Diabetes and Hypertension Screening Day in Zandspruit

Setting up our testing station

Project HOPE South Africa as part of the HOPE Centre project, funded through the Lilly NCD partnership held its first diabetes and hypertension screening event in Zandspruit on Saturday 16th June 2012. Despite a freezing cold day and recent service protests in the community which shut down everything, we managed to screen over 150 people and generated a lot of interest in our project in Zandspruit. 

Nurses registering patients

Screening events like this one are part of our strategy to sensitize and make communities aware of the growing problem of (pre)diabetes, (pre)hypertension in these urbanising areas. In sub-Saharan Africa only 15% of people with diabetes have been diagnosed, meaning the vast majority of people are living with the disease and only presenting at the clinics when complications have set in. By offering free screening opportunities like this one, we are able to catch the diseases sooner, get people onto treatment when necessary quicker and improve patients quality of life.

Our team of volunteer nurses

We were supported by a wonderful team of 13 volunteer nurses provided to us by Empilweni Nursing College in Randburg who helped us weigh and measure patients so we could take their  BMI, prick fingers to get a random blood glucose value, take blood pressure and then provide counselling and referral services at the end. Teams of nurses from the college will be a regular part of these screening days ensuring that we can screen as many people as possible at one go

Patients queuing for the various tests

Homemed, a medical diagnostics company donated all our glucometers, strips and lancets and provided training to the nurses on how to use the glucometers.

Getting a finger pricked!

All the patients that we saw, received education material about the risks of diabetes and hypertension, were educated about their results, and where necessary were referred either to the government clinic for an immediate follow up, or to Project HOPE's clinic for a re-test in 3-6 months time. This is  a really important piece of the puzzle. Many times patients receive tests, but because nursing staff are over stretched they do not have the time to sit down with the patient and explain thoroughly what the numbers mean. Project HOPE is using a very simple, yet effective stop light system approach so the patients were able to see if they were in the 'Red' or danger zone, 'Yellow' or warning zone, and 'Green' or healthy zone. 

Project HOPE will be screening in Cosmo City this Saturday the 23rd June, and then again in Zandspruit in August. Over the next couple of years we will be repeating this on an regular basis.

Check back next week for pictures of our screening event in Cosmo City!

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Cosmo City Baseline Survey

Over the past four days a team of twenty community members, led by Project HOPE's Lebo Molete underwent training on how to conduct a community health knowledge survey and screen for risk factors such as blood pressure, weight, and waist circumference.

The team went through a day of training and then surveyed the community for three days. Each morning the team met and we distributed out bags full of survey forms, BP machines, scales and packed lunches! The whole family got up early each morning to make sandwiches!

 



It was an interesting experience, following on from our survey in Zandspruit which is a neighbouring township where the majority of people live in tin shacks. In Zandspruit there were a lot more people around during the week, as a high percentage of people who live there are unemployed. People were out on the dirt streets, talking with neighbours, wandering around but in Cosmo City the environment was quite different.

Cosmo City developed as a sort of social housing experiment where people from neighbouring townships were relocated into the area. It is designed to offer a mixture of government subsidised housing with low and medium cost traditional housing split up into various extensions, intermixed with schools, a business park and shops. The idea was to develop an economically diverse area for the emerging middle class.

While we were surveying we noticed a stark constrast in attitudes of people living in the different extensions. During the week, the traditional housing sections were virtually empty, with many people having gone to work. The people that were at home tended to be quite suspicious of us, many saying that they didnt want to be surveyed because they had medical insurance. Contrasting this was the government subsidised housing sections which were full of people due to high unemployment who were more than happy to get screened as for them with no health insurance access to medical services is a challenge.

Cosmo City unlike Zandspruit does not have a government clinic servicing its population so they have to travel either to Zandspruit or closer into Johannesburg to get primary care services. This makes it more challenging for people to get regular preventive health check ups.

Project HOPE picked Cosmo City to be part of the HOPE Centre Project because combined with Zandspruit it provides us with a nice socio-economic mix of people enabling us to see in terms of diabetes and other chronic diseases where the burden lies and if ones economic status changes a persons health behaviour.

More pictures can be found on our facebook page - click on the right hand tab to like it!

Thanks for reading!

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Project HOPE attends the first Healthcare in Africa Conference



The Conference Participants



I was privileged to attend the first Healthcare in Africa summit organised by the Economist in Cape Town in March. Leaders from across the healthcare field gathered together at the Cape Town Convention Centre for two days of interesting discussions looking at the many challenges that healthcare in Africa faces today.

Minster Motsoaledi

The first day was spent discussing how Zambia and South Africa are changing the way healthcare is delivered on the continent through the development and implementation of a National Health Insurance system to help reduce inequities in the system. The highlight was listening to the Ministers of Health from Zambia Joseph Kasonde and Aaron Motsoaledi from South Africa. These policy makers were then challenged by stakeholder representatives.

