April 2013 ~ The HOPE Centre

When I moved to South Africa a few months ago, I knew that I wanted to get involved as a volunteer with one of the many wonderful organizations promoting health in this country where so many people face enormous barriers to health and wellness. I am so happy to have found Project Hope where I’ve been able to take part in the wonderful work they are doing in the Zandspruit township near Johannesburg.

The project I began when I started working at the HOPE Centre clinic in Zandspruit was an inventory tracking system for the clinic pharmacy. In this busy clinic, open 3 days per week, patients are primarily seen for the treatment of diabetes and hypertension. However, nurses also address common illnesses/ailments as many patients do not have ready access to family medicine providers. Thus, the clinic pharmacy is as busy as the clinic and stocks a wide array of medications to treat patients.

As I started the process of building an inventory system that could be implemented in the clinic pharmacy, I was struck by a number of similarities between the challenges I saw in this clinic in South Africa and other healthcare practice environments I’ve worked in.

The first was the challenge of ensuring that the clinic was able to stock the right number of the correct supplies to meet the variable demand created by patients coming in with an unpredictable set of symptoms and conditions. This is a challenge almost all providers face but especially so here where the clinic attempts to keep all medications on-hand and not create another barrier to care by sending patients out to a pharmacy with a script.

The second is that in order to match supply with demand as effectively as possible, record-keeping must be accurate and detailed enough to inform regular purchases/ordering for the clinic. As I evaluated the barriers to getting this data at the HOPE Centre clinic pharmacy, I was met with the familiar “paper problem.” Records were kept on paper and not electronically in a form that could be used to easily evaluate how many and what kind of medications were being used each day at the clinic.

Finally, across most healthcare practice environments, the detailed and sometimes monotonous tasks of collecting data, evaluating that data, and making decisions based on it are not what most healthcare providers want to, nor should spend their time doing. Their valuable time is better spent with patients: educating, treating, and providing care. While the behind-the-scenes tasks are important, it is important and often a significant challenge to ensure that providers receive the support that they need to do their jobs seamlessly and maximize the time they are able to spend with patients.

With an inventory system now in place that will help address some of those challenges, I hope that the HOPE Centre clinic in Zandspruit will now be even more efficient and able to treat more patients who I know greatly appreciate the much-needed and high-quality care Project HOPE is providing in this community.

Julie Brink

It’s hard to believe that our two months in South Africa have already ended. The time went so fast and I am sure that is because we were so busy all the time.

Jo busy in the Hope Clinic

Working with Project Hope is a life changing experience and exposes one to a cultural exchange that provides insight and understanding at a level unparalleled. Being able to walk in another person’s shoes and see what life is like for people living in poverty and deprivation provides an education that cannot be gained otherwise. The entire project is focused on teaching healthcare professionals and community health workers to treat, diagnose, and prevent diabetes and hypertension. The project enables the local people to be able to find long term solutions to improve the health status of the people in their communities.

The Emthonjeni Hope Centre Clinic is a great asset to the community and provides easy access to treatment and care that in the past has not been accessible to the residents of Zandspruit. Whilst in Zandspruit we met a 50 year old gentleman who had suffered a stroke while at home alone. Health Care Workers from Project Hope happened to be making a pre-clinic visit to this particular man’s compound and found him with symptoms of a stroke, including hemiplegia, and unintelligible speech. They were able to get emergency care to him and when he was released from the hospital, he was referred to the Hope clinic. In a short period of time he was walking on his own, and has now fully recovered the use of his arm and has a near normal blood pressure with minimal medication. He attributes his life and recovery to the clinic. He truly believes that if Project Hope had not been in the community, he would not be alive today.

Jo's sister and fellow exchange nurse: Dot, organising medication.

Much of our time spent working with the Project was organizing the clinic, helping to streamline processes and improve the timeliness of visits. Upon arrival at the project, the clinic often had wait times for patients of several hours. The implementation of new processes has been successful in decreasing the appointment wait times to less than 60 minutes which was a goal for the clinic. Streamlining procedures for drawing blood for lab tests has helped to decrease wait times so that most patients are waiting less than 20 minutes and the process for the Family Nurse Practitioners (FNP’s) is much smoother. Improving the ability for the FNP’s to see more patients is an important step to providing more patients with services.

Jo and Dot training volunteers how to test glucose levels

In addition to the improvement in the clinic, it has been important to evaluate the services and provide assurance intended outcomes are being achieved. Data collection, collation and analysis of the data are an integral part of this project. This work will be ongoing, but has already demonstrated that treatment for hypertension has been successful. Also, there is a decrease in the glycosated hemoglobin’s for the diabetic patients.

It has been a tremendous privilege to participate in this project and I will never forget the wonderful experiences. Seeing a 22 year old mother with four children under the age of 5 with a blood pressure of 200/120 and being able to get her on medications that may save her life was very rewarding. Having a 35 year old gentleman come to the clinic with a blood sugar of 25.1 mmol/l and being able to get him medications and education to help manage his diabetes was a testimony to the importance of the clinic. There are multiple stories of this type that have provided meaning and importance to the project.

Zandspruit resident screened by Jo & Dot's team

One of the other great benefits of this project is the fact that local people are trained and become employed by Project Hope to sustain this project. Not only does the project provide much needed employment for several people, it is strengthening their self esteem, providing value to their lives, and helping them to become advocates for their patients and the clinic. It has been a genuine privilege to be able to provide leadership and development for these young people and to know that their lives will be improved for this opportunity.

Zandspruit scene

I cannot personally say enough about how much meaning this project has brought to my life. There are so many skills that I have been able to develop and improve and the cultural exchange has been immeasurable. I will never forget the people I have grown to love. I hope that I have been able to make a small contribution to the Project and I know that the Project has had a life changing effect on me.