The people gather long before the Phelophepa train pulls into the station. Some have been there all night, hoping to be first in line for the 'good, clean health' that the name of the train promises. They may need glasses, or a toothache eased. A youngster stressed by school might need counselling, and his grandmother could require medicine for her high blood pressure.
The Transnet Foundation’s two healthcare trains, Phelophepa I and II, are designed to provide basic medical help and education.
Each train has a permanent staff of 22 healthcare professionals, including nurses, healthcare educators, opticians and dentists. The trains also carry managers, translators and security staff. Local workers are hired on a temporary basis.
Also onboard are a team of final year healthcare science students. They are future pharmacists, opticians, nurses, psychologists, dentists and oral hygienists, and they are there to run tests and dispense basic healthcare. The students are getting practical training where it can do the most good – in communities in rural areas where healthcare is hard to find. More than 1 000 students spent a fortnight working on the trains last year.
Residents at each stop play a major role, so when the train leaves the station, it leaves a legacy. Some are trained in healthcare education outreach, visiting schools and old age homes. Others are tapped to join a Local Organising Committee to meet with key stakeholders to prepare for the train’s visit. Their task is to identify schools, retirement homes and other places that need visits from the Phelophepa healthcare workers to check on their vision and dental needs. Members of the committee also make sure the station is ready to receive the train and that the community knows it’s coming.
After the departure of the Phelophepa, they are able to use the skills they have developed in social mobilisation to lead other projects in their area. Phelophepa I first left the station in 1994, functioning as an eye clinic. Phelophepa II was inaugurated in 2012. Each train services four provinces, spending two months in each between January and September. The two trains help nearly 400 000 people every year, both inside their custom-built cars and in outreach programmes.
Transnet has involved business in its activities. The dental clinic, for example, is partly sponsored by the Colgate Palmolive Company – the multinational helped to pay for dental chairs, x-ray units and other equipment. There are usually 75 tickets distributed to those in the queue for dental care on a first come, first served basis every day, and procedures cost only R10.
Roche Ltd sponsors both the pharmacy clinic and the healthcare clinic. The latter treats minor ailments as well as diabetes and offers screening for cancer. It can handle 120 patients a day. The pharmacy clinics dispense close to 20 000 prescriptions every year. Whether it’s aspirin, vitamins or medication for a serious problem, each prescription costs R5. The eye clinic is perhaps the best known of the services on offer. Here, too, the opticians can test 120 people a day with state-of-the-art equipment and fit glasses on the same day – a very popular aspect of the operation – for only R30 a pair.
The psychology clinic is very busy. Unemployment, HIV/Aids and violence are as prevalent in rural areas as they are in an urban environment, leading to depression and despair. In the areas visited by the trains, there is usually no-one to turn to for help. This clinic offers one-on-one, face-to-face counselling, as well as psycho-educational workshops – two ways to help patients find solutions to their overwhelming problems. The educational clinic, sponsored by the Canon Collins Trust, offers five days of healthcare awareness education onboard to residents who will be able to help their communities after the train has moved on.
While Phelophepa is still in the station, healthcare workers engage in a number of outreach programmes. A chief professional nurse and two final year nursing students visit primary schools suggested by the Local Organising Committee. The resident optician and a student also visit primary schools and check on pupils who may need onboard services. A dental educator and a final-year dentistry student offers oral hygiene education – and toothpaste. An Aids action programme is focused on providing training dealing with the condition.
A programme run with St John, an international provider of community healthcare care training, identifies key people in the community to train for work in home-based care. In a community counselling programme, workshops are organised to educate adults in alcohol and drug abuse, child discipline and HIV/Aids. These workshops reach some 7 000 people every year. The children are not left out: in fact, some 20 000 pupils annually are counselled on conflict resolution, teenage pregnancy, career choice, abuse and violence.
Since the beginning of Phelophepa, the trains have reached 20 million people, changing lives and bringing healing and healthcare education to communities in great need of care. The international community has honoured the Transnet Foundation for the Phelophepa project many times. Among its honours: Phelophepa was the first South African CSI initiative to win the United Nations Public Service Awards’ prestigious Africa Prize. The Impumelelo Innovation Trust Award went to the project in 2006, and the Honor Society of Nursing’s 2010 Sigma Theta Tau International Archon Award went to the foundation for the Phelophepa project.