Our Clinic Staff

On Average, we see about 40 patients a day in our clinc at Zandspruit.

The Clinic

Patients can schedule appointments to limit their waiting time.

Educating Patients

Calsses are held daily to assist our patients in achieving healthier lifestyles.

Our Community Garden

Ladies within the community tend to our gardens. The produce is sold to local businesses.

2011 World Diabetes Congress, Dubai

Greetings from Dubai! I'm attending the World Diabetes Congress which is hosted by the International Diabetes Federation (IDF) every two years bringing together experts in diabetes and other non communicable diseases from across the globe for a week of interesting lectures and workshops. Topics vary from the latest medical research into the development of an artifical pancreas to providing health education on diabetes in rural settings.

I have spent most of my time getting to know the various African diabetes associations, picking up contact details and learning about the challenges that they face as we look forward into 2012 and the expansion of our diabetes work across the continent. I have met people from Tanzania, Rwanda, Uganda, Zimbabwe, Zambia and Kenya all saying that diabetes is a growing problem in their respective countries, and all looking for help to address the various challenges that they are facing. Its a very exciting time to be working in this health area, and particualarly on the continent of Africa which according to the IDF will experience the highest growth rate in diabetes prevalence (90% growth) over the next 20 years and yet at the same time very challenging considering it has the least amount of money available to spend on addressing the problem currently.

Project HOPE has a booth in the exhibition hall and in talking with the various people that have stopped by  it is clear that organisationally we are positioned really well in terms of the need that is out there in the various countries. From both health professional education like we currently do in India as well as looking into innovative ways of getting health messaging and diagnosis and management services across to patients in resource poor settings where health professionals simply arent around such as in rural and urban poor areas of South Africa Project HOPE is working hard to find solutions and bring a better quality of life to those that are currently underserved.

Project HOPE Partners with Eli Lilly and Company to bring Non Communicable Disease Services to Johannesburg

 After a long wait and lots of hard work, I am excited to announce to you today that Project HOPE has secured a five year, up to $3.5 million US Dollar grant from Eli Lilly and Company to implement a non-communicable disease (NCD) project called the HOPE Centre in Zandspruit, Johannesburg,  South Africa.

The Eli Lilly NCD Partnership is a new $30 million, five-year commitment to address non-communicable diseases with Project HOPE and five other non-governmental organization (NGO) partners in four countries (South Africa, India, Brazil and Mexico) around the world. Eli Lilly is launching the partnership, which combines the company’s unique resources with the expertise of HOPE and other leading global health organisations, to identify new models of patient care that increase treatment access and improve outcomes for under served communities.

This is a very exciting time for Project HOPE, as together with Eli Lilly, we work together to find solutions to some of the world’s most pressing health problems related to chronic diseases. Non-communicable diseases in South Africa represent a major challenge to the country, in particular in areas like townships where already existing health services are either overstretched or non-existent.

Together with local community stakeholders, the City of Johannesburg, the University of Pretoria and Eli Lilly, Project HOPE will run the HOPE Centre project, based out of Emthonjeni Community Centre in the heart of Zandspruit which is a township on the outskirts of Johannesburg.

Thank you to all of you who have supported this initiative over the previous months. I cant wait to share with you the developments over the coming weeks.
In the mean time if you have any further questions or comments please feel free to contact me on slawson@projecthope.org

Thanks for reading!


PS. Remember to "like" us on facebook to get regular shorter updates.  

Follow us on Facebook

Hi All!

In preparation for a very exciting announcement, I have created a page on Facebook that you can now follow. This will be used to post shorter updates, photos etc. If you use facebook, you can now click "like" on the right hand box.

Check back very soon to hear about some exciting news that Project HOPE is going to announce!!!


Presentation to the American Chamber of Commerce

A few weeks ago I was invited by the American Chamber of Commerce in South Africa to present Project HOPEs plans for our chronic disease program for South Africa. Project HOPE participates on the HIV/health forum at the Chamber which is made up of representatives from US corporations, US government, NGOs and other interested parties.

