Today I had the opportunity to visit two community-based primary health care facilities -- Gugulethu 24-hour Community Health Center and Brown’s Farm Community Health Center. The visit was coordinated by Dr. Robert Martell, Medical Superintendent for the Cape Town Metropolitan Health District.
Gugulethu is one of the older townships within the Cape Town metro district. The community is primarily formal settlements (i.e. non-shack dwellings). There are approximately 300,000 persons in the catchment area for the CHC. The CHC has a maternity ward for ante-natal care and non-problem births. Gugulethu CHC also features a trauma center that treats a large number of gunshot and knife wounds, most related to alcohol abuse, and victims of domestic violence.
At Gugulethu there is a dedicated Anti-Retro Viral (ARV) Clinic with approximately 1,300 persons on ARV Therapy. The Clinic is housed in a purpose-built pleasant building with a large waiting room. Newly diagnosed patients could distract themselves by watching the highly dramatic Afrikaans “soapies” on a large television while waiting to be attended to. The unique ARV program relies largely on HIV-positive counselors (who are themselves stable on ARV Therapy) to counsel and encourage patients in their adherence to drug regimens. The program also uses the “Buddy System” and cell phone text message reminders and has a high rate of patient compliance. According to the Clinic Director, budgetary constraints limit treatment to basic ARV drugs. Patients that fail on these treatments might be able to participate in clinical trials for other HIV/AIDS medications. There is a Buddy Room that has days dedicated to common illnesses – Diabetes, Asthma, Hypertension, etc. – where patients get treatment, special information and support groups meet.
Browns Farm is a large community consisting of both formal and informal (shack) settlements, including the infamous Crossroads squatter camp, where residents survived Apartheid government harassment (including murder) and countless attempts to level their shack community with bulldozers. Not surprisingly, the community runs a tight ship at the Browns Farm CHC. The current facility, a rabbit warren of shipping containers and connecting sheds, is immaculate and patients proceed through intake, preparation and treatment in an orderly fashion (see picture). Construction of a 5 Million Rand ($800,000) new facility is well underway and expected to be completed by August. The new facility will be air-conditioned with sky-lights and a spacious waiting area and several consultation rooms. The gentleman who showed us around let us know how large the community was and mentioned to Dr. Martell that the CHC needed two more doctors.
* God Bless Africa
