This is a post about power.

This is a post about power. Not electrical power, nuclear powers, or power outages, but differences in power.

Recently I was privileged to host several of my fellow MUD 4 volunteers in Umphumulo.  It was great to have visitors and get to show off what I love about my site.  During their visit, we walked around the Umphumulo area, explored the church center and the old Lutheran seminary, picked guavas and avocados, and took turns cooking on my gas burner when the power went out.  Perhaps the most interesting part of the visit was our tour of Umphumulo Hospital.   As I was giving my friends a tour of the hospital campus, we ran into a couple of the doctors I’ve gotten to know over the last few months.  They told us that there was an elective C-section scheduled for later that morning.  I thought that we might be able to observe the procedure, as the operating theatre in Umphumulo is never particularly busy or crowded.  We were pretty excited about the idea, and after a little bit of asking the doctors gave us the ok. 

Around 11, our group of four Americans trooped into the tiny changing room outside the operating theatre.  After getting decked out in green scrubs covered with emblems reminding us that they belonged to the KZN Department of Health, we got ready to enter the theatre.  Unfortunately, the matron informed us that the operating rooms did in fact have a maximum capacity, and as a result only one of us could observe at a time.  We were a little disappointed, but after explaining that my friends wouldn’t have a chance to visit other than today and asking very nicely, we worked out a way to let my three guests observe together.  Several nursing students who were planning on watching the procedure offered to come back another day, and I offered to watch from outside the operating room doors. 

The procedure went perfectly, and the mother gave birth to a healthy baby girl around 11:45.  Soon after, we thanked everyone for letting us observe, changed out of our scrubs, and walked back to the church center. 

I didn’t realize this story had anything to do with power until later that afternoon.  I was telling my friend Smangele what I had been up to that morning, and she asked me a question that had never occurred to me.  Smangele simply wanted to know whether we asked the mother if we could observe the procedure.  I thought for a second.  We had permission from all sorts of people… the doctors performing the C-section, the matron in charge of the operating theatre, the nurses who had volunteered to let us observe in their place… but not the mother. 

Since I’ve been in Umphumulo, I have probably observed more than 20 C-sections.  I’ve seen watched different groups of doctors and nurses work, seen cases that went well and ones that couldn’t even get started, and gotten to know the major points of the procedure.  Yet I have never thought to ask the mother for permission to watch.  Sure, I have written permission from the chief of medicine that allows me to observe, ask questions, and help throughout the hospital.  I’ve made friends with many of the doctors and nurses, and have often been invited to observe interesting cases or procedures.  How could I do all this without the patient’s permission?

How many mothers in American hospitals would let a handful of random people—with virtually no formal medical training—observe their C-section without even asking why they were there?  It’s not exactly a modest procedure for the mother, and I can’t even say that the patient is under general anesthesia and won’t know who is observing.  C-sections aren’t the only procedures I’ve observed at the hospital here either… I imagine the young men whose circumcisions I observed weren’t exactly pleased I was in the room.   Yet I have never even been asked my name by a patient. 

Once again, my friend Smangele had an answer.  She suggested that the reason I have access to so many private moments in patients’ lives has everything to do with the dynamics of power.  Many power differentials probably had a role in creating this situation, but I want to focus on four.

The first three are the differences in power between doctors and patients, between men and women, and between Zulu speakers and English speakers.  All of these power differentials are rooted in the culture of this rural area in South Africa.  Umphumulo is a very traditional place, and the most of the adult population can only speak Zulu.  English is one of South Africa’s 11 national languages, but despite being considered the language of education and commerce isn’t widely used in rural areas.  The vast majority of people who live in and around Umphumulo are unemployed, surviving on pensions, or dependant on family members working elsewhere, so the “language of education and commerce” can easily be translated to the “language of power”.  People with jobs, education, cars, houses, and money make decisions, know how the world works, and speak English.  Doctors fall into this category for all these reasons.  American volunteers do as well, even if we only have an education and speak English.  As a result, most Zulu speaking patients rarely question the medical system they are a part of at Umphumulo Hospital, especially the doctors who make decisions about their care.  Similarly, many doctors rarely ask what their patients think about the care they receive, or even if they have questions about it.  The gender difference also plays a large part.  Rural Zulu society is dominated by men.  Men are the head of the household, the breadwinners, and the final decision makers in most Zulu families.  Women are expected to cook, clean, and raise children; traditional practices like lobola (when a groom “purchases” his bride from her family before they can be married) reinforce this patriarchy.  The feminist movement hasn’t made much ground in the rural areas of KwaZulu-Natal, despite women constitutionally having the same rights to live and work as men.  The fact that my presence has never been questioned by a mother on the operating table highlights all of these power differentials.

