The audio is in isiZulu. See english summary below

MABUTHO: Lomtholampilo ka Dr Hugo Templeman  ose Elandsdoorn nokuyindawo yasemakhaya eyakhelwe ngabantu abalinganiselwa ekhulwini namashumi asithupha ezinkulungwane, 160 000 wasungulwa ngonyaka ka 1994 njengomtholampilo omncane kanti kuthe ngonyaka ka 2001 wabe sewunwetshwa sewuba isikhungo sezempilo esithi masenze konke okwenziwa izibhedlela ezinkulu. Njengoba igciwane lesandulelangculaza liqhubeka nokudla lubi kuleli lomtholampilo wamukela inqwaba yeziguli eziguliswa izifo ezisondelene negciwane lesandulelangculaza.  ULettie Msiza, 30, wase Mashikana eMpumalanga village, ufike kulomtholampilo ngo April ka2004 engakwazi kwenza lutho ngaphandle kokulala ngesisu ngenxa yezilonda ezinqeni ngenxa yokugula okuhambisana negciwane lesandulelangculaza.

LETTIE MSIZA: Ngize ngokugula ngoba bengisesibhedlela sikahulumeni ngigula kakhulu bathi mangihambe ngiye ekhaya. Abazange bangitshele ukuthi kungani ngiye ekhaya ngoba bengibona ukuthi angifanelanga ukuya ekhaya ngendlela ebengigula ngayo.

MABUTHO: Nakuba esahlezi njengesiguli kulesisibhedlela kodwa isikhathi esiningi usichitha esebenza kwelinye lamahhovisi akusona lesisibhedlela okuyingxenye yezinhlelo zawo lomtholampilo zokwenza ngcono impilo yabagulayo ngokuthuthukisa ulwazi lwabo kanjalo nokubavulela amathuba empilo engcono. Uthi ukusebenza ebe eseyisiguli kulomtholampilo kuyamsiza ngoba kumenza athi ukulibala ukugula kwakhe okwesikhashana.

LETTIE MSIZA:   Manje isikhathi esiningi bengisichitha ngihleli ngingenzi lutho udokotela wase ethi kungcono lesisikhathi asichitha ehleze eze emsebenzini ngibe bhizi ngasomething. Angisacabangi izinto eziningi ngoba manje ngibheke lomsebenzi engiwenzayo sengifana nabanye abantu.

MABUTHO; UMn Herbert Bholotini naye uphila negciwane lesandulelangculaza. Wafika kulomtholampilo eselahle ithemba ngokuphila emva kokuhambela izibhedlela ezahlukene kanye nabelaphi bendabuko. Njengamanje usesebenza kumnyango wecounselling yalomtholampilo emva kokuqeqeshwa ngaphakathi kuwona lomtholampilo ka Dr Templeman.

HERBERT BHOLOTINI: Into engiyibonile nengiyifundile ngingakaqali ukusebenza lana nanoma sengiqala ukusebenza lana nangesikhathi sengihamba njengesiguli. Ngiye ngaqaphela ukuthi eClinic bayakubuza ukuthi uphethwe yini bakunike iPanado. Angikhumbuli bethi mangizihlole  ukluthi nginalo igciwane. Enye yezinto eyangenza ukuthi ngize lana iService yabo ingcono kakhulu. Kuneziguli engihlangana nazo ezifika lapha ngoba zithi esibhedlela zijikisiwe. Ngike ngaba nesiguli ngo January ebinesine CD4 count ewu 60 bathi makabuye ngo March. Awucabange ke lowomuntu iCD4 count yakhe engaphansi kuka200 belokhu bemenzisa ama up and down uzogcina kuphi? Ekubeni uyabonakala ukuthi impilo yakhe ayiyinhle. So kunomehluko okhona phakathi kweNdlovu Medical Centre kanye namanye amaclinic. Kodwa ke akumele sigxekane ngoba kunabantu okudinga bayiswe kuzona lezibhedlela. Kumele mhlawumbe sibe nama workshop sibe nokusebenzisana kunokuthi sigxekane.

MABUTHO: Oka Tempelaman uthi nakuba umtholampilo wakhe unokusebenzisana nemitholampilo engaphansi kukahulumeni kodwa ubona sengathi ubudlelwano abanabo buhamba kancane uma kubhekwa umonakalo osudalwe igciwane lesandulelangculaza. Uthi isifiso sakhe ukuthi athole ithuba abonise ukuthi lomtholampilo wakhe wenza ngani ukuthi ube kulelizinga okulona ukubalekela ukuthi kube khona ukubhekana ngeziqu zamehle phakathi komtholampilo wakhe kanye nezinye izikhungo zezempilo.

DR HUGO TEMPLEMAN: Those relationships are growing but not fast enough seeing the HIV pandemic that is around us. On the other hand the last thing that I want to do is to show them how we have done it. Because then, instead of being an addition where we can learn from each other we will be seen as a threat and then it will spoil the whole concept of public partnership.

MABUTHO: Khonamanjalo uMn Peter Mehlape wenkampani enkulu ekhiqiza imishini yokubala ama CD4 count iBectone and Dickson Global Technology Company nesanda kunikelela ngomunye wemishini yayo kulomtholampilo uthi usewahambe wonke amazwe kodwa akakaze awubone umtholampilo ofana nalona ka Dr Templeman nokwenze ukuthi inkampani yakhe ibone sisikhulu isidingo sokuthi inikele ngeminye yemishini yawo emikhulu ukuze kuzosizakala umphakathi wendawo.