It was a good opportunity to make contacts and share our vision for South Africa. To say thank you I was presented with a small gift from Lauren Marks who is the co-chair and who is a Health Program and Public Private Partnership Advisor for USAID.

Its cold in Johannesburg

We are now right in the middle of winter here in Johannesburg. This means that you have to scrap ice off the car in the morning (with a credit card as they don't sell scrapers here!), get the blankets and oil filled heaters out to try to take the chill out of the air.
For people living in shacks it can be a particularly miserable time of year as their homes are freezing and many people are walking around with coughs, colds and flu.
God First, a local church here in Johannesburg that works with the poor has an annual blanket drive where members donate blankets and warm clothes which are then distributed out to various NGOs. This year Project HOPE received over 20 blankets and various items of clothing.

These will be distributed out of the next few days in Zandspruit where we are currently working and should help make the cold weather a bit more bearable for a few people.

Diabetes is not such a big deal right?

Diabetes is not such a big deal right? I mean, I know that I am a little bit overweight and maybe don’t exercise enough and drink a bit too much, but I can change that when I want too. And even if I get diabetes, I just need to lose some weight and maybe pop a pill or too, no big deal.”

Image courtesy of the Sun Newspaper
 This could be seen as a reasonably common response in Western countries such as the UK and USA where we are slowly being desensitized to our country’s expanding waist lines. Our fast paced lifestyles and ever increasing sedentary work environments mean that we have less time to exercise, cook meals and maintain a healthy lifestyle. Instead we opt for convenience.
For a lot of us we have an insurance policy just in case we do get sick – it could be the National Health Service in the UK, it could be in the form of health insurance in the US or even medicaid. If we are diagnosed with diabetes, we have access to a specialist, access to all the necessary tests, access to check up visits, access to quality education given by someone who knows what they are talking about and a constant supply of medication never needing to worry that our pharmacy may run out.

Let’s shift our focus to Africa for a moment and compare. The number of people with pre-diabetes and diabetes is estimated to grow the fastest in Africa over the next 20 years increasing by an estimated 98%. One of the main reasons we are aware of diabetes as a disease is because our governments spend incredible amounts of money on its prevention and treatment. The North America and Caribbean Region spent an estimated USD214 billion on diabetes in 2010. This represents about 57% of the total global healthcare expenditure for diabetes. In comparison, the Africa Region spent an estimated 0.4% or USD1.4 billion.