Day two looked at some of the practical challenges that healthcare systems on the continent face like the role of both the public and private sectors in healthcare delivery, what the best investment in public health infrastructure is and what the role can civil society play. We had interesting presentations from the President of Save the Children, the International President of Medecins Sans Frontieres and the CEO of Discovery.

Derek Yach and Adrian Gore

Later in the day the issue of chronic diseases came up which was of particular interest to me. We talked about how to tackle the double burden of disease that is now emerging on the continent as people are living longer and diets and lifestyles are changing, using new technology where healthcare workers are few and how can we in Africa prevent these chronic diseases such as diabetes and obesity from becoming the problem that they are today in the developed world. We had an excellent presentation on this from the SVP of Global Health and Agriculture at PepsiCo, Derek Yach, and from the CEO of Discovery, Adrian Gore.

The take home message of the conference was that the need is great and that there needs to be engagement from all sectors of society if we are ever going to be able to provide a level of healthcare that we can be proud of to our citizens on the continent. Project HOPE is well placed through our work in Johannesburg and across the region to help with this great mission.

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New Staff start with Project HOPE

 Project HOPE in South Africa welcomes two new staff to its senior management team to help with the HOPE Centre project:

Lebo Molete, our new Program Officer has an extensive background in social policy and health having previously worked in the UK and South Africa. He has a particular interest in non-communicable diseases and  was the founding member of a local NGO called PHELA (Public Health Education Liaison and Advocacy Project) which seeks to improve the quality of life of patients with chronic diseases through patient education and support groups.  Lebo is currently completing a Masters degree in Public Health.

Carol Diplock, our new Manager of Operations and Finance comes from having spent 15 years working for a leading UK charity called Voluntary Service Oversees (VSO) as their Office Manager having established their office in South Africa and assisting with the opening of their office in Mozambique.

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Its all go! The start of our baseline surveys in Zandspruit

The last couple of weeks have been hectically busy for Project HOPE South Africa. I have been looking forward to this for a long time – finally getting to dig down deeper into the community of Zandspruit and sit in people’s home and learn about what the community’s perception is on good health and barriers to good clinical care in the community.

The idea of our baseline survey is to get a good understanding of the community's awareness on the chronic diseases such as diabetes and to collect some prevalence data such as blood pressure and BMI before our activities launch. This will help us to measure the project's impact over time.

 Project HOPE South Africa has formalised a partnership with Project HOPE Mexico to provide technical assistance on this project and it was great to have Courtney Guthreau our Global Diabetes Specialist come and participate in this whole process her team will be helping us develop the training materials that we use in the future.

I was able to interview and hire 20 young residents from Zandspruit to help with this process. Hardly any of them had any real understanding of what diabetes and high blood pressure was, and few had done any sort of surveying before. We spent the first day training on how to undertake a survey and had great fun learning how to weigh each other and take each other’s blood pressure.

Each morning we assembled at our base at Emthonjeni Community Centre had a quick briefing and then armed with our Project HOPE bags full of survey forms, tape measure, scales and blood pressure machine and packed lunches we split into pairs and went to one of the 10 recognised sections in Zandspruit to begin surveying.

Because this is part of a formal research project that we are conducting with the University of Pretoria we had to take a random sample of the community so we used dice to choose which home we would visit!  We would go to a predetermined starting point, get our clip boards out and roll our dice to see if we would sample on the left or right side and then roll again to see which home we would stop at.

For me it was the first time that I had visited certain parts of the community and was taken aback with the numbers of people that are crammed into such a small area and the lack of any real infrastructure. The smell of sewage was in some places very strong running down the middle of dirt paths. A common complaint when talking to people was the issue of access to health care – having to wait for such a long time to be seen by a nurse puts a lot of people off from going to the clinic as well as the lack of money to buy healthier food due to high unemployment rates. Poor living conditions also came up lots.

Yet in the middle of these difficult living conditions you find a people that are very resilient, up-beat and wanting to improve themselves.

Although our results won’t be published for a few weeks, informally we can say that the vast majority of 400 people we interviewed were overweight (a key risk factor for developing diabetes) and many had high blood pressure. We found that a number of people were "tired" a symptom of poor diabetes control, some had lost strength in their hands and feet, some had eye problems and other headaches. All these are symptoms of diabetes and high blood pressure.

With only 15% of diabetes cases being diagnosed it is so important that the community becomes more aware of these diseases and empowered to make choices that improve their health and productivity.

Please check back for regular updates now. We still have our clinic assessment to undertake tomorrow and then another big survey in a neighbouring township this month to conclude all our baseline work.

Remember to like our facebook page (right hand side) to get regular shorter updates!



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