Good Practices and Innovations in Public Governance 2003-2011

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Good Practices and InnovATIONS in Public Governance state-of-the-art kitchen was installed to prepare almost 400 meals per day and a satellite commu nications network. The setting up of the project involved practices, which were directly related to the mobile character of the service. In the case of the Dental and Optometry clin ics, early decision making, involving electronic equip ment, had to take into account the weekly vibrations and jolts involved with a train journey i.e., packing away of sensitive equipment and securing what can not be moved or packed away. The Health clinic quickly realized the importance of education as a means of prevention and then set up the Edu clinic, which gives five days of primary healthcare lectures to a volunteer group of 16 at each station, i.e., every week. The Pharmacy on the train was also very innovative as it developed a set of pictures, which depict the pre scribed regimens to solve the language problems. Be cause there are nine different languages encountered, the medical staff found great difficulty in explaining the necessary regimens to follow when taking medicines. Phelophepa comes from the seSotho and seTswana languages and it means “good, clean health”. The “well-oiled machine with a heart”, as the train has been dubbed, is the only train in South Africa that brings affordable and professional health care to rural communities. Besides providing direct medical care, Phelophepa’s key focus is health education and awareness. Transnet and Phelophepa produce literature in all the major South African languages, which is distributed to teachers in the community to pass on knowledge and awareness of pertinent health issues like teenage pregnancy. The volunteers that work on Phelophepa are also armed with knowledge, which they use to educate and empower themselves and their communities. Rural (African) schoolchildren generally walk miles to and from school through grasslands, the husks and pol lens, of which cause sever Allergic reactions and inflammatory complications (Vernal). Once the steroid/moist cell inhibiting eye drops have cleared the condition and therefore, the Eye clinic dispenses funded specta cles to these children to prevent a recurrence. Services rendered on the train include: health screening, cancer screening, diabetes screening, eye testing and provision of spectacles, dental restorative processes and extractions, oral health education, individual counselling therapy and community counselling workshops. Patient fees are no more than R30 (Rand), e.g., a health clinic consultation costs R2.50, dispensing a prescription costs R2.50, spectacles cost R30, and extracting a tooth costs R10. All of the train’s clinics and offices are equipped with computers and connected to the internet via satellite, which enables its staff to transmit data, consult with other medical professionals and establish referrals and appointment times for individual patients. In its classroom, Phelophepa gives a full-time five-day training course to 16 community members in basic healthcare measures. Graduates of this programme become volunteers in the community who disseminate the information they received from Phelophepa. Following the train’s 232
2008 Category 2: South Africa departure, the Order of St John gives these 16 people a week of instruction in homebased care, with a focus on HIV/AIDS. Phelophepa also runs several community outreach programmes throughout the course of its stay. These include: a school outreach programme, through which it offers screenings and examinations as well as oral health education to children at community schools and pre-schools in the surrounding villages; and a counselling outreach programme wherein staff visit local schools to conduct sessions with teachers, children and parents on a topic of their choice. The Phelophepa Health Care Train has increased access to health care services in deep rural areas. Since its inception in 1994, the Phelophepa Health Care Train has reached over 4,500,000 people. The health clinic sees between 20,000 to 25,000 patients each year. The eye and dental clinics see 120 to 150 patients per day. Phelophepa dispenses about 80 pairs of spectacles daily. Since 1994, counselling programmes have reached 263,570 people. More than 8,000 community members have been trained in basic health care and 1,443 people have received home-based care training. In addition, Phelophepa creates temporary employment for 50 to 60 local community members at each stop who provide translation services, record patients’ basic personal information, or work as cleaners, security staff and assistant cashiers. Such individuals earn between R30-60 for the week. Phelophepa is the only health care train in the world. Phelophepa works with several government departments. The Department of Safety and Security provides security services to the train during its stays. The Department of Public Enterprises (DPE) regards Phelophepa as a flagship programme within Transnet, of which DPE is the major shareholder. The Departments of Social Welfare and Education support some of Phelophepa’s services by, for example, registering orphans for social grants at school outreach programmes. The Department of Health recognizes Phelophepa as a legitimate source of health care support and strives to inform as many people as possible about the train’s arrival. Transnet business units carry out much of the technical work required for the train’s operation. Spoornet and Transwerk conduct infrastructure maintenance, stock upgrading and technical assistance to the train. Transtel and Arivia.kom supply and maintain the communications equipment and services to the train including a satellite dish, telephones, and computer equipment. Phelophepa’s primary objective is to deliver efficient, credible and cost-effective mobile healthcare services to poor rural communities where health care facilities are either inadequate or non-existent. In addition, the project seeks to enhance basic health care awareness in rural South Africa and to empower people to enhance their physiological and psychological health. The train makes visits to 36 locations in four 233
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This publication provides an overvi
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