Archives For health care

Johannesburg-South-Africa-dentist-DalalLike many poor people in South Africa, Mtuseni has little experience with health care. I am always surprised and saddened when he tells me that someone in the settlement died, often of some undiagnosed disease. As he says, “Nobody investigates.” Lacking insurance and without money to pay for care, people who are sick don’t go to the doctor. Sometimes they die… and I wonder if the cause may have been something easily treatable.

School has been my top priority with Mtuseni, but his overall health has always been in the back of my mind. When I visited in January I brought him two big bottles of multivitamins, enough to last over a year. I take a vitamin every day, and I eat well. For someone like Mtuseni who doesn’t have much food at home — vitamins are even more important. When I first explained the concept, he asked me, “What are these magic pills?” His lack of knowledge about something as simple as vitamins shocked me. What did they teach him in high school? But the vitamins have worked their magic. During this past South African winter he was rarely sick compared to previous years. He even had a growth spurt that required me to get him a bunch of new pants!

But vitamins were easy. The bigger issue was when Mtuseni told me a couple years ago that he hadn’t been to a dentist since he was 5. He has a beautiful smile, but periodically would have tooth and gum pain that kept him awake and made eating difficult. I knew this situation had to be rectified, and told him I’d find him a dentist.

When I explained what would happen — an exam and x-rays, a cleaning, maybe some fillings — he said “No dentist will do all that.” I think his only experience is with the free-clinic dentists who mainly work the pliers. As he told me years ago when his mouth was hurting, “Darkies don’t get teeth fixed. Darkies get teeth out.” After I got over my shock at the “darkie” term and we discussed what it meant in the US, I told him that going to college and working in the professional world, he wasn’t getting teeth yanked.

But everything in South Africa takes time. It’s hard enough researching doctors in your own country — how could I do it from 8,000 miles away? Plus, Mtuseni is afraid of doctors and terrified of needles. I wasn’t relishing the challenge.

Thankfully, my Joburg pal Jacquie — who helped me get Mtsueni’s laptop — asked around and got me some referrals and a list of dentists. I e-mailed a few, selected one… and then prodded and cajoled my little scaredy-cat to set up an appointment. He kept “yessing” me and then “forgetting.” Given that he constantly reminds me of how mature and grown-up and capable he is now that he’s 20, I used it to my advantage. When he texted me that he was afraid, I replied “You’re not a child. Man-up and go.” Not elegant, but poking that budding male ego worked.

So he just finished up treatment this week. Amazingly, he only had one cavity and some early gum disease. (The lack of cavities likely a result of not having lots of sugary goodies to eat at home.) With a full cleaning, filling, fluoride treatment and lesson in oral care, he’s on the path to good dental health — and his smile has even more star power!

Many thanks to Dr. Salwa Dalal and her team for being responsive to my notes and directions. For taking photos. And for being Johannesburg-South-Africa-dentist-Dalalsensitive to Mtuseni’s fears and making his first adult dental experience enjoyable. (Or tolerable. He told me everything was painful. But the kid truly can be a wimp and has a flair for the dramatic.) So he survived, his mouth is healthy, and this should go a long way in helping him get over his fear of doctors.

Next on the list… a physical!


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The Hammer Comes Down

September 23, 2012 — Leave a comment

There’s a great episode of Modern Family that opens with the Dunphy kids cleaning the kitchen… because Claire overheard them say they were bored. They discover that admitting to boredom in range of mom’s hearing has consequences.

It works the same here. Don’t ever let this long-distance dad hear the answer “nothin much” when I ask “What’d you do this weekend?” Not when there’s a backload of unfinished tasks stacked up like planes over LaGuardia on a foggy night.

Shortly after Mtuseni started college, I began paying him a monthly allowance once I realized that his family wasn’t covering daily expenses. Like any kid, it’s important that he earn the allowance. Since he can’t come here and wash my car, he has a variety of tasks such as writing blog posts or answering interview questions or making LinkedIn contacts. Mostly, the tasks are designed to advance his development and, at this stage, prepare him for finding an internship. And he always has an easy out of sending me photos from his phone; they help me tell his story on the blog, are important to the upcoming book — and I just like to see that he’s healthy and doing well.

Yet almost every month getting him to do these tasks is like pulling teeth. He always waits til the last minute and needs reminding, and sometimes the work is half-assed and paired with excuses and rationalizations.

In the course of regular interactions, I’ll ask Mtuseni to do other simple things. Like call the dentist I tracked down for him. Or write a new LinkedIn profile. Or send me weekly status reports of his grades so we don’t get drama-filled, near-fail situations like last term. “Ok,” he says. “Will do.” And these things are never done.

I know recent research has shown a developmental issue in the brains of late teen boys that limits cognitive capacity for tasks like memory and logic. But with Mtuseni lately, I’ve been wondering if the bad car accident he was in at 13 rattled his brain too much. It’s pathological! And driving me insane.

Positive reinforcement — offering allowance bonuses for extra tasks — was never effective; he could barely do the standard tasks. I’ve been reticent to take the opposite approach and dock him pay when work isn’t done; he really does need every rand. But my being loose with the allowance and letting tasks slide every month has diminished the only leverage I have with him. Dad has cried wolf too many times, and my little lamb has become complacent.

But a few days ago, he told me he went to see The Avengers, and it was expensive with popcorn and soda. Yeah, no kidding! That’s why I haven’t bought food at the cinema in 15 years (something about an 8,000 percent profit margin on popcorn just rubs me the wrong way). And given that my own discretionary spending has been curtailed to virtually nothing so I can afford his tuition and expenses and gifts and dental care (if he ever makes the damn appointment!)… well, he can learn a hard financial lesson about accountability and deal with the consequences.

So I told Mtuseni today that this week starts a new allowance structure — with various missed tasks resulting in specific deductions from the base amount. If he doesn’t step up, he’s going to have a very lean October.

Your teenage years are over, buddy. Welcome to the decade of learning responsibility.

Somehow I think Claire Dunphy would approve.


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Today Mtuseni’s school had a memorial service for a student. He said she was stabbed in a random crime. She wasn’t a friend, but he’d seen her around campus.

In the three years I’ve known him, Mtuseni has had more experience with death than I’ve had in a decade. In addition to dealing with the murder of one of his college peers…

  • during senior year, he told me a high school classmate “just turned red” and died in a few days
  • last winter, he had to end a MXit chat to go to a service because “someone in the community died last night”
  • at the end of this past semester, the father of one of his friends in the settlement died
  • and this time last year, his older brother Moses was killed by a car

Five deaths in three years. And these are just the ones he’s told me about. I guess this is the reality of living in deep poverty in a country with high rates of violent crime. He seems to take things in stride. Is there any other option? But for a sensitive, thoughtful kid like Mtuseni, it has to create some tough calluses on his heart.

His world is a chess board of risks: Crime and disease. Sketchy taxi vans and epic traffic accidents. Minimal access to health care. No heat or air conditioning or plumbing at home. Smoky kerosene lamps and candle fires in the settlement shacks. I don’t dwell on it; there’s too much good happening with him and we still have a long road ahead. Still, worry has set down roots in the corners of my mind — like some gnarled tree, its bare branches constantly scratching in the dark. Sometimes I ride my bike to escape. Sometimes I inhale boxes of cookies.

Mtuseni said last week that his main goal is to get a good job and to take his little brother and sister away from the settlement. If I could, I would scoop just them all up to come live with me.

For both of us, graduation and a good job can’t come soon enough.


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