Right to Care's operations in the Western Cape began in 2009. We have established an excellent relationship with the Western Cape provincial government, at all levels, from provincial to district and sub-district levels.
We have grown to supporting 11 sites with 22 staff members, as well as the Overstrand Mobile VCT outreach programme. Nine of these sites are in the Overberg district (Hermanus, Kleinmond, Zwelihle, Gansbaai, Stanford, Caledon, Bredasdorp, Grabouw, and Swellendam) and we recently started supporting two sites in the Central Karoo (Beaufort West and Prince Albert). In future, our staff in the Karoo will be involved in supporting down-referral to sites such as Laingburg, Leeu Gamka, Murraysburg, and Nelspoort.
Our primary focus has been identifying staff needs of sites and filling critical posts that are vacant and not funded by the government. We have achieved this in the Overberg and are well on the way to providing the Karoo sites with desperately needed staff. Right to Care support for the province is based in both the CCMT-accredited government sites but extends to peripheral and primary healthcare clinics.
The need for support and training is substantial. Sisters in the clinics we support have been taking on HIV care without formal training. Vast distances, especially in the Central Karoo, make training difficult and expensive to provide. Nevertheless, we have begun offering training courses in the Overberg and Central Karoo. This has been met with enthusiasm.
We provide further support in the form of clinical expertise and telephonic backup. Moreover, Right to Care specialist staff members with clinical expertise provided on-site expert support to clinical teams. The support has been well received.
Having determined the staffing needs, we have a very good understanding of our supported sites. We are concentrating on implementing the HIV, TB, and PMTCT guidelines set by the National Department of Health. We are hoping to establish a mobile clinic support team in the Central Karoo, consisting of a doctor, nurse, and counsellor. It is envisaged that this team will offer services to the outlying areas; thus, bringing the treatment to the people. Currently the DoH transports people from outlying towns, such as Murraysburg to Beaufort West, for treatment. This is expensive and exacerbates the problems of loss to follow up and treatment failure.
We are building a dedicated HIV-TB facility at the Kleinmond Clinic. The new facility will house the Dots worker, and will have two consulting room and a new waiting area for TB patients. Construction will begin in the first quarter of 2010.
Our greatest challenge is the up-skilling of all staff at Right to Care supported sites and the spreading of knowledge to staff at supported sites, and doing this over a vast geographical area.
The dedication and enthusiasm of staff in these resource-limited districts is inspiring and will underpin the programme’s success.