Good Practices and Innovations in Public Governance 2003-2011

Good Practices and InnovATIONS in Public Governance
provinces in one year and the remaining four provinces in the following year. Gauteng
is excluded as the network and spread of its health services is considered to be superior
to that of the remaining eight provinces.
Reaching as many people as possible is the aim and object of Phelophepa’s outreach
programmes. Not everyone is able or willing to come down to the train, so the train’s
staff make visits in the community to conduct outreach activities. At each stop, Phelophepa
staff also conduct two ‘Health Days’ in one of the local villages. This comprises
of a full day of health-related activities in order to raise awareness about health
and health care issues. Phelophepa hopes that health education and awareness will
help community members to avoid contracting some preventable illnesses.
Lessons Learned
Mobility is a key feature of Phelophepa’s operations. The Phelophepa Health Care
Train can reach much larger numbers of people, being mobile, than it could if it were
permanently stationed in one location. Since Phelophepa only visits each location for
a week, it became clear to its implementers that something had to be done to ensure
that their visit left a lasting impression and lasting benefits for patients. So, Phelophepa
launched a health education programme to achieve maximum impact on the
health of the communities they visit. This programme allows them to teach 16 people
in each community basic health care procedures so that they can continue to treat and
educate patients once the train has left.
This initiative has managed to bring aboard private sector operators as well as public
ones. This approach is key to its sustainability. It receives 49% of its funding
from Transnet who, as the implementing agency, will continue to fund this initiative
indefinitely. The rest of the project’s funding comes from a range of corporations
including a few large companies like Roche Products and Colgate-Palmolive.
Because of its successes, and its national and international exposure, Phelophepa is
unlikely to see funding dry up in the near future. Phelophepa is also socially and
culturally sustainable as a result of having achieved significant community buy-in
and participation in each of the locations that it visits. Having been in operation for
over ten years, Phelophepa’s organisational structure, policies and procedures are
well-entrenched.
As a result of past success, this initiative is being replicated and expanded. The Minister
of Public Enterprises has requested that a second train be built, to be operational
in 2008. While initially quite an expensive venture, Phelophepa is a cost-effective
method of healthcare service delivery. The key aspect to replicate here is
mobility, and not necessarily a train per se. In South Africa, a train works well because
of the existing railway infrastructure that had previously served the mines and
transported conscripted workers during the apartheid era to and from the mines. Also,
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