Bringing health services to farmworkers in remote areas of Western Cape

In keeping with its commitment to conduct oversight on health services in the Western Cape, the National Council of Provinces delegation visited a mobile clinic site at Brewelskloof Hospital in Worcester to assess its efficacy.

The mobile clinics consist of three buses that have a 14-day schedule - and they are part of the Western Cape Government's intervention to bring health services to people on farms in far-flung areas of the Winelands district, said its Head, Ms Charlotte Stemmet.

"The mobile clinic health services are indispensable for people living in remote areas. One of the most valued characteristics of a mobile clinic is its ability to follow up on patients and provide the necessary care, especially when it comes to children and TB patients, to enhance treatment compliance. Moreover, there is more scope to observe the domestic environment of the patient and to take the necessary steps to address health risks such as sewerage water at farm workers' homes," she said.

This project, which covers so much ground, proves to be an effective way of dispensing health care services in this district, she said. "We treat up to 40 people a day. People who would not normally be reachable, especially women who need health planning, antenatal and postnatal care."

Moreover, this service has helped in bringing the much-needed interventions to arrest the spread of communicable and non-communicable diseases in this district, she said. "The clinics help with cervical and breast cancer screening and HIV and TB screening, especially the detection of TB contacts, as well as the screening of other chronic diseases such as diabetes and hypertension and the routine evaluations and renewal of chronic medication, and referrals," she said.

"The success story of this intervention is that it has employed non- governmental organisations (NGOs) in the area to promote health education and to dispense medication to patients," said Ms Handri Liebenberg, the Deputy Director of Comprehensive Health Services in the district.

"These NGOs help us with TB projects, distribution of condoms and HIV testing. But also, we have to date trained health care assistants in full health care services that suit the farming community," she said.

The challenges faced by these mobile clinics is that they need to be maintained and upgraded regularly to ensure that they function optimally and there are currently no funds to do so, said the Clinical Manager of the Breede Valley, Dr Bennim Botha.

"The challenge we are faced with is that we need to upgrade these clinics. Currently, they need air conditions, staff toilets and electronic filing systems. These are technological systems that are not currently available but that are needed to optimise their services."

After this site inspection the delegation went to the Worcester General Specialist Hospital. Its Chief Executive Officer, Ms Elbie Vosloo, explained how thy have streamlined its services to meet the patients' demands. One of which is its outreach project which has transferred anaesthetic, orthopaedic and oncological skills to district hospitals, she said.

"The establishment of this support system has enabled these hospitals to be well equipped in catering for much-needed health services in this area," she said.

One of the hospital interventions is the reconfiguration of its emergency centre, which was, due to a backlog, not optimally meeting the demand for health care services of its jurisdiction, she said. "The new rotational system of doctors who work 12 hours a day for five days and then get five days off, has improved our services and enabled us to meet the demand for health care services of our population.

The success of this configuration is that now our doctors are not on call and there are suitably qualified doctors to attend to emergency cases. This configuration has afforded doctors time to pursue their academic studies. And unlike before, there is now a waiting list of doctors who want to work for us because of this benefit."

The Worcester General Specialist Hospital has Thuthuzela Centre, which is recognised as the best sexual assault survivor centre nationally, said Ms Vosloo. "Our success in this regard is due to the availability of forensic nurses in this centre, who render a 24-hour service. As a result of that, it has a high conviction rate compared to others nationally," she said.

Parliament News, 15 September 2016