As part of my semester, I have to undertake an independent study research project paired with a community engagement volunteer opportunity. Because of my interest in religious life and pastoral work, I am working at the Holy Cross Hospice in Gaborone, a palliative care facility run through the Anglican church, shadowing and aiding their volunteer chaplain and helping out with other tasks at the hospice as needed. I wish I had been able to start working there earlier in the semester, but as I have learned in the past two and a half months, business gets done very slowly here, and if you don’t just show up at people’s offices and pester them until they respond to your questions, it’s hard to get much done. Two weeks ago I started helping out at the hospice, and already there is lots to talk about.
I am only able to go on Monday and Friday mornings because I have class at other times of the week and it takes about half an hour via public transportation to get to the site, so it doesn’t make sense to go when I only have an hour or so between classes. I leave my residence hall at about 6:55AM, walk to the combi stop at the north gate of school, wait for a combi on the correct route, ride for about 15 minutes, and then walk through a neighborhood to the converted house where the hospice is located. We are supposed to get started at 7:30am (Holy Cross only provides day care on-site, so patients haven’t arrived at that point), but so far everyone has been about ten minutes to an hour late everyday, so I usually end up sitting around, drinking tea, and chatting with my coworkers for a while. Recently I have started helping out with the cleaning during that beginning time, sweeping and mopping the floor each morning while I chat with the two women who do the cleaning work as their job, and that is nice for actually getting to do something right away.
My favorite person at the hospice is the cook, Annah, who was the first one to welcome me and make me feel really comfortable getting to know everyone and helping out in a totally new setting. It’s a little overwhelming cause almost everyone speaks Setswana nearly the entire time, and my rudimentary skills from a few months of the language don’t help me much, but Annah has been really good at making me feel included even when I have no clue what is going on around me. She makes fun of me cause I’m not good at peeling potatoes without a peeler, but by the end of the semester maybe I’ll get the hang of it without cutting off half the potato in the process. I told her how to make my favorite food, homemade noodles the way my grandma taught me, and she got really excited at how good they sounded and keeps telling me she is going to try to make them for her family sometime. Maybe I can weasel my way into a dinner invitation.
Last week Monday was the first time I got to work with the chaplain, which was an interesting experience. Ketshotseng is a part time pastor at a Pentecostal church in Gabs and volunteers at the hospice twice a week, doing bereavement and end-of-life counseling for patients and their families. On Monday, a few minutes after our morning meeting, they loaded me, Ketshotseng, and Kealeboga, one of the social workers, into a van and took us out to Old Naledi, one of the poorest parts of Gabs, to offer bereavement counseling to two families who had just lost family members. I thought I was just coming along as an observer, but soon Ketshotseng told me that she wanted me to participate in the counseling, which was absolutely terrifying. I have vague notions that I’d like to be a pastor later in life, but I have never had any training in pastoral care and I am supremely under qualified to be offering grief counseling to families, especially families who only speak Setswana. I expressed this concern to Ketshotseng, but she paid it no mind.
I won’t give much detail on any specific families to respect their privacy (and I’ve made sure it is okay for me to write about this in general), but in that day we met with two families, one who had lost a 35 year old father, and one where we spoke with an 18-year-old man who had lost his 21-year–old brother. One of the issues I’m looking at in my research is how it is difficult to apply Western palliative care practices that are often used to care for a much older average population than the demographic that may need palliative care in Southern Africa, especially in areas where HIV/AIDS is prevalent, like Botswana. In many of these situations we aren’t just dealing with the loss of someone who has retired and no longer has dependents, but with younger people who are a vital and necessary part of the economic and social demands of their family and community. That makes everything more difficult.
At both homes we sat outside on an assortment of plastic chairs, pieces of wood, and blocks of metal that looked like they had something to do with car maintenance and spoke with the families for about half an hour. With the first family there was a young girl, either the daughter or niece of the man who had passed, who looked just a little bit older than my 7-year-old cousin, but as she bounced her baby sister on her knee and wiped away tears during our session, I saw a strong young woman who was experiencing much more than anyone that age should have to face. One of the issues we are working on now is figuring out how to get this girl back into school, because her birth certificate was somehow lost recently and it has created problems with her school registration. It struck me as an example of how this organization provides care not just for people nearing the end of life, but for all the many needs that are distantly related to those patients in the community at large. With both families we talked about the difficult realities of losing someone from the family, not just for the emotional loss, but for structural and economic reasons as well. The one young man was learning a trade from his older brother, but otherwise had no formal education, and with no one to complete his training he didn’t know what he would do to make money going forward.
At both residences, Ketshotseng tried to get me to help with the counseling, and I eventually asked a few questions as she translated for me, but it was very uncomfortable. At the end of each session she asked me to pray with the family, which I felt slightly more equipped to do, but still, not fully knowing the cultural expectancies, ways of grieving, body language that would be interpreted as comforting in this cultural context, or even the religious beliefs of the families we were working with, I feared that I was doing more harm than good.
This Monday we met with one of those family members again at the hospice for a follow-up session, and later in the morning Ketshotseng dropped the bomb that this might be her last week working at the hospice because she’s having trouble finding affordable childcare for her daughter. After scheduling another appointment with this young man, she turned to me and calmly said, “So you will run the follow-up session with him next week, okay?”
No. Not okay.
I thoroughly expressed this sentiment, and was assured that one of the social workers can join me and lead the session if that would make me more comfortable (yes, please, and even then I’m not prepared and shouldn’t be trusted with this kind of thing), but then I frantically started asking Ketshotseng everything imaginable about how I could help in this setting, with no training, little cultural context, and a history of reading lots of things about terrible white people who enter an unfamiliar context and try to take control when they have no business imposing their ideas or “expertise” on a situation. To make matters worse, in this case, I truly have no expertise at all. Ketshotseng gave me some helpful thoughts, but I’m still woefully unprepared and terrified of worsening the grieving process for someone if they continue to ask me to do this.
There’s nothing like a real-life, daunting challenge to get you to the library. Monday afternoon I spent a long time in the UB library finding a stack of books about pastoral care and bereavement counseling. I had to set up an account at the library cause I hadn’t checked out books yet, and I think I concerned the woman at the circulation desk cause all my books had titles like “Understanding Death and Dying,” which is probably not often the first set of books someone typically checks out from the library. I will continue to try to get out of this position of counseling families by myself, or at least get myself to a position where I know I am doing something more helpful than not, but since it now seems like I will inevitably be doing something along those lines, the least I can do is try to be a little more book-smart about it all.
It is a good experience, and I know I will come out of this with a lot of positive learning experiences, right now I’m just terrified that my limited experience will cause me to leave a negative impact on a fragile community of people.
When I get back to Grinnell, talking people through roommate conflicts as a CA is going to feel like a walk in the park.