Kimberly Vrudny

Inzame Zabantu

In Health Care, HIV/AIDS, Non-profits / NGOs, South Africa on August 10, 2010 at 2:45 am

Community Health Centre

Inzame Zabantu Community Health Centre is a medical clinic situated in Phillipi, in an area called Brown’s Farm, about 20 kilometers from Cape Town’s city centre. Whereas many governmental clinics in South Africa are dreary structures, worn by time and lacking funds for proper maintenance, Inzame Zabantu is light and airy, with windows that wash the waiting area with warmth and sunlight. The walls are painted with bright colors, and the grounds are well tended, even with a garden outside its front door. In completing the portraits and still lifes for 30/30, I interviewed Zethu Xapile, an administrative nurse at the Centre, to learn more about this remarkable Clinic in the new South Africa.

Please tell me about the community in which the clinic is located.

Brown’s Farm is an informal settlement that was developed immediately after apartheid was overturned in 1994. Many people are still living in shacks in Brown’s Farm. Even those who live in houses made of brick and mortar have shacks behind their houses, as many families attempt to shelter extended family on the same plot of land. It is common to have about ten or twelve people living in a house with only two bedrooms.

The area has an estimated population of about 80,000. The unemployment rate stands at 60%. Those who are employed are working as laborers and domestic workers, and earn very little income. Pensions and social grants generate an average income per household of around R800/month. The situation is very difficult. Teachers from the local schools sometimes bring children to the clinic who have collapsed due to hunger; nurses learn that they have gone for days without food.

What is the history of the Clinic? Was there a medical facility here prior to the building of this structure?

In 1994, members of the Brown’s Farm community approached the government with the request for a health facility. They received a donation of old shipping containers from a company called Safmarine. Wellconel, a pharmaceutical company, also donated used shipping containers. The government then prepared the containers and furnished them. The health centre started operating in 1994. The facility was given the name “Inzame Zabantu,” a phrase in Xhosa that means “the people’s initiative.” From 1997 to 2003, the administrators of the facility repeatedly submitted requests asking the government to build a proper structure, but they did not allocate funds for this purpose.

Meanwhile, the facility formed a partnership with the J. L. Zwane Community Centre. The clinic benefited from this partnership by receiving donations of medical equipment and non-pharmaceuticals from partners in the United States. In the year 2000, a woman from Dallas, Texas, donated five more shipping containers to give the clinic more working space and a roof over the containers to create a waiting space for the patients.

Please tell me about the process of winning the grant to build the new clinic?

In 2003, Professor Househam, Head of Health in the Western Cape, visited Inzame Zabantu. The staff stated its case, explaining how the containers were very cold in winter, and how the heat in summer was equally trying. He immediately set up a team to work with Zethu Xapile, an administrative nurse at the Centre, to generate a design and plan for the new building. The current building, which was officially opened in September 2006, is the beautiful result of that visit.

Please, describe the clinic.

The new facility consists of six consulting rooms, a treatment room, a dressing room, a preparation room, a reception area, a pharmacy, a boardroom, a staff tea room, an office, and a waiting area.

How many people are on staff here?

The government employs the clinic’s staff, which consists of one medical doctor, three clinical nursing practitioners, one professional nurse, two nursing assistants, one pharmacist, two pharmacy assistants, two administration clerks, two general assistants, and two health promotion officers.

How many patients does the clinic service daily, on average?

200 clients a day visit the Centre, on average. The clinic could not cope without its partners including individuals and non-governmental organizations. The Antiretroviral Service is run by an NGO called Absolute Return for Kids (ARK). Lay counselors do the pre- and post-test counseling. Additionally, a pharmacist from the United States worked at the Centre for a year on a voluntary basis.

Inzame Zabantu operates at a Primary Health Care level, providing curative, preventative and promotive health care, which means it is the first point of entry in the health care system for residents of Philippi and its surrounding area. The clinic sees clients from the age of thirteen and up. The service is free. As the only facility in the area, the clinic adds services that are much needed in the community.

What are the most common illnesses that are treated here?

The most common illnesses are chronic diseases of lifestyle, like diabetes, hypertension, and HIV/AIDS. Clients who need further management are transferred by an ambulance to secondary and sometimes tertiary health care providers.

Do you offer services here for clients who are HIV-positive?

The rate of HIV/AIDS in the area is 1:5. For this reason, the antiretroviral service is growing very fast. Inzame Zabantu started offering this service in July 2007, and up to now, has registered 1,202 clients on antiretrovirals. 77 more clients are awaiting the start of the regimen. The facility is too small to manage so many clients.

What are your limitations? For what kinds of illnesses/tests must you send people away in order for them to receive treatment elsewhere?

As this is a small facility, with limited space, there are services that we do not yet provide, but would love to offer at a future stage:

Inzame Zabantu does not have a tuberculosis service. Rather, nurses investigate and diagnose clients, but then send them to another clinic for treatment. As tuberculosis is one of the opportunistic diseases associated with HIV/AIDS, the Centre would like to make it easy for its clients by providing both ARV and TB service under one roof.

Maternal health is a must for any health care facility but, in the case of Inzame Zabantu, there are not enough rooms to be able to provide such a service. Maternal health includes family planning, cervical screening, and basic antenatal care. Residents of Brown’s Farm have to travel more than 10 km to access such a service.

There is no x-ray facility, so again residents of Brown’s Farm travel on foot about 10 km for this service.

Do you have plans/hopes for expansion, or replication?

Given all of this, it is clear that Inzame Zabantu wishes to expand to be able to render a quality service to its clients, and to attend to every one who comes to the facility. All the same, its beautiful architecture, graceful garden, and warm interior design expresses the care this facility provides to the residents of Brown’s Farm, who took the initiative to develop a proper health care center in a deeply impoverished section of the townships outside of Cape Town.

Thank you for providing this information.

Inzame Zabantu stands as a place of hope and promise in the community. Please support its work, if you are able. Donations can be given through “Arm in Arm in Africa.”

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