Achievements over the twelve months that the project has been running, include an increase in the tuberculosis cure rate from 59% to 100%, the early identification of child abuse cases, increased clinic attendance and a serious attempt to address the malnutrition problem.

The Philisa (to heal) Community Health is run by the five community health workers, who also live in the informal settlement, and visit people on a daily basis.

The improved TB cure rate was mainly as a result of the health workers who have been trained as TB supporters.

Many people in Masiphumelele are casual labourers who cannot attend the clinic during office hours. They previously were left untreated. Now each TB client is assigned to a health worker according to the area in which they live and they are able to collect the tablets from the health workers house at a time convenient to them. They are also able to build a relationship of trust with the patient which promotes compliance.

According to statistics from the South Peninsula Municipality, the attendance at the clinic has increased from 1 367 visits per month in 1997/8 to 2 035 visits per month in 1998/9.

The reasons for this are that the health workers are making people aware of the clinic and are following up on people who default on appointments for family planning, baby weighing or immunisations. Many people in Masiphumelele did not know that there was a clinic until the health workers started telling people during their home visits.

The health workers aim to educate the more than 10 000 residents on health issues, dispense medicine for minor ailments and refer patients to the clinic or hospital.

About 800 homes are reached every three months, also addressing problems such as HIV/AIDS, child abuse, unemployment, malnutrition and poverty.

The health workers, led by married mother of three Pumla Gobololo, work closely with the clinic staff to address tuberculosis and HIV/AIDS and run workshops on the weekends, educating the community on the subject.

They also provide education sessions to the patients waiting for treatment in the clinic waiting room.

University of Cape Town nurses Tanya Doherty and Chantelle Juby first became involved with the community of Masiphumelele four years ago through the Students Health and Welfare Centres Organisation (SHAWCO) at UCT.

SHAWCO is a group of medical and paramedical students running clinics in underserved areas, in the evenings either from mobile sites of the local clinics.

Their involvement grew as they started establishing relationships with the community that had no adult curative healthcare services.

Doherty and Juber visited the clinic every Monday night, seeing between 40 and 60 patients.

They then approached the University of Birmingham for funding and received some money that has enabled them to train the community health workers and extend the clinic to accommodate Philisa. Funding from the British Lottery Board for the fifth health care worker and the training of a co-ordinator has since been stopped.

“It is crucial for a co-ordinator to be trained as this would enable us to hand the project over to the community,” Doherty said.

Since the workers have started there have been many successes, including the improved TB rate and the early detection of child abuse cases.

The community health workers have also been closely involved with an occupational therapist and together they have referred many disabled children to the appropriate care.

The four women and one man have attended various training courses such as first aid and skills development and will this year focus on home care training and HIV counselling.

“The people tell us about their problems, mostly poverty related issues,” says Gobololo.

Malnutrition and unemployment are the two other main problems identified by the health workers.

“We try and put them in contact with employment opportunities where we can, but the unemployment has led to such poverty that we will soon be looking at distributing food parcels,” says Gobololo.

Gobololo and the other health workers have also grown accustomed to the fact that they are the only link the community have with any health care services during weekends or after-hours.

“We regularly get woken up to attend to stab wounds or a woman in labor.

One day they called us to tell us a woman was on the verge of giving birth. By the time the ambulance arrived, we had delivered the baby,” Gobololo says proudly.

Asked why she chose to become involved, Gobololo doesn’€™t think twice before answering: “It was my dream to become a nurse. I want to be involved with people, but especially my community. In the past they didn’€™t know where to go when they were sick, now they know us. We are working for them, to heal them.”

Anyone interested in more information on Philisa can contact Tanya Doherty on 082-898-2390.

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