Health Programme

HIV~AIDS
In partnership with the Eastern Cape Dept of Health, the Donald Woods Foundation runs the largest rural, integrated HIV Programme in South Africa, and one of the most successful, with over 55,000 rural people tested to date. Our priority focus is to capacitate local people to own and run their own Support Groups and to drive the decentralisation of services from hospitals to clinics and outlying communities. To date, we have built eight clinics, with a further five planned for 2011. The Foundation is now expanding this programme to four other hospitals in the Eastern Cape with wider components from TB integration to Orphans & Vulnerable Children and Home-based Care.

TB Integration
One third of people on the planet are infected with TB. In the Mbashe region, HIV cases are rapidly increasing and in some district hospital wards, as many as 80% are presenting with concurrent tuberculosis. Treatment failure of TB is rising and many are presenting with TB for the second, third or even fourth time. Predisposing factors include increasing HIV affecting the immune system, the difficulties of implementing a successful DOTS programme in an under-resourced setting, and the increasing incidence of multi drug-resistant tuberculosis. For children there are inadequate services for those presenting with chronic illnesses and chronic respiratory conditions, as well as long-term malnutrition and poverty among children. Our work with multi-drug resistant TB at Fort Grey will focus on data tracking of patients through an integrated knowledge management system with hospitals across the Eastern Cape.

Home-Based Care, decentralisation and roll-out of services
A key component in a difficult geographic area with no transport infrastructure and dirt roads, is to roll out services to be offered as close to people’s villages as possible. Building clinics and increasing access through 4x2 vehicles has increased programme reach immensely. In addition we train Community Health Workers in both health promotion and care for people in their homes, to limit the need to travel to obtain medicines or the help they need where this can be offered in the home. This decentralisation of services is an important component in the effectiveness of our work so that people can access life-saving services for the first time as quickly as possible.

Orphans and Vulnerable Children
Of an estimated 50,000 vulnerable children in the area, we aim to screen and reach 20,000 orphans and vulnerable children and treat at least half of the 3,200 who are estimated to be HIV positive, over a four year period. Components of the programme include applications for identity documents leading to social grants, fostering and family support including food gardens. We work to ensure every child aged 7+ is in school, has all the basic health checks and follow-up treatment that is needed. For families affected by HIV, the paediatric clinics see families together and ensure children at risk are assessed. The programme supports effective screening, care and / or drug treatment, nutrition, crèche facilities, support groups, trained OVC Care Workers and partnerships between schools, outreach clinics and the Departments of Health and Social Development.

Training and Professional Development
Essential to being able to ensure quality health services in the area in the future, is the need to upgrade the training and development opportunities so as to ensure a quality of life, skills empowerment, development for both the individual and the professional capacity in which they operate.  As part of the Department of Health’s ‘Revitalization programme’ at the Hospital, the Foundation assists with high quality recruitment for training and professional development, including specializations in the areas of  HIV, TB, maternal health, eye health, paediatrics, palliative and home-based care. A critical part of this strategy is a well equipped training centre for doctors, senior nurses, senior management and programme specialists, so that multi-disciplinary training can become the norm, as well as different on-line training be used to overcome distances and cost of centralized training.

Food Security and Nutrition
Essential to the success of the Wellness and OVC programmes is access to nutritional food at an affordable cost. In this area there are severe logistical difficulties such as uneven terrain, lack of roads, little ground and rainwater harvesting – all of which are a major challenge to family health. Training will also be needed such as balanced crop planting, timing, maintenance and harvesting. The plan is to incorporate this training into the clinic and school activities to support OVC and TB programmes, but also for these systems to be replicated by individuals in their homes. In schools, the aim is for each child to ‘own’ his or her own 1m x 2m plot and the subsequent produce. Small-scale income generation will also be linked to the programme to provide food for the crèches and support group activities.