South African transport utility Transnet has launched the R82-million Phelophepa II health train, which, together with Phelophepa 1, has the potential to make a difference to the lives of 370 000 patients a year.
The new train-based healthcare service was officially launched by Public Enterprises Minister Malusi Gigaba at the Mount Ruth train station, in Mdantsane, in the Eastern Cape, in March, and will be joined in 2013 by Phelophepa 1, which is undergoing a 12-month refurbishment.
Train manager Onke Mazibuko, a psycho-logy major student who first stepped onto the train as a trainee with the Phelophepa medical team in 2009, has since worked through the ranks to become the manager of the service. He says a daily highlight for him is the appreciation of patients, which is overwhelming.
He adds that, though the challenge of being away from one’s family can be difficult, as the staff live on the train for nine months of the year, this is compensated by Transnet allowing employees five home visits a year. Employees are also entitled to yearly leave of ten weeks.
He recalls that the lack of water supply in some of the areas the train visited was a significant challenge.
“In some of the places we went to, like the Mount Ruth station, in the Eastern Cape, we either had to rely on the fire department or the municipality to provide water for sanitation purposes but, with the second train, the ablution system is effective and also contributes to saving water,” he said.
Final-year optometry student at the University of the Free State Suandré van Rooyen, an intern on Phelphepa II during its launch run, says: “There is a lot of work to be done for rural communities and I am grateful for the experience as it pushed me out of my comfort zone. I have learnt that, when you are passionate about your profession, you will be able to do it from anywhere and under any challenging circumstances.”
Speaking at the launch, Gigaba said: “This initiative presents corporate social respons-ibility as it should be.
“What started as a three-couch eye clinic has become a beacon of hope to rural areas of the country. Healthcare services provided by Phelophepa include basic eye care, dental care, counselling and basic screening services for high-blood pressure, tuberculosis and diabetes, besides other ailments.”
He reiterated the need for private–public partnerships to deal with the social challenges in South Africa, particularly in rural communities.
Gigaba noted that the train boasts the use of advanced technology, such as fibre- optics as a network medium, which is a first for any train in the country, and the latest in wireless network and satellite technology.
“A R102-million budget has been set aside for the train for the financial year, as access to quality healthcare is a basic human right that the train provides for poor communities,” he added.
From 2013, the two trains will, for the first time, work together to visit all the eight provinces on a yearly basis.
“The first train will visit the Eastern Cape, the Northern Cape, the North West and Limpopo, while the other train will take the Free State, KwaZulu-Natal and the Mpumalanga route,” said Mazibuko.
Phelophepa II was engineered and built at Transnet’s Salt River facility, in Cape Town, where maintenance and servicing will also be done.
The new train was built using South African skills, as it is government’s aim to ensure that we industrialise our country by improving our people’s skills and continuously developing them to be able to actively participate in the economy, Gigaba added.
The highly successful healthcare service is the result of a partnership by Telkom, international pharmaceuticals company Roche and Colgate-Palmolive South Africa and universities.
Roche chairperson Dr Franz Humer says it is the company’s vision to deal with pressing issues that affect the communities that they operate in – hence, the support of the Phelophela train for the past 18 years.
“In South Africa, the lack of quality healthcare services in rural communities is a challenge. By partnering with Transnet, we are ensuring that we also play a role in improv- ing the lives of previously disadvantaged individuals,” he says.
Engineering News previously reported that Roche sponsors the train’s pharmacy and health clinic, which were renamed the Roche Health Clinic, in 2001, and provides services that include basic health education, screening and examinations, cancer screening and education, minor ailment treatment, and diabetic screening and education. Roche is one of the longest-serving train sponsors.
Transnet group CE Brian Molefe says Phelophepa II aligns with the group’s strategic aims, which are in line with the government’s New Growth Plan. “We are honoured that the people of South Africa are allowing us, through our corporate social responsibility projects, to make a difference in their lives in partnership with training institutions, the private sector and various departments of the State.”
Meanwhile, Transnet foundation portfolio manager for health Dr Lynette Coetzee is impressed with the technological advances on the second train. “On Phelophepa I, we had a large satellite dish that we had to set up at every stop to locate the network, which posed a challenge in some of the most rural settings. With the second train, we have a new wireless technology and this also allows the students to bring in their laptops so they can work on their assignments on the train.”
Coetzee emphasises that people should not compare the two trains, as they are equally important. “There is nothing wrong with the old train in terms of service delivery – it just needs to be refurbished. Work that needs to be done on the train includes upgrading the ablution and communication systems, electrical boxes and the interconnection between the couches,” she said.
At the launch, Transnet chairperson Mafika Mkhwanazi applauded government for its continuous support in building the country’s infrastructure to promote better living conditions for all.
Colgate-Palmolive South Africa GM Bradley Farr said: “Our company is proud of its long association with Phelophepa. The on-board dental clinic provides oral health services and hygiene education to communities in the most remote rural areas of South Africa. We must also acknowledge the dedication of the academics and students who have committed their time to the clinics, and we look forward to an ongoing partnership.”
Affordability is the main driver of the train services: the charge for a pair of spectacles is R30, dental procedures can cost R10 and medication costs R5 for the dispensing of a script.
Final-year university students are keen to secure an opportunity to ply their medical skills on the train.
“We have students from various faculties, such as dental, pharmacy, psychology, besides others, who get a two-week oppor- tunity to work on the train. The training is intensive because, at times, we work an 18-hour shift and, coming mostly from urban settings, this is often a challenge for students to adjust to in the first few days,” said Coetzee.
About 60% of the train staff consists of graduates because they now have the urge to give back and immediately see the contri- bution their skills make to patients on a daily basis, she added.
The aim of the healthcare initiative is health education and awareness to ensure that the train leaves a legacy long after it has passed. Coetzee said the total number of patients treated is about 20-million to date and includes a significant number reached through the basic healthcare awareness training. This include basic eye hygiene, how to treat diarrhoea in infants and other minor ailments.
“For each patient receiving medication, a pharmacist spends ten minutes with the patient to educate him or her about why he or she is getting the medication, so as to promote a level of education and understanding of ailments and, possibly, help to avoid a recurrence,” said Coetzee.
For every stop, the train’s mandate is to train 20 volunteers, chosen by the communities, in basic healthcare and encourage them to go out and transfer this knowledge to their com- munities and families. This is the ‘each one, teach one’ initiative, which ensures that education is a continuous process, she added.
“We would like to go back to our old routes to revisit remote areas, such as Camata, in the Eastern Cape, but Phelophepa is not an income-generating project for Transnet, hence, it cannot keep the railway lines running in this secluded area. Also we use Transnet carriages for our train and our schedule has to fit into their schedule,” she said.
The train currently refers patients for services, such as further psychological assistance and HIV/Aids treatment, to local health providers because it is not a stationary healthcare service.
To deal with this problem, Coetzee said there are future plans to involve universities currently providing students for the train to also get involved in health awareness projects at community level. This would allow for long-term sustainability of the awareness initiative and continue the legacy of the train by providing continuous community volunteer training.
“It would ensure that long after the train has passed, the work continues with external support for the community, unlike only waiting for the train to provide the service once every two years. Our passion is health education to highlight the dangers of certain behaviour to avoid future recurrence,” she said.
Coetzee said, with the second train, Transnet aimed to consult 170 000 to 200 000 patients over a period of 35 weeks, with a total of 370 000 patients when both trains run con- currently next year. “We want to continue with the high quality of service we currently offer and continue making a difference in the lives of people in poor rural communities.”