Being aware of diabetes is the first step in preventing it. Yet in Africa many people have not even heard of the disease. People are unaware. When you are sick, you get to go and see a doctor. You may have to wait a few minutes as often doctor’s surgeries run behind on time, but if you make an appointment you are likely to see a doctor pretty quickly. That’s not the case here. There are no doctors working at the primary clinic in Zandspruit. Furthermore the clinic covers an area in which around 200,000 people live. If you are sick and want to see a nurse you spend the whole day waiting.  So generally people wait until they are very sick because they cant take time off work or are scared of losing their jobs. This means that  if early detection services were available diabetes in a patient could have potentially been prevented.
When a person has diabetes, they don’t get access to the same services like you would in the UK or US. In Zandspruit, they see a nurse who is only able to do very basic tests. Because her time is constrained by the volume of patients she must see, she cannot give very comprehensive education about the disease as this is time consuming. Therefore a person with diabetes is likely to have a poor understanding of the disease and therefore wont manage it well. In the UK or US, you will have your feet checked at least once a year, your eyes checked, you will have your cholesterol, you HbA1c and a plethora of other tests done to make sure that everything is ok. These tests, because they are costly are not available here.
Accessing medication is also a real issue here. Sometimes the clinics don’t have the medication that you need. If you need insulin you cannot access that at the clinic you have to travel to a hospital which costs money.
Lifestyle changes are also difficult to make here. People’s incomes are stretched to the maximum especially if they are unemployed. This means that they will purchase cheaper, unhealthier food, rather than more costly healthier options. Exercise in a township is difficult when there are no facilities.
To cut a long story short many patients with diabetes have said that they would rather have HIV because they see that as more manageable with more resources available to them. This is terrible. Complications of diabetes are costly and as they progress disable a person, thus not allowing them to work. Because of the lack of management services, patients disease can progress quicker meaning that complications can set in at an earlier stage reducing their productivity resulting in an increasing burden to an already overstretched family.
This is why Project HOPE is here in South Africa. Through the HOPE Centre project we intend to change the way diabetes is managed in the community. We will empower people with knowledge and skills so that they can prevent getting the disease, or if they have it already manage it in partnership with a qualified team who will be able to provide them with quality care and treatment options.
Diabetes is a big deal. It is a real and present danger to the lives of many in South Africa and we need your help to stop it. Please would you consider helping?There are various ways you can help:
 A financial gift of $100 would allow us to screen 29 patients and provide them with education on diabetes. Go to our gift catalogue link to make a donation.
Raising funds for the project such as completing a sporting event such as a running race or triathlon, or holding a garage sale and sending the proceeds to the HOPE Centre project? If so, contact me on slawson@projecthope.org for more details.
Spreading the word to your friends and family about what Project HOPE is doing in South Africa by giving them the link www.thehopecentresouthafrica.blogspot.com and asking them to visit the blog?
Volunteering for the project. We are looking for a variety of people who could donate some of their time to help us with various projects such as editing video, designing flyers, or even coming and teaching patients here in South Africa. If you are interested please contact me on slawson@projecthope.org   
Thanks for reading!

Ps If you want to check to see if YOU are at risk of developing diabetes, the American Diabetes Association has a great free lifestyle test, just click here

Sponsor a Screening Day

To launch the HOPE Centre project we would like to run 3 community screening events - one in Zandspruit, one in Cosmo City and one in Kya Sand. These screening events will be publicised on the local radio station, through the local clinic and through other "bush communication" mechanisms! We anticipate to do these at the end of March.

The aim of the screening days is to first help raise awareness in these communities about the growing risks of non-communicable disease. Second is to identify people who are at risk of developing an NCD so that we can prevent its onset. Finally to be able to refer people who need follow up investigation to our new clinic and the new set of services that it will bring to these communities.

During the screening days we will have a nurse and a couple of community health workers who will take blood pressure, BMI and blood glucose as well as provide some basic health and nutrition education. It is anticipated that at each screening we will screen between 300-400 people.

However we need your help. Each individual screening costs $3.50 (2.30 GBP) which includes the nurses time, medical supplies and health materials.In addition we need to purchase a Gazebo and portable table and chairs that can be used. Therefore we are looking to raise a total of $5,000 (3,333 GBP) to cover these costs.

Please would you consider donating to this great cause A $100 donation could screen 29 people!
For people wanting to donate in the USA, please click on the gift catalogue link. This takes you to our giving catalogue page where you can fill out your details.
For people in the UK, please contact me directly - slawson@projecthope.org. We have made arrangements so that you can "gift aid" your donation.

**Please note that 100% of your donation will come directly to South Africa to help fund these screening days.**

I look forward to keeping in touch and posting some pictures of our screening days up on the blog very soon! Thanks for reading!

Project HOPE 2010 Annual Report

Project HOPE has just published its 2010 annual report entitled, "HOPE Endures." It gives a great overview of what has been going on around the world in the various Project HOPE locations. Check out page 5 which gives a brief overview of our new project in South Africa.

I have also put it on the right hand side under "More Information" if it takes a while to download.

The picture of the Lawson family in it is a little bit dated, so I thought I would include an updated one below taken at Christmas. Enjoy!

