venture beyond the conventional and globalized developments of this city, another world is found. This world houses some of the most impoverished families of Botswana. I have been exposed to similar environments around the world, namely India, where the rich and poor are clearly separated; however, I came to Botswana expecting to have less of a middle class and more people on the same playing field, so to speak. After learning more about economic policy in Botswana, I realized that the wealth distribution here is characteristic of many developed countries. This distribution is one that upholds the rich and upper-middle-class and proverbially oppresses the poor simply due to the nature of its market economy and capitalistic values. And while it is obvious that the typical rich-poor gap exists here in Botswana, as it does around the world, the poor in areas around Gaborone are not visible unless one immerses him- or herself into village communities.