HIV & TB Hotline Roadtrip '16
National HIV & TB Hotline for Health Care Workers Road Trip: A Trip to Off-the-Beaten-Track Clinics
Sunflowers in the Free State (Briony Chisholm©