Community Solutions for Sustainable Development: Perspectives from South Africa

5 Alberta Youth were selected to go to Hamburg, in the Eastern Cape of South Africa in July 2015 as part of the Alberta Council for Global Cooperation’s Change Your World Tour. They were hosted by the Keiskamma Canada Foundation, and visited the projects of their partner, the Keiskamma Trust

Be inspired to learn about the health, art, and educational programs run by The Keiskamma Trust, and supported by ACGC Member Keiskamma Canada Foundation. Youth have presented their experience at 18 events in Lethbridge, Wainwright, Peace River and Edmonton so far, and are not done yet!

Nurturing a Healthy Community

The Keiskamma Health Programme, based in Hamburg, Eastern Cape, aims to improve the overall health status of the Peddie South community and reduce illness from preventable diseases. This is done by addressing the social causes of disease and focusing on primary health care in 47 villages in the surrounding area. The programme works closely with local clinics and the Department of Health in order to support and strengthen existing services.

In South Africa the HIV/Aids statistics are still staggering. There are 5.6 million people living with the disease and it is estimated that over 2 million adults and a quarter million children still require treatment. Despite the largest treatment programme in the world, the ARV (anti-retroviral) coverage rate is only 52%, and in 2011 there were 380 000 new HIV infections, and 270 000 South Africans died due to AIDS related illness. Over 2.1 million children have been orphaned by AIDS. Clearly there is still much work to be done.

Although HIV/AIDS is the condition with the largest public significance, it is not the only epidemic which needs to be addressed. South Africa has one of the highest rates of TB in the world and new infection rates have increased by 400% over the past 15 years. HIV is driving the TB epidemic and many patients are struggling with both.

The Keiskamma Trust addresses these health priorities through community awareness events and an innovative community health worker programme that reaches out to all members of the community. The Community Health Worker (CHW) initiative is highly successful and currently employs 51 health workers and 6 team leaders. They are engaged on a new nationally accredited training scheme, using innovative low-cost cell phone technology, which is an exciting new development in an already vibrant programme.

Programme History – –13 Years of Filling in the Gaps

In 2000, Dr Carol Hofmeyr began to work in the village of Hamburg at the mouth of the Keiskamma River. Her combined skills as a medical doctor and creative fine-artist, as well as her passion for human rights and well-being, began to transform the lives of the people she worked with and taught. The poor health service in the area could not be ignored and Dr Hofmeyr started working in clinics to assist the communities she was working in.

In 2005 there were no HIV treatment services available in the Peddie district. The health programme was established by a handful of passionate local and professional people to provide ARVs and palliative care to AIDS patients in their own homes. Community Health workers visited patients, helped them take their medication, did pill counts, reported side-effects and assisted them to access clinics and treatment. At the same time, the health workers received education about all aspects of HIV/AIDS.

As there were almost no other HIV treatment services available at that time, patients came from all around the country seeking care. Due to ill health and huge distances travelled, it was clear that the patients needed somewhere to stay while being prepared for treatment. Urgent fundraising led to the establishment of the Umtha Welanga in 2005, where patients could be cared for with compassion and dignity.

In 2006, Nompulelelo Hospital (the district hospital in this area) became accredited to provide ARVs. And over the years the government response to the HIV epidemic has changed; so the Health Programme has provided a flexible response, supporting government provision and always with the well-being of the community at its heart. Nowadays, the Keiskamma Health Programme is in line with the National Strategic Plan (2012 –- 2016) and addresses national and provincial health priorities. Generous funders have provided a lifeline through difficult times.

Future Health Focus -– Where Do We Go From Here?

There are currently lots of changes in the South African Health Service and the next stage of the programme is to fully align ourselves with current South African Health Care Reforms. These reforms aim to deliver a health service through primary health care outreach teams, which have community health workers at their core.

The South African Department of Health has recognised the excellence of the Keiskamma programme and is starting to fund a portion of their activities in 2013. Commitment from the government to support the programme and its employees will be the next encouraging step in this journey of hope and determination.

Currently the main activities of the health programme include:

  • Advocating for improved access to quality health care for all members of the community
  • Strengthening collaboration with the Department of Health and the Department of Social Development
  • Training and supporting a team of community health workers (CHW)
  • Providing comprehensive primary health care services (with a specific focus on PMTCT and TB case-finding) through trained CHWs
  • Psychosocial support
  • Nutritional support (distributing emergency food parcels, community food gardens, Gogo gardens)
  • Establishing support groups
  • Community awareness campaigns
  • Transportation services for patients unable to access health care
  • Monitoring & evaluation of the health program
  • Research to inform policy