By Justine Gerardy
Moutse lies in a long, dusty valley that history wedged into a geographical twilight zone.
The area has been part-bantustan, part-apartheid South Africa, post-democratic Mpumalanga and is now re-demarcated Limpopo.
It is a place where powdery red dust lingers; kicked up by heels hitting the unpaved roads around the area's solitary shopping mall.
At first glance, it is entirely unremarkable. An anonymous clump of humanity in the sprawling outback that belongs to South Africa's poor.
But Moutse is also a place of stunning dichotomies and unexpected attitudes. In this area, "impossible" is a mindset.
Something worth doing is worth doing well. And a Third World environment does not mean Third World delivery. Or as Dr Hugo Templeman puts it: "The fact that you are poor and live in a township and there is no service delivery doesn't mean you can sit on your butts waiting till manna falls from heaven."
Some years ago, the area was the final stop in Liesje and Hugo Templeman's nine-month "honeymoon" down Africa from Holland.
In search of First World possibilities and Third World pathologies, Hugo had accepted a post at the Philadelphia state hospital in the KwaNdebele homeland.
The family moved into the hospital compound in Dennilton township on a R2 000 monthly salary - less than two nights waiting tables in Holland.
A brief stint in the KwaNdebele government followed, but the couple could no longer ignore the desperate lack of services on the other side of the KwaNdebele border gates. The dream was to build a clinic.
In 1994 they took out a second bond on their home after negotiating for a piece of land in Elandsdoorn - the "South Africa" side of the road - and bought 40 000 bricks.
Building started in the first week after the country's first democratic vote. It was also a few days after their second child was born and, for Liesje, breastfeeding and delivering bricks are welded into her post-1994 memories.
The Ndlovu medical centre opened in September.
The aim was to bring quality medical services to those who had never had it and did not imagine it.
"On one of the first days when I opened the clinic as a GP practice, an elderly lady looked inside and saw how it looked. She said is this also for black people? That is how deep it was hammered in. And that irritated me," says Hugo.
The clinic had two patients on day one, none on day two and three the next day. Five months later, a second doctor had to be found. From the medical success grew insight and recognition of the area's deeper needs.
When an old man asked Hugo to pick up 10 stamps in Groblersdal 27km away to avoid the double taxi fare, it drove home the inequity and dependence on the town and its 6 000 white people.
Failures led to learning. Unsuccessful home gardens due to roaming chickens eating the veggie seeds and a lack of water strangling the rest, led to boreholes and nurseries.
Currently, the annual operating budget of the Ndlovu Trust that grew out of the clinic is R40-million to R50-million. It employs 240 people and has created opportunities for thousands.
Among them is the woman who was hired to run the postal agency - the result of those 10 stamps - who is now the clinic manager. And the three original woman who started the practice with the Templemans are still there.
The project has branched out into nutritional schemes, pre-schools, bakeries and sports grounds. It runs a nappy factory, skills training and has sunk 28 boreholes and delivered communal taps.
World-class medical facilities include a 24-hour maternity ward that has had one maternal death in 10 years, a full-time laboratory, a farm programme, and a mobile dental clinic.
TB and HIV/Aids orphans' records are being stored electronically with GPS co-ordinates that can track defaulters and potential disease outbreaks, and giant vaults store frozen serum for future research.
In the afternoons, groups of women can be seen expertly hopping on the netball fields of a sports club that Dutch soccer legend Johan Cruyff funded and opened.
The project gets funds from the Royal Netherlands Embassy, the Nelson Mandela Children's Fund, the Liberty Foundation, and Stichting Dioraphte.
Richard Branson is to be a partner on another project near Bushbuckridge based on the Ndlovu model.
Ndlovu also gets a chunk of US President George W Bush's billion-dollar fund to fight HIV/Aids through local NGO Right to Care.
"He's the most remarkable person doing remarkable things for black people in that area," says Dr Ali Bacher, a director at Right to Care, of Hugo.
"I came away inspired by this chap. Who says that if you live in a black township, you live in third class facilities?
In Elandsdoorn, the finishing touches are being put to the Ndlovu Aids Awareness Centre - which employs 60 youths - and includes an amphitheatre with a giant movie screen.
For Hugo, there is no compromise. "There's only one standard and it's a good standard."
"There's always gaps because I always want to go a step further. As Liesje sometimes says, I'm the accelerator and she's the brake and if the brake-pads are not functioning... well, then I continue."
Liesje says the couple works hard, but live a comfortable life.
"I think my kids are happier than a lot of kids who live in urban areas," she says.
The word "pride" pops up a lot in Elandsdoorn: both at facilities built and at the opportunities to pull oneself up.
Lives have also been changed - literally reversed off death beds - in a country that has six million HIV positive people.
Templeman, who started the first ARV rollout in then Mpumalanga, has a no-nonsense approach to HIV-Aids.
"HIV was a death sentence and is now a chronic manageable disease like diabetes or high blood pressure with excellent results," he says. But deaths and the number of people not accessing ARVs remain high.
"Approximately 2 000 people turn from HIV negative to positive a day in this country and we say that we're doing well? We're doing damn bad," says Hugo in his typical hard-hitting fashion.
"Throw in 900 deaths a day - in a country that boasts the world's largest ARV rollout - and there is nothing to be proud of.
"We have the most people on treatment in the world but what we lack is even worse and that is never mentioned," he said.
Roughly 1,6-million to 2,1-million people are in direct need of ARVs, he calculates.
"At the end of 2007 we had 400 000 people on treatment. That's a damn bad score."
"This is a process of mass mobilisation and if you are not ready to mobilise the masses in the fight against HIV, you are going to fail.
"Because those who are not infected are affected and those affected are all of us."
"I'm the wealthiest man in the world. Money can't buy what we've done up here.
"I don't have a job, I've got one fantastic hobby which takes all my spare time away. It is fun."