Last week, I had the opportunity to visit the remote village of Sekhutlane (pronounced something like ‘Sek-qui-kla-nay’), a 5 hour’s drive from Gaborone. I was there with some members of BUP, the University of Botswana – UPenn Partnership, to meet government healthcare workers who had participated in a mobile health program to perform vision screenings on schoolchildren using a smartphone app (called “Peek Acuity;” more on that in another post).
Sekhutlane is a village of about 700 people, and most people seem to farm or work in government-sponsored volunteering positions that provide food and water. There are hardly any shops, and the closest upper high school is in the next village, 70km away. Since the main mode of transport in Sekhutlane is a donkey-drawn cart, 70km is a prohibitive distance for most.
We hadn’t brought any lunch, and the only place to get ready-made food in the village is a small bakery that makes simple rolls and loaves in an outdoor oven. The bread was warm, soft, and delicious after such a long car ride. We learned from the healthcare workers, Kenewe and Kagiso, that the villagers eat canned food most of the time, especially canned beef and fish. Kenewe and Kagiso are not from Sekhutlane originally – the government assigned them there to work for two years. They are both far from home and hope to get reassigned to a less remote location in the future.
Though we were there to learn more about a mobile health endeavor, the challenges in Sekhutlane rarely involve technology. There are vision problems in the village, often due to the dust, but the more pressing issues are HIV/AIDS management and teenage pregnancy. Kagiso said that, since junior high is the highest level of school in the village, many of them finish school at 15 and become parents. They don’t know what else to do, he said, especially since they aren’t exposed to a range of possible professions they might aspire to. Kagiso is also frustrated with the way the government “spoon-feeds” the villagers, providing them food and even housing for minimal work – he wishes the government would instead incentivize them to become self-sustainable in some way.
The president of Botswana is experiencing a bit of backlash right now for a recent visit to Sweden, where he discussed Botswana’s military policy and its “need” for an air force. A few people I’ve met, including the healthcare workers in Sekhutlane, are frustrated that the president is talking about war in such a peaceful country. Instead, they say, he could be focused on bringing health and education to all areas of the country.
We arrived on Sekhutlane’s “ARV Day” – the healthcare workers devote one day each week to providing the villagers with the newest stock of antiretroviral drugs for HIV/AIDS treatment – so the clinic was quite busy. Kagiso and Kenewe told us that HIV is so common, and the village so small, that they can usually figure out which villager is responsible for a new case. They said that since HIV/AIDS is so out in the open in Sekhutlane, there’s very little stigma about it there, and people feel comfortable talking about their partners and the disease.
When I was in Lobatse, someone said that a main contributing factor to the high rate of HIV/AIDS in Botswana is an attitude here of “I am my own boss.” I suppose it’s the flip-side – the lack of a common collective attitude – that is the real culprit, a mindset that doesn’t encourage thinking about how your actions affect others. Kagiso and Kenewe also happened to mention this individualism with regards to other issues in the village. Kenewe talked about a time she once tried to help a young child at school by providing him with new clothes. The other parents became jealous and angry with Kenewe, and they stole the clothes off of the child to put on their own children. She gave up after that.
Another example of this thinking came up in our discussion about the vision screening, the initial reason we went to Sekhutlane. As a result of the screening, two children were diagnosed with vision problems, and their parents needed to bring them to a specific site on a specific day to receive glasses. Only one family had the means to do this, so only one of the two children actually got their glasses. “Why couldn’t that family take the other child, too?” I asked. “You only take care of your own here,” said Kenewe. That’s the attitude: fierce independence, even to the disadvantage of other community members. I’m not sure what caused this “I am my own boss” culture, but it’s been fascinating to hear it come up in so many discussions about health here.
Overall, it was great to see Sekhutlane and understand rural Botswana as a contrast to Gaborone.