Johannesburg - Portia Lekgoto faced a dilemma: how to
take her three-year-old daughter to a doctor without missing a day of work
while waiting in line at one of only two public health clinics in the South
African shantytown of Diepsloot.
She decided to take her daughter to Quali Health, a new
private clinic that a friend had told her about. While she had to pay R250 for
the visit, she finished the consultation by mid-morning.
“I am going to now drop my daughter off at her granny with
the medication we have been given and then I will go into work,” Lekgoto, 34,
said at the clinic. “This place, the staff are friendly and it’s nice and
clean. I’ll definitely come back.”
People walking into a well-resourced health centre
in a township and getting immediate help is an unusual sight in poorer areas of
South Africa like Diepsloot, a shantytown of about 140 000 people that was born
a year after Nelson Mandela came to power in the first all-race elections in
1994. The more than 80 percent of the nation’s population with no medical
insurance depend on a public health system that the World Health Organization
ranks as one of the worst in the world or on traditional healers who
usually provide herbs as medicine.
Quali Health was started in May by Nthabiseng Legoete, a
37-year-old doctor, after visiting India, where she saw people with no medical
insurance using private care at a hospital in Bangalore. By September the
clinic in Diepsloot, which offers primary care, was turning a profit and is now
seeing about 3 000 patients a month. In March, with funding from the
Development Bank of Southern Africa, she opened clinics in Tembisa, Soweto and
Alexandra townships around Johannesburg, South Africa’s commercial hub.
India experience
“I chose to visit India because I knew there were pockets
of excellence in terms of low-cost health care,” Legoete, dressed in silver
sneakers, jeans and a white doctors coat, said in an interview at the clinic.
“I saw a production line approach to a lot of services, where one person is
dedicated to one function and becomes better and faster at that one thing. It
creates a seamless process through the entire service.”
India and South Africa share some common health problems:
high vulnerability of young children, poor sanitation and diseases such as HIV,
malaria and tuberculosis. Neither country has a well-functioning public health
system, according to WHO. India ranks 112 out of its 191 member states, while
South Africa is 175.
Shortage of care
“There’s a massive, massive shortage of quality
affordable medical care,” BPI Capital Africa analyst Kate Turner-Smith said by
phone from Cape Town. “At R250, this is still a day’s wage for many to see a
doctor, but it does mean getting better sooner and that is positive both for the
person and for national productivity.”
Health Ministry spokesman Joe Maila didn’t respond to
calls, text messages and emails requesting comment.
Quali clinics aren’t cheap for the people it targets and
who may earn on average about R3 500 a month. Yet the fee buys patients access
to doctors, physician associates and nurses, medication, antenatal sonar, and
heart, blood and blood pressure tests. Circumcision or a pap smear test,
including the lab fees, costs R150. General practitioners in Johannesburg
charge as much as R500 a visit for a consultation alone, and the average cost
for insurance is R1 550 per person per month.
After Legoete took all her savings and borrowed from
friends and family, she opened the clinic that operates seven days a week from
8 a.m. to 8 p.m.
State spending
“Our target market is employed people who are currently
reliant on the public health system,” she said. “They are being forced to
choose between going to work or getting a health check.”
She believes Quali clinics can also help the nation’s
public system by relieving some of the pressure.
South Africa spent R171 billion, or 12 percent of its
fiscal 2017 budget, on health. That’s set to rise by 8.3 percent a year until
2020, the fastest growing category of state spending after debt servicing and
post-school education. As much as 38 percent of South Africans at some point
turn to private health care, according to a 2013 report by consulting firm
Econex, spending more than R140 billion a year.
Quali is providing quality for money, said Dumaluhle
Sibanda, a 29-year-old assistant manager at a pizza restaurant who came to the centre
to look after his one-year-old son while his partner was seeing the doctor.
“For some this is still expensive, but I think it’s good
value,” he said. “Some of the doctors around here are more like traditional
healers and the medication you get is not regulated medication and while the
doctors may have certificates, they are not professionally qualified doctors.
Here you know what you are getting.”