Cape Town - For every five people who go to a clinic in the Eastern Cape there are another 45 who do not. To change this, the Zanempilo mobile clinic is bringing medical services to the people.
On one morning it sets up at a taxi rank in Port Elizabeth, offering a free service to taxi drivers - most of them men who don’t go to clinics. They are offered free tests for HIV, tuberculosis and blood pressure. They also receive counselling or referrals for HIV, substance abuse or emotional issues.
The next day it is in impoverished Kleinskool, which is kilometres from the nearest clinic. Some people push their children or elderly in wheelbarrows, but others are too weak or ill to get there or cannot face the long wait.
Resident social worker Priscilla Grootboom said a large percentage of people in Kleinskool are unemployed and hungry. “They go from church to church for food. It’s survival here. People don’t have the money to catch taxis to the clinic.”
In Kleinskool, many young mothers survive from month to month on the R350 child support grant.
An initiative of the Nelson Mandela Metropolitan University’s School of Clinical Care Sciences, Zanempilo - Xhosa for “bringing health to the people” - sees on average 40 people a day.
First in line is Laverne de Vos, 21, who has a six-month-old child, Terri-Lee. She has come for family planning and an HIV test, for which she gets an immediate result: negative. A postgraduate nursing science student talks to her about her home life and how to maintain her negative result.
The School of Clinical Care Sciences raised the R1.5 million it cost to convert a 13-ton truck into a mobile clinic. Zanempilo has two examination rooms, a consulting room, chemical toilet, wheelchair hoist, sluice and mini pharmacy.
Final-year and postgraduate students in nursing science, radiography, emergency medical care, dietetics and pharmacy serve on Zanempilo, which is managed by Sister Shanene Olivera, a full-time advanced primary healthcare professional nurse.
Working alongside Olivera is Sifundo Sonti, who has a qualification in basic life support. He drives and maintains the mobile clinic and is the data capturer.
Olivera and Sonti are the backbone of Zanempilo, with doctors and other health sciences staff making contributions. “Working in our communities is the best kind of teaching base for our senior students, who consult under the direct supervision of lecturers and clinical mentors,” Olivera said.
The Zanempilo team also visit people at home to find out whether treatment is needed and to explain what personal healthcare means, from identifying symptoms to helping young mothers learn how best to look after their babies.
The emergency medicare team gives advice on how to avert or respond to fires and how to guard against one of the major causes of death among infants in informal communities - drowning in buckets of water.
The training helps the team identify gaps in their knowledge or where training programmes should be adapted to meet community needs.
“One of the patients who touched me in Masakhane township was an old man who had been attacked by boys,” said Patient Machaba, a nursing science honours student.
“He had been suffering at home for several days. He had a rib fracture and respiratory distress, and when we took him into the examination room, he started crying. If a man cries it shows he is desperate.
“We attended to him carefully and then referred him to Livingstone Hospital. We arranged transport. A charge was laid against the attackers. What was heart-warming was to see how the old man left Zanempilo compared with how he arrived.”
Olivera said Zanempilo was carrying out more HIV tests than some clinics because it is non-threatening.
“We give people time to discuss their problems. It is about respecting people’s dignity. I think it also helps that we are not from the community.”
Each time Zanempilo visits a community, the team runs a public health campaign.
“Substance abuse and drug addiction are a major problem,” said nursing science honours student Ashleigh Rossouw.
“Some patients are not teenagers yet and they are addicted to a range of drugs. Where possible, we help them to be admitted to the Elizabeth Donkin Psychiatric Facility in Port Elizabeth.”
Missionvale in the Nelson Mandela Bay Metro has one of the country’s highest incidences of foetal alcohol syndrome.
“This is why it is so important we go into communities and homes to teach. If we don’t, these practices won’t change,” said Professor Dalena van Rooyen, head of the School of Clinical Care Sciences and deputy dean of health sciences.
She is also the president of the Academy of Nursing of South Africa.
“Health sciences at (the university) is in an exciting and dynamic phase. We are working towards a much more inter-professional, engaged practice. We are strengthening our partnerships with the Department of Health, sea rescue, police and emergency services - it is all about sharing skills and strengths and working together for the benefit of our communities.
“Zanempilo is one of the approaches we use to develop a pro-social graduate, someone aware of social justice and the reality of communities. Our students’ need to understand the person they are treating - who they are, what the issues are in their lives, what support network they have. It is all about developing holistic, home-based health care.”
Weekend Argus