Good Practices and Innovations in Public Governance 2003-2011

2008 Category 2: South Africa
South Africa was rated 67th according to the Human Development Index in 1995, the
most recent HDI ranked South Africa 121st.
The Solution
The Phelophepa Health Care Train was conceived in 1993 as a three-coach optometric
clinic by the Rand Afrikaans University Department of Optometry and Transnet’s
(a parastatal transport corporation) corporate social investment department. The
Transnet Foundation, which took over ownership of the project, provided all of the
funding for the initial stages of the project and currently funds about half of the
train’s expenses. The Transnet Foundation is the implementing agency. The Transnet
Foundation, which is the corporate social investment arm of Transnet, South Africa’s
state-owned transport and logistics enterprise, believes that whilst many other organisations
may view social investment as a means to attaining goodwill within the
community, Transnet has an additional mission. The Transnet Foundation is based on
empowerment towards the future and acquiring selected initiatives that will provide
long-term sustainability not only to the organisation, but to the country as a whole.
Dr. Lynette Coetzee, the Transnet Portfolio manager, is one of the key people in creating
and implementing the idea of the train.
Private sector partners include Roche Products, the Colgate-Palmolive Foundation,
and the Canon Collins Education Trust for Southern Africa (CCETSA). These partners
offer some funding support; provide technical, provisional and logistical support;
and share their expertise in subjects such as diabetic care, medicine, cancer
treatment, oral hygiene, and education/curriculum development. St. John’s Red
Cross Society (NGO) provides the week-long training courses in home-based care
offered to graduates of Phelophepa’s five-day basic health care training.
For Phelophepa to secure credibility and function most effectively, it must establish
community support, gather input and ensure community participation. A week ahead
of the train’s arrival, a Phelophepa team arrives in the area that the train will be visiting
and finalizes arrangements with the community. They engage in discussion with
all local medical personnel in the area, and set up referral mechanisms. The team
consults with local community leaders and authorities and selects 16 persons to participate
in a week of health instruction on the train; and identifies individuals to be
recruited for translation, clerical, cleaning and other services. They also identify the
schools to be visited by outreach programmes and the village, in which to hold
Health Day activities.
Building the train was one of the most difficult design and engineering projects ever
tackled by Transnet Rail Engineering. Old coaches had to be refurbished and fitted
with special healthcare equipment. One of the coaches was converted into a power
car and installed with enough equipment to provide electricity for 14 to 21 days. A
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