2015 Rural Awards acknowledge achievements in rural health

Deprivation is worst in “ex-homeland rural areas” according to a range of DHB indicators that covered income, unemployment, living standards and education

One of the highlights of the conference is the Pierre Jacques award for Rural Doctor of the Year and the RuReSA Lifetime achievement award.

This year the Rural Doctor of the Year award was presented to Dr Ndiviwe Mphothulo from Taung District in North West Province. Dr Mphothulo’s dedicated work in the service of TB patients

Dr Mphothulo - rural doctor of the year, 2015
Dr Mphothulo – rural doctor of the year, 2015

and the fight against TB in Taung district is truly outstanding. And it all began in 2003 when this Soweto born and bred junior doctor was placed in Taung District hospital for his community service year. Since then he’s never looked back and his passion for public health has taken him to the forefront of the fight against TB in the community, starting with the TB ward at the hospital. Dr Mphothulo has been instrumental in developing protocols, setting up a TB/HIV co-infection treatment program with more than 95% collaboration, providing telephonic advice to local clinics and medical officers from other hospitals in the district and liaising with the South African Social Services Agency (SASSA) for grant applications and home-based care groups on patient follow-up. Dr Mphothulo also took up the challenge of decentralising MDR-TB treatment by managing the satellite unit at Taung District Hospital, which went from 20 beds to 33 beds in January 2011 and is close to achieving the goal of curing 100 patients by the end of this year. On top of this, he is also the author of a book titled, “TB cases from Taung – A perspective from a rural district hospital” which highlights the management of difficult TB cases in a rural setting with scarce resources.

In his acceptance speech, Dr Mphothulo was gracious in acknowledging that his achievements would not have been possible without a supportive team of health care workers and the political will of the district health services.  And he reminded us that health care is a long supply chain that begins with the Constitution, passes down to the president and ministers and then to MECs and health facilities before finally making a difference in the lives of patients.

RuDASA also acknowledged the lifetime achievement of Dr Reynier Ter Haar, a South African doctor who’s been based at Nkhoma Hospital in Central Malawi for the past 18 years. In the past 4 years he’s been actively involved in initiatives to improve the quality of care and quality of life for people in the surrounding area, as well as strengthening the links between rural medicine and Family Medicine training for Malawian medical students. His list of achievements include developing a program for Indoor Residual Spraying (IRS) for malaria control that has seen significant reductions in the number of paediatric admissions to the hospital since 2012. Through Dr Ter Haar’s leadership, Nkhoma Hospital became the first CHAM (Christian Hospital Association of Malawi) hospital to enter into a service level agreement with the Ministry of Health to provide free care to maternity and under five patients in the hospital catchment area and for referral of these patients needing hospital care at no cost to the patient. In addition, Dr Ter Haar’s cervical cancer screening program, developed in partnership with Edinburgh Global Health Academy and Lothian NHS UK, is set to become the model program for cervical cancer screening in the country.

Unfortunately Dr Ter Haar was not present to accept his award due to family commitments but we hope to see him at next year’s conference in the Eastern Cape.

Lifetime Achievement Award

Rural Rehabilitation SA (RuReSA) presented a Lifetime Achievement Award to Dr Pam McLaren, an occupational therapist who pioneered rural rehabilitation services. She is described by colleagues as having a “brave and daring heart” for stepping out of the boundaries of the city and taking rehabilitation to the people who need it most and had the least access to health care services.

In the early 70’s she was based in Oshakati General Hospital, Namibia, working with amputees from the war in Angola – who walked using “tree stumps’ as legs to get to Oshakati where they could be fitted for a prosthesis. Later at Manguzi Methodist Hospital, near Kosi Bay, she started an income generating project using indigenous knowledge of basketry, woodwork and plants; so that mothers and grannies with children in the malnutrition ward could buy peanuts for the peanut porridge promoted by the Nutrition Rehabilitation Unit. Little did she know that her post was funded by 2 doctors out of their own pocket for the 1st year!

Pam became more aware and more concerned with the social injustices faced by people during her research for her Masters in Soweto (1975-78) when she tried to rehabilitate the people who had been thrown off trains by ‘tsotsis’ and who were subsequently called ‘disabled’; and then by her work at Manguzi – a ‘deep rural’, very remote area in the grips of poverty and malnutrition. A whole year after arriving at Manguzi she had access to a Land Rover from The Evangelical Alliance Relief (TEAR) FUND and was able to travel into the sand forest and the palm veldt and discovered literally hundreds of people, with many different conditions, unable to travel to hospital.

Pam was a co-founder of the Rural Disability Action Group (RURACT) in 1986, an organisation that aimed to bring isolated rural based therapists and rehabilitation workers together in the days before the magic of email and internet; and RuReSA (in 2011) a modern version of RURACT. She has also contributed widely to DART (the Disability Action Research Team) from 1995, and developed a statistics bank for rural rehabilitation and disability, at a time when rehabilitation statistics were non – existent! Pam was the catalyst for therapists to move out of the cities and into rural areas, her awareness of social injustice and her determination to change the lives of those affected by social injustice helped create the community rehabilitation service in South Africa today, and influence the policy of the KZN rehabilitation service, and most recently the national policy regarding rehabilitation through her work on the national Framework and Strategic Plan for Disability and Rehabilitation for 2015.

In 1983 Dr McLaren received the “Wheel of Service” from the Rotary Club of North Durban, for distinguished contribution to better human relations; and in 1992 the Bronze Medal by Community Health Association of Southern Africa (CHASA) for contribution toward the knowledge of disabled people in rural areas.

Pam remains enthusiastic about the future of community based rehabilitation, and the new generation of therapists following in her footsteps, as well as recognising the influence of all those she worked with: “I look back at all the photographs of individuals who gave me the strength and determination to face the “rapids” (on my journey) I realise how much I learnt from their humanity and wisdom. The simple interventions, I was able to offer, as the only therapist in that huge area, were so appreciated, nothing being taken for granted.”


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