The HOPE Centre Chronic Care Clinic

The HOPE Centre project is located in a township called Zandspruit which is about 45 minutes away from down-town Johannesburg (Look on the right hand side of the blog to a link to a map of the area). It has a population of around 75,000 people with the vast majority living in shacks like the one pictured. Services to the township are pretty limited. Bordering on Zandspruit are an additional 3 townships, one of which is now formalised - meaning the government is building low-cost housing and 2 are squatter camps. So the total population in the area is around 300,000. In terms of healthcare they have access to one primary clinic that is staffed by a couple of nurses. Waiting times are lengthy and many people only go when they are extremely ill. Little preventive medicine is done resulting in many people developing these diseases that are easily preventable.

The HOPE Centre really is a beacon of light in this quite depressing environment. First and foremost it will educate the community about the risks of chronic diseases such as diabetes and cardiovascular diseases that are having such a detrimental effect on people's lives. Secondly, it will provide needed access to trained health professionals who can deal with the various illnesses and associated resulting complications.                                    

Yesterday was an important day in the development of the HOPE Centre project. We had a visit from the Department of Health to the site to look at our facilities and confirm that we could go ahead with the project. I am glad to report that we got the OK, and we are now good to go. Partnering with the Government is so important, particularly from the standpoint of sustainability and future handover. We are now in the process of formalising the partnership with an MOU that will hold all partners accountable.                                   

So, after a long wait I can finally formally introduce you to our new clinic. Project HOPE has partnered with a local NGO called Emthonjeni Community Centre. This organisation was many years ago donated a significant piece of land and buildings in what is now the heart of Zandspruit. This building, a beautiful thatched house and outlying buildings serve as offices for a variety of NGOs working in the community. Currently two days a week an antenatal clinic is run from the building. Project HOPE will work out of these two clinic rooms initially one day per week, expanding the services as we raise funds running the chronic care clinic. It is hoped that in time we will be able to build a newer, larger clinic on the site in the not too distant future.

Please keep checking back to see how we are doing. Over the next few weeks we will be holding screening days in the communities to formally launch the project with our partners. I would encourage you to sign up to receive our newsletter. Please feel free to contact me if you would like to know more about the project and if you are interested in supporting the project. Thanks for reading!

The HOPE Centre Approach

So what's so unique about the HOPE Centre approach compared to other projects? This is a question that I have had to answer many times when presenting this project to potential donors. My answer goes something along the lines of this:

"The HOPE Centre approach is unique first and foremost, because there isn't anyone else in the country doing exactly this! Secondly, while some organisations are thinking about working in chronic disease, they are not thinking holistically. They think curative only (or in this case management) rather than preventive first, curative second."

That's what I think will make this project stand out - its integrated, holistic approach to prevent and manage chronic diseases such as diabetes and cardiovascular disease in a setting where resources are extremely limited and where people struggle to survive on a day to day basis.

The HOPE Centre will tackle chronic diseases in a number of ways:

1) Clinically - we will open a chronic care clinic that is staffed by a professional nurse, with additional help from volunteer specialists such as doctors, podiatrists, opthalmologists and pharmacists. This clinic will receive referrals from the government clinic and will serve a catchment area of over 300,000 people. People will be able to receive comprehensive screening, counselling and medication for their conditions if needed.

2) Peer Support - Arguably one of the most important factors in managing a chronic disease, or trying to modify ingrained behaviours so that you don't develop a chronic disease is support from peers who are in the same situation. Patients who have been screened by the clinic or who have been referred to us by other partners will be encouraged to join these support groups. They will meet on a weekly basis for a period of one year. During these weekly meetings Project HOPE and its partners will provide comprehensive health education, counselling, nutritional assessments, vegetable gardening and cooking classes, physical activity assessment and classes as well as continued health monitoring to make sure the disease is under control and stable. After the one year period these peer groups will "graduate" knowing how to manage their disease well, what to do if something goes wrong, and will become "change agents" in the community - being able to encourage others not too live in a way that puts them at risk of getting a chronic disease.