The fourth power differential is the white elephant in the room.  Pardon the pun, but racial issues are still surprisingly close to the surface, despite 17 years of freedom in the rainbow nation.  On second thought, maybe it’s not so surprising.  How much racial tension still exists in the US almost 150 years after the end of slavery and 40+ years after the civil rights movement?  I can’t speak for all of South Africa, but in my experience the color of my skin has played a role in earning me questioning looks, inspiring wild assumptions about my personal wealth, education, and connections, placing me in seats of honor at weddings and other functions, and allowing me to go wherever I want in Umphumulo Hospital.  Don’t get me wrong: I’m not saying that people in Umphumulo are racist.  Nor am I suggesting that my race places me in a superior position to many people in my community here.  I am simply saying that race still causes questions and assumptions that may have little to do with the truth.  Racial issues are undoubtedly woven into the three power differentials mentioned above as well, and I am not nearly competent enough to address them.  Simply put, despite very little overt racism today, the abuse of power by one race on another during apartheid cannot be waved away as easily as we might like.

What can we do about unhealthy power differentials?  Personally, I can start by making sure I have the patient’s permission to observe procedures in the future.  More broadly, we should be more observant to ways in which we unconsciously take advantage of power differentials.   Once we realize these power differentials exist, it’s easy to take steps to flatten them.  Asking questions opens channels for dialogue, and dialogue helps to both expose power differentials and empower people to level them.  That’s what volunteering (and life, I suppose) is about: becoming aware of unnoticed details that have always surrounded us and working to change these circumstances by uniting with those around us.

He is Risen Indeed!

Despite celebrating the death and resurrection of Jesus more than 20 times, I never realized that three days can be a long time.  When I was in first or second grade, I specifically remember trying to count the number of hours that Jesus was in the tomb to see if he was really dead for three days.  Friday afternoon until Sunday morning seemed a little bit short, and I remember thinking that Jesus had stretched the definition of 3 days in the tomb a bit. 

The holy week celebration I participated in this year was like nothing I have ever experienced.  In many ways, Lutherans in Umphumulo remember the events leading up to Jesus death and resurrection just as my home congregation has in St. Louis.  We both remember the last supper on Maundy Thursday and take part in Jesus’ amazing example of service by washing each other’s feet.  Good Friday provides a chance to reflect on the depth of Jesus’ love for us: how he endured the beatings, pain, insults, and rejection in order to save the world from our sins.  And Sunday morning is the culmination of it all: Christ is risen!  Both in Umphumulo and in St. Louis, I also had the privilege of spending time and sharing food with friends and family to celebrate Jesus’ resurrection. 

Here the stories diverge.

All 15 congregations that make up Umphumulo Parish met to worship together for holy week.  The parish had arranged to use the facilities of Nyamazane Primary School, which is about 10 km from my house in Umphumulo.  During the days leading up to Easter, I had wondered how evening services would work.  Relatively few people have access to cars or private transportation, and nobody seems to like walking home after dark.  I soon learned that the most people were planning on spending the entire period—from Thursday evening until Sunday morning—at Nyamazane.  High school students, middle aged women, retired men, grandparents, and young adults all brought blankets, a change of clothes, and pads to sleep on and camped out in the various classrooms for three nights.   I was, in a word, impressed.  I’ve been to my fair share of youth conferences where young people happily sleep (or stay up late talking) on the bare concrete floors of classrooms, but I didn’t expect many churchgoers (especially 60+ year old grandmothers) to jump at the opportunity.  Full disclosure—I only spent one night at Nyamazane; everyone who was there for the entire weekend has my highest respect. 

The inescapable difference between holy week in Umphumulo and in St. Louis is the amount of time spent worshipping and in community with each other.  Beginning with the Maundy Thursday service at 6:30 pm, I spent 42 of the next 62 hours in church.  Frankly, I couldn’t imagine how I could stretch what is traditionally a couple hours of services in the U.S. into three days.  More importantly, I was terrified of listening to Zulu preaching for three days.  My Zulu isn’t nearly good enough help me understand anything more than the most simple sentences and phrases; sermons were going to be rough. 

In addition to services celebrating the last supper on Thursday and Jesus suffering and death on Friday, the weekend was filled with singing, sharing testimonies, meetings, dancing, and Bible studies.  In between all this worship, we talked, ate, and tried to stay warm at night and cool during the day.  All weekend had been leading up to the Easter vigil Saturday night, and amazingly Saturday evening arrived before I knew it.  After sharing dinner, everyone crowded in to a huge canvas tent that had been set up in the school’s courtyard to watch Mel Gibson’s “The Passion of the Christ”.  I had never seen the film before, and it was an excellent reminder of why we had been gathered together since Thursday evening.  After a short break, everyone reconvened in the tent where we had been worshipping all weekend.  Since I couldn’t understand most of what was being said around me, I soon lost track of who stood up to speak.  It was all I could do to keep my eyes open, and I took a 45 minute rest around 2 am. 

