Sizwe Tropical Disease Hospital was established in 1895 for the treatment of various infective illnesses including small pox, typhoid and malaria. However due to the overwhelming burden of the tuberculosis disease, since the mid 1990’s, it has become a referral centre for drug-resistant TB. Multidrug-resistant TB (MDR-TB) and Extensively drug-resistant TB (XDR-TB) patients are referred from all around Gauteng to this specialized hospital. MDR-TB and XDR-TB can occur when a course of TB treatment is not completed by the patients but can also be spread between people who have never had TB. If the diagnosis of MDR or XDR-TB is confirmed, then the individual is referred to this hospital for a lengthy period- at least 6 months.   

There is a significant overlap between the TB epidemic including drug-resistant TB and HIV infection. In most local TB clinics in South Africa, over 40% of the patients are co-infected. At Sizwe Hospital, over 70% of the patients have both HIV and TB.

It is in these circumstances, that an HIV clinic was established. The clinic now called Thusong Clinic was established in 2006. All patients who are admitted to Sizwe Hospital are asked about their HIV status. If they are aware that they are positive they are referred immediately to the Thusong Clinic.  Many are aware of their status and are already on antiretroviral treatment. Care is taken to ensure that there are no ARV drug interruptions. Those who are not aware of their status are encouraged to test for HIV and then entered into HIV care should they be HIV infected.  

Right to Care provides staff support: counselors, medical officers, and other staff, as needed. The clinic was recently refurbished and is now operational. The open plan and airy construction boasts a state of the art air extraction system to prevent infection between patients and to staff members.  Over 900 patients have been treated in this clinic with about 300 active patients. Once the drug-resistant TB is cured, patients usually return to their closest HIV clinic for follow up. A dedicated team of data capturers employed by Right to Care ensure that accurate statistics from this hospital are collected and entered into TherapyEdge, a patient management system.