Johannesburg, 1 April 2008—The dedication and commitment of South Africa’s HIV clinical staff has drawn the praise and admiration of a group of foreign doctors and nurses, who have completed a six-week stint as volunteer mentors at HIV clinics in the Northern Cape.

Reporting on their experiences to the management at the Johannesburg-based Right to Care, which funded the programme, the four visitors – two doctors and two nurses – lavished warm praise on those with whom they had worked.

Sister Kathy Wolff, a nurse practitioner from Philadelphia Pennsylvania, was impressed by how well the sisters and the counsellors knew their patients. “The sister who does most of the work with the patients on ARVs lives near the clinic, and tells patients she is available 24/7. Both she and the counsellors have helped patients after hours who come to their homes when they are in need,” says Wolff.

“The same was true for the two sites we visited, the peripheral clinics in Marydale and Niekelshoop, where they are more staffing shortages, yet there was still a sense of personal attention to each patient, beyond just their medical needs.”

Says Dr Chitra Babu, a specialist registrar from a teaching hospital in Manchester, England, “We found the staff to be extremely dedicated while working with the limited resources available to them. When we arrived here, our aim was to help, mentor and transfer some of our knowledge and skills, but in the process we have ended up taking away quite a lot as well .”

The four visitors were divided into two teams. Babu and her fellow team member, Kathy Wolff, were assigned to the Ethembeni clinic in the Karoo town of Prieska in the Northern Cape. The other two were assigned to an HIV clinic in Jan Kempdorp, north of Kimberly (also in the Northern Cape).

The visits were initiated by The International Centre for Equal Healthcare Access (ICEHA), an NGO based in Stellenbosch, in the Western Cape. Funding for travel and accommodation costs came from Right to Care, a non-profit organisation with the mission of facilitating access to HIV care and treatment.

The visitors were unanimous in their praise of the South African clinic personnel, who had to work in demanding conditions, with high patient loads.

The clinic in Jan Kempdorp is treating an estimated 700 HIV patients. This has been done very successfully, with a viral suppression rate of 90%, according to Dr Mike Snow, who spent his mentorship period there.

“The nursing staff were running just to stay still,” says Snow. Nursing staff had the additional difficulty of crammed conditions, which were exacerbated by renovations being done to the clinic buildings.

Discussing their contribution, Sister Michelle Evers remarks, “They appreciated having others recognising and advocating on their behalf. In South Africa, nursing is a very hard system to work in.”

Says Babu, “We found the staff to be very dedicated and committed to their patients and their community. We were impressed with the wide variety of skills that doctors and sisters exhibited, dealing with patients of all age groups.”

Both visiting teams found scope for improvements in clinical workflow at their respective clinics. In each case, the team suggested new workflow process, filing systems, and documentation.

Asked where the needs were at the clinic in Prieska, Wolff lists the problem areas as, “Charting and data collection; infection control; a high rate of alcohol abuse leading to delays in ARV initiation; and a lack of training and resources at satellite clinics.

“We made a start in addressing most of these.”