PETER MEHLAPE: They have done something out of the ordinary. I have never seen it anywhere on the African continent. The set up here is very unique in that it is very effective. The reach is beyond an average clinic where the centre is incorporated into the community.

MABUTHO:  Kanti lomtholampilo awugcini nje ngokuthi unikeze usizo lwezempilo kwabagulayo, kepha uphinde ube nezinhlelo ezisiza umphakathi ezibandakanya ukunikezelwa kwamathuba emisebenzi kubantu bendawo ngokusungula amaProject omphakathi ukufundisa amakhono intsha kanye neziguli esezihlale isikhathi eside esibhedlela. U Dr Tempelman uthi bekungakuhle uma kungasungulwa eminye imitholampilo esezingeni elifana nalona wakhe ezindaweni zasemakhaya ngoba kulapho abantu befa khona kakhulu ngenxa yokuntuleka kosizo lwezempilo kwazise izikhungo ezisezingeni eliphezulu zisemadolobheni.

DR HUGO TEMPLEMAN: Don’€™t do it only in big centres and in urban areas, but bring back care there where suffering is most and that is in rural areas. The highest prevalence, the highest amount of useless deaths because there is no access to care.    

MABUTHO: Ngenxa yezinqubomgobo zombuso wobandlululo kaziziningi izikhungo ezisezingeni elifana neleNdlovu Medical Clinic ezindaweni zasemakhaya. Lokhu kwenza ukuthi abantu abagulayo isikhathi esiningi badluliselwe kulezozikhungo ezisemadolobheni nokiyizona ezingcono.

ENGLISH SUMMARY.

A good model of rural clinic

Dr. Hugo Templeman, a Dutch physician who runs one of the best clinics in the impoverished rural village of Elandsdoorn in Limpopo province says that his is a model rural clinic.

The Ndlovu Medical Centre was founded as a small health facility by Templeman  in 1994 after seeing a high number of people succumb to AIDS in the area. Today the clinic boasts its own pharmacy, X’€“ray machine, laboratory and a successful maternity programme which includes the prevention of mother-to-child HIV transmission programme. In addition to offering health care, the centre runs a number of successful development projects in the area, including a  bakery, pre-schools, and computer school, offering employment to locals.

The clinic has earned itself a good name from the local community. It is well-recognized for giving a second chance to people sent home to die by conventional government hospitals, particularly those with AIDS.

Soft-spoken, Lettie Msiza, 27, from Mashikana village is one of these. She was admitted to Ndlovu Medical Centre in 2004 when her immune system had collapsed and she had large sores on her back that made it uncomfortable to sit.

‘€œMy aunt brought me here after the government hospital told me to go home. I don’€™t know why they sent me home because I was seriously ill. I could not do anything except lying down on my stomach,’€ she said.

Although she is still confined to a wheel-chair, she is much better than when she was first admitted at the clinic. She now works as an administrator at the clinic.

“Working while in hospital is helping me a lot because I sometimes forget that I am sick and it make me feel like all other normal people,’€œ she says.

Herbert Bholotini is a counselor at the clinic. Before that he was also a patient at Ndlovu Medical Centre. He says he came to the clinic after he heard people talkabout it. What he has learned through his experience as an HIV positive patient visiting different clinics, he says, is that ‘€œin most clinics they just ask you what’€™s troubling you and then, they give you Panado’€.

‘€œI do not remember being asked to take the HIV test in these other clinics. Not so long ago, I had an HIV-positive patient (from a government clinic) who came here in January. That patient was told to come back in March. But he is sick. His CD4 count was 60. Just imagine if they keep on taking that patient up and down – where is he going to end up? So there is difference between Ndlovu medical centre and these other clinics’€, he adds. ‘€œBut we don’€™t need to criticize each other because have some patients that we need to refer to these other hospitals. We need to have some workshops where we can learn from each other,’€ said the outspoken Bholotini.

On the other hand Dr Templeman says although he does have working relationship with government’€™s clinics, he thinks it is moving at a snail’€™s pace.

‘€œThose relationships are growing but not fast enough, seeing the HIV pandemic that is around us. On the other hand the last that I want to do is to show them how we have done it. Because then instead of being an addition where we can learn from each other we will be seen as a threat and then it will spoil the whole concept of public partnership,’€ he said.

The outstanding work done by the clinic caught the eyes of Becton and Dickson Global Technology company. It recently  donated a CD4 count machine to the clinic. The Managing Director of the company, Peter Mehlape, says the machine will help the clinic to carry on doing its ‘€œextra-ordinary job’€ of serving Elandsdoorn community.

‘€œThey have done something out of the ordinary. I have never seen it anywhere in the African continent. The set up here is very unique in that it is very effective. The reach is beyond an average clinic,’€ said Mehlape.

Dr Templeman reckons that there should be more clinics of a high quality standard in rural areas because it is where the majority of people who need health care reside.

‘€œDon’€™t do it only in big centres and in urban areas, but bring back care there where suffering is most and that is in rural areas. The highest prevalence, the highest amount of useless deaths because there is no access to care,’€ he said.