When I woke up, Baba Mabaso (the parish pastor) was leading a formal church service in the tent.  In fact, he was baptizing two members of the community, and confirming about 8.  I had to blink a few times to make sure I wasn’t dreaming about a confirmation held at 3 am on Easter Sunday, but once I woke up the experience was very striking. After a while, the service moved out of the warmth of the tent and out of the gates of the school.  We stopped about 100 meters away in the center of a dirt soccer field, and Baba Mabaso read the story of Jesus’ resurrection.  At 4 am, the moon was bright enough that I could see my shadow, which was good because the candles kept blowing out.  Still, I now feel as though I have a much deeper understanding of what the original Easter Sunday might have been like: “Early on the first day of the week, while it was still dark, Mary Magdalene went to the tomb and saw that the stone had been removed from the entrance.” (John 20:21)

I’ll never forget what happened next.  Standing there in the dark, about 200 people of all ages exploded.  Everyone was singing, dancing, and trying not to step on each other in the dark.  People were blowing vuvuzelas and smashing cow bells.  A few people got into their cars and started doing doughnuts in the middle of the soccer field while leaning on their horns.  The joy that had erupted from everyone around me as we celebrated the empty tomb was so palpable you could taste it.  After an entire weekend of singing and dancing, we sang and danced and acted like God’s kids for the entire world to hear.  They probably did too; there wasn’t much else happening at that hour of the morning.  It turns out that the resurrection is a lot more exciting when you’ve been waiting for it for three days.  I loved it. 

Our Easter Sunday service ended by 5am.  Everyone was exhausted, and I’d never been happier.  We shared a tea and a light breakfast together before everyone started to head home.  I walked in my front door around 7, and was asleep by 8.  He is risen indeed!

Readjustment

After spending almost three weeks away from Umphumulo, I returned feeling distinctly out of place.  Ok, maybe out of place isn’t the phrase I’m searching for, but I couldn’t help but feel like I didn’t fit here as well as I remembered. 

It first hit me while I was standing on a street corner in Kwadukuza watching a little red car drive away to the airport.  As I walked a couple blocks up the street to catch a kombi (minibus taxi) back to Umphumulo, I couldn’t keep from imagining flying back to the U.S., starting life as a student again, seeing friends and family, and being free to act unashamedly North American.

As soon as I got into the taxi, my American bubble burst.  I became conscious of my accent, my mannerisms, my dress, and my daily schedule.  I started to enunciate more, resigned myself to not wearing chacos and shorts every day, and started mentally preparing myself for unpredictable work schedule of Umphumulo.  Some of my walls went back up: my camera and ipod went back into storage, and I began to polish answers about what I’d been doing for the last three weeks to deflect attention from the fact that I went on a glorified holiday of the type many of my friends cannot afford.  I even caved into the temptation to lose myself in one of the new books I borrowed from other volunteers, and spent Saturday evening reading by myself.  On Sunday morning, I felt dazed by the overwhelming amount of Zulu during church, and day-dreamed my way through a youth league meeting afterwards.  

In other words, I got homesick.  Maybe more than I ever have before. 

And once again, my hosts in Umphumulo effortlessly reminded me that I am home.  The day after the bubble burst, I went to church, met several people I’d never spoken to before, and had great conversations with them.  I shot baskets with my neighbors, and helped herd some cows out of the church center.  The cows proceeded to go straight into the bishop’s yard, so we chased them out of there too.  I made home-made potato wedges with fresh guacamole for dinner, and then spent an hour and a half helping my friend prepare for his math exam the next day.  The next morning, I woke up at 5 to go running with another friend from church, whom I learned was running the same marathon as me the next weekend.  We even ran a route that was almost completely new to me, which was something I didn’t think was possible in Umphumulo. 

It was the perfect combination of activity, conversations, and invitations.  I felt re-energized, and not just because of the coffee I drank to stay awake after my early run.  Returning to Umphumulo helped me realize that not only do I have family in the US, but I also have family in here.  The amount of people who gave me grief for disappearing for three weeks was more than enough proof of that.  Coming home to Umphumulo helped me to see that even though many of the factors that define who I am mark me as an American who should be wildly out of place in rural KwaZulu-Natal, there are just as many that label me as a member of this community.  Six months ago, I would have had trouble believing it, but I thank God for the people and experiences that have shown me this part of myself.