3) Education and Screening - we will be working with the Department of Health to provide training materials and develop screening techniques that Community Health Workers can use as they go door-to-door in the communities making people aware of diseases such as diabetes, HIV, TB etc. Project HOPE will empower these Community Health Workers to be able to act as the "first line" in preventing chronic diseases in communities by educating them on the diseases, risk factors, and then helping them to identify potential cases and allowing them to refer them to clinics so that they can be seen before its too late.

The ensure quality of the highest standards, Project HOPE will be working with the University of Witswatersrand in all phases of the project - from  determining the current chronic disease priorities through a baseline survey, developing and fine tuning the interventions including curriculum development, monitoring and evaluating of the project and publishing the results in various academic and non-academic forums.

All of this is getting me VERY excited!! I hope to update you next week with some pictures of our new clinic and of the communities that we will be working in. Thanks for reading!

Why Focus on Chronic Disease when people are dying from AIDS?

Its true, people in South Africa are dying from AIDS. South Africa has the largest number of infected people living with HIV estimated at over 5.7 million. The national prevalence rate is around 12%. Yet there is something else going on in South Africa and across the developing world that is not receiving as much attention as it should and that is the rise of Chronic Diseases. These include diabetes, cardiovascular disease, cancers and chronic respiratory diseases.
Lets look at some numbers to make a comparison. In 2005, over 35 million people worldwide died from chronic diseases.  It is the leading cause of death and disability and currently accounts for almost 60% of deaths and 43% of the global disease burden.  In the same year 2.8 million deaths were from HIV/AIDS worldwide. By 2020, it is estimated that chronic disease will account for 73% of all deaths.  Chronic disease is no longer a “Western problem.”  The reality is that four out of five chronic disease deaths occur in low and middle income countries.

Here are some facts about Diabetes:

- Today 300 million people worldwide have diabetes.
- 10,000 people die everyday from diabetes - that is double the amount of people dying 
   from AIDS
- In sub-Saharan Africa 12.1 million people are estimated to have diabetes, with only 15%
- By 2030 23.9 million adults in sub-Saharan Africa will have diabetes - more than the
   number of people that currently have HIV.

In South Africa, an epidemiological transition is taking place with a shift in disease burden from infectious diseases such as HIV and TB to chronic diseases.  With the change in eating patterns, and rural to urban migration, many of the new urban poor are now encountering a “double burden” of disease.  Not only do they continue to be susceptible to infectious disease, but with the availability of nutrient poor but calorically dense food, combined with a sedentary lifestyle, they are at increased risk for obesity and developing chronic diseases.
In South Africa, chronic diseases accounted for 28% of all deaths in 2002.  In 2005, a study showed 51% of men and 77% of women in South Africa were overweight, a major risk factor for chronic disease, predicted to increase over the next 10 years.  Between 1997 and 2004, 195 people died per day because of some form of cardiovascular disease (CVD) in South Africa.  Models suggest that by 2010 there will be over 600 deaths per day in South Africa due to chronic disease. Premature deaths caused by CVD in people of working age (35-64 years) are expected to increase by 41% between 2000 and 2030.  Diabetes in South Africa is an emerging problem particularly when prevention messaging and early detection screenings are very limited.  Many people present themselves at clinics when they are already suffering from a complication of the disease.  Access to insulin and regular blood sugar monitoring is challenging in impoverished areas.

In response to the facts, Project HOPE is taking a leading role in addressing this crisis. Since 1998 Project HOPE realised that this problem was only going to get worse and began addressing it before anyone else in providing training to healthcare professionals in China, India, Mexico, New Mexico, and now South Africa.

The HOPE Centre project, is our response to this crisis in South Africa. Please check back regularly to see how we are getting on.

Welcome to The HOPE Centre Blog

Welcome to the HOPE Centre Blog! The HOPE Centre is the new signature program for Project HOPE in South Africa. Below is a short introductory video from me, Stefan! Keep checking back to see the progress we make over the coming weeks.