The current shortage of healthcare practitioners in South Africa poses a substantial threat to the adequate provision and delivery of healthcare. Many in the healthcare sector believe that this shortage constitutes a national crisis.
South Africa’s doctor to population ratio has declined well below the global average of 15 doctors per 10,000 people. Currently, we have six doctors per 10,000, and only ten specialists per 100,000 people. It’s not uncommon for doctors and nurses in the public health sector to work extended shifts, doing the work of two or three people, with understaffing resulting in patient backlogs, delays in life-saving interventions and a lack of medical support when dealing with epidemics, such as HIV/AIDS and the Covid-19 pandemic.
Changing lives from the ground up
The Tshemba Foundation was created in 2017 to address some of these shortages, particularly in the hardest hit rural areas. Tshemba is a medical volunteering programme that connects healthcare professionals from around the world with primary healthcare clinics. Situated in Acornhoek in Mpumalanga, Tshemba places volunteers in the local district hospital, Tintswalo, as well as across the network of clinics in the broader region.
Over and above attracting volunteers, Tshemba also works to foster a more cohesive healthcare system in the district, bringing together the private and public sector for a more successful model of healthcare intervention.
“Volunteers play a critical role in rural healthcare, but ultimately it’s the passion and dedication of everyone involved and our willingness to work together that is seeing results,” Inez Allin, PHC Coordinator at Tshemba Foundation. “We are changing what primary healthcare looks like in these rural areas by linking government, non-profits and medical volunteers. Together, the sum of our parts is exponentially more powerful than what we can achieve alone and seeing the direct and immediate on-the-ground impact of these interventions is incredible. It’s food for the soul.”
Grass-roots solutions that make a difference
One such partnership is with Hlokomela, a non-profit organisation that has an award-winning HIV/AIDS educational and treatment programme, as well as a primary healthcare clinic.
Situated in the Mopani District of the Limpopo Province, near Tintswalo’s feeder area, Hlokomela has successfully turned the tide of HIV and AIDS in the district.
South Africa has the biggest HIV epidemic in the world, with 7.7 million people living with HIV. In 2020, nearly 4,500 South Africans were newly infected every week. One-third of these are adolescent girls and young women aged 15 to 24. These are staggering figures, by any stretch of the imagination.
Globally, a region is considered to be suffering a ‘hyper-endemic’ HIV epidemic if more than 15% of the adult population is HIV positive. South Africa far exceeds these numbers.
At yet, in the Maruleng Municipality, the prevalence of HIV and AIDS has dropped from 23.9% in 2005 to 6% today, thanks in large part to the interventions of Hlokomela.
Leading the way in the fight against HIV/AIDS
In 2005, Christine du Preez , a nursing sister married to a Limpopo fruit farmer, started a one-room clinic on Richmond Farm. She immediately recognised that too many farm workers were tragically dying from unknown causes in the Maruleng Municipality. Once it became clear that the cause was AIDS, Hlokomela secured the funding necessary to dispense anti-retroviral treatment (ART) and started an education and awareness programme to help the local community understand how to prevent the transmission of HIV, as well as that there are treatments available to supress viral load. For pregnant mothers, ARTs significantly reduce the risk of transmitting HIV to an unborn child, for example.
Since then, Hlokomela has not only proven what’s possible in the fight against HIV/AIDS in South Africa, but the clinic has grown to play an important role in primary healthcare in the area, diversifying into a donor-funded primary healthcare clinic, treating everything from the common cold to hyper-tension, asthma, diabetes and a range of chronic and acute illnesses. In a world where specialised healthcare can seem unattainable, Tshemba, Hlokomela and Tintswalo Hospital are working together to ensure this isn’t so.
“We receive chronic medication from the department of health but our organisation’s salaries are funded through donors,” explains Laverne Stebbing, clinic manager at Hlokomela. This is one of the reasons why Tshemba’s medical volunteer programme is so important.
“Tshemba’s volunteer programme means that twice a week we have doctors working at the clinic,” says Stebbing. “Our professional nurses assess patients and then, where necessary, we can book follow-on appointments with our volunteer doctors. Tshemba’s volunteers range from generalists to specialists, such as gynaecologists and ophthalmologists. It’s amazing that we can offer this level of care in our rural community and that we can change lives in one of South Africa’s most rural areas.”