I ask one of the University of Cape Town medical students if I can use the bathroom, and he throws me a look of disbelief and maybe pity. We’ve been standing in this tiny mobile clinic for five hours— of course I need to use the loo!

The medical student is worried about my safety. He doesn’t want me to venture out alone, so he calls over his helper, a middle-aged woman who is from the community. We’re in Gugulethu (goo-goo-leh-too), a poor, black township 15 kilometers outside of Cape Town. The homes all around us are tiny shacks made of pieces of scrap wood and metal nailed together. Most don’t have running water or electricity.

The assistant tells me all the homes in the vicinity use buckets for human waste. She assumes I don’t want to use a bucket and decides to escort me to her shack. Before we depart, the UCT student takes my purse.

We move through the township. It is 11pm on a cold winter night. The only lights are candles burning inside the shacks. To stay warm, families huddle under blankets, which get soaking wet when it rains and the shacks leak.

The assistant leaves me outside as she hurries in to grab a roll of toilet paper. She hands me the roll and leads me to her luxurious bathroom: an outhouse. She turns on her cell phone and places it inside so I can see where I’m peeing.

The University of Cape Town sends a team of medical students and a doctor to Gugulethu once a week as part of a project called SHAWCO, the Students’ Health and Welfare Centers Organization. The project began in 1943 and became famous under apartheid as black and colored communities were left in dire need of medical help. Apartheid ended in 1994, but with a 40 percent unemployment rate in South Africa, many black and colored neighborhoods are still woefully underserved.

I went to Gugulethu with the SHAWCO students one night this past summer— it was their winter. I had been living in Cape Town, interning at the Cape Times newspaper.

Patients lined up outside the mobile clinic and waited for hours to be seen by one of the four medical students, who were all volunteering their time.

It was evident the doctors-in-training cared tremendously about helping the community. Less clear was the quality of the medical care they were able to dispense.

The students used the most basic medicine and supplies. They looked at rashes or other ailments and then flipped through their books, trying to make a diagnosis and determine what medicines to prescribe.

One man who came in described having a burning feeling when he urinated. The clinic couldn’t afford the myriad tests it would take to determine which STD was plaguing the man, so a student gave him a drug that cures most STDs. One of the STDs the clinic couldn’t test for was HIV.

People came in with tuberculosis, back problems, rashes, high blood pressure and asthma. One baby had pneumonia and had to be taken to the hospital with her mother at the end of the night.

After seeing dozens of patients, we loaded back onto the UCT van, and I watched huge rats picking through a pile of garbage.

We drove through the dark cold township, and I saw a crowd of guys huddled around a fire to stay warm.

The van eventually dropped me off at home. I was in Cape Town as part of a USC program and the school had housed us in luxury apartments at the Waterfront, the touristy part of town. The USC students joked that the school had been so worried about our safety— South Africa has the second highest murder rate in the world— that they put us in a complex surrounded by a moat.

I walked into my apartment with heating and lights and a refrigerator and a tiled bathroom and a pool on the patio. A housekeeper had made my bed.

It felt good to be warm but also depressing. I knew there was no justifiable reason why I lived in luxury and the residents of Gugulethu lived in utter poverty, using buckets for toilets.

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Hanna Ingber Win is a staff editor and writer for Pop and Politics. Pushing Off is a column of her dispatches from twentysomething land. You can contact her at hingber@gmail.com