Case Seminar Global health: Conflicting interests

Bongiwe was back at the office after a long day in the field! Her job as psychosocial counselor at the small community based NGO in Swaziland could be quite strenuous and she sometimes wonder how long she is going to stand the many desperate stories she has to deal with every day. Today was however one of her more difficult days. She spent almost all day at the social welfare office trying to get the attention of the over burdened Mr Simelane, the social welfare officer in charge of the industrial area where Bongiwe works. The case she sought attention for this time was for the two children one of the Mentor Mothers had discovered lock up in one of the small apartment rooms not long from the office. Constance, the Mentor Mother of the area had been alerted about the children’s condition by one of the neighbors. The neighbor told that the two children, one and four years old were locked up in the apartment every day as the teenage mother went to work in one of the textile factories. The mother, who previously had been unemployed, had finally managed to get a job the neighbor told Constance. Since she had no one to take care of the children she had left them at home, leaving only a little thin porridge for them to eat. The neighbor said she had offered to care for the children since she was currently unemployed, but the mother had refused, saying that she could not afford it.

When Constance came to the small room she found the door locked and no sign of life from the room. When she knocked at the door she heard someone move inside and after awhile she managed to speak to the four-year-old through the room’s only window. The child confirmed that the mother, who actually was her stepmother, had gone off to work in the morning and would return later that night. The small child began to cry and Constance could hear how the older child quickly smacked the younger one who eventually stopped making noise. Devastated by the scene Constance went to the NGO office and found Bongiwe to tell her about the situation and to get her support.

Bongiwe remembered how she had hurried back to the room together with Constance, to find it just as it had been described to her. Now there was however a crowd gathered outside the small room and people were discussing in quite voices. Alarmed by the crowd the four-year-old had started crying and tension was mounting outside the little room. Someone suggested that they should break down the door, but yet another said that the landlord would evict them all if they did. Harsh word about the mother started to be heard and someone thought that they should teach her a lesson once she got back. Constance, who is well-known in the area managed to calm the crowd and reassure them that she and Bongiwe would find some solution to the problem. Once alone she managed to calm the older child and told her to be patient.

The rest of the day they had spent at the factories trying to find the mother, without any luck. Late in the afternoon they returned to the apartment to wait for the mother. Time passed and the mother did not show. Bongiwe and Constance decided to go home and continue with the matter the following day. They left their mobile phone numbers to the neighbor and said that she should call if the mother came back home.

The following day Constance found the children in a similar situation, door locked and the window closed. She could not communicate much with the children but soon learnt that the mother had forbidden them to talk to anyone. This made Constance deciding to stay until the mother came back, no matter how late it would be. Bongiwe joined her in the afternoon and together they waited for the mother to come back. At 8 pm she finally arrived. At first she was quite hostile, but the respect for Constance made her to restrain herself, and they could have a talk about the situation. Nosisa, the mother, explained her situation, saying that she had no other choice since she had now got a job and that was the only way she could provide for the children. The children’s father had stopped to pay any support. Previously he had given her a couple of hundred Rands a month. It was not much, but enough to get by on. He only came by when he wanted sex, but as long as he provided for them she could not refuse.  Now when he had stopped coming and she managed to get a job in the textile factory her situation was much better and she did not want to lose this opportunity.

Bongiwe tried to explain that the children could not be left alone all day, that it was not safe and that they could not take care of themselves. Nosisa said she understood that it was not a good situation but that she had no other option. She thought that she would give the four-year-old back to her ex-boyfriend. The child was not hers, her boyfriend had brought it since one of his other girlfriends had gone to South Africa and left her with him. Now Nosisa had to take care of the girl and since she did not know the ex-boyfriend’s family she did not know where to go with the child. She thought that maybe she should just chase her, but now it was good that she could take care of Nosisa’s child while Nosisa went to work. Constance wondered where Nosisa’s family came from and if she could not go back to leave the children with Gogo (grandmother). When mentioning Gogo, Nosisa suddenly turned sad and explained: “I have failed my parents as I did not listen to their advice when they tried to warn me about the destructive path I had undertaken. Instead I ignored their warnings and thought I was having the best time of my life, as I had vibrant friends and a sugar daddy who promised me a good life without my parents. To feel more accepted and loved by him I also joined in his habit of smoking and drinking, after which we would have great sex. Little did I know that he was just using me and would soon dump me just like the other girls who got involved with him. It was a double blow for me as I was dumped just after I had discovered I was pregnant. I could not handle the fact that my sugar daddy had dumped me for his former lover.” She would pause and sigh deeply as she tried to hold back her tears as Bongiwe and Constance listened to her story. “Worse still was when I started antenatal care and discovered I was HIV positive, I was filled with so much hatred for the man I once loved so much and even gave up my education for. I was uncertain of the future, with my baby, no job and no place to stay. Going back home is not an option for me!” At this point Nosisa had gone from sadness to anger. She turned on Constance and Bongiwe and started accusing them for trying to take her child away from her. She started to become violent and they had to leave.

For the following two weeks Constance had tried to gain Nosisa’s trust. Bongiwe’s frustration had been mounting as the children had still been locked in the room while Nosisa had gone to work, and Constance started to worry about their nutritional status. Bongiwe had been to social welfare already the next day to try find a solution. Mr Simelane had not been available until a couple of days later, but could then not promise that he could do anything about the situation. The father seemed to have absconded and it was not clear what constituency he belonged to, or what was his family. Without the family’s approval and involvement he could not do much. Maybe Bongiwe could go to the community police to get support?

The situation had not moved forward and when Bongiwe now was back at the office after yet another fruitless day at the social welfare she thought that she might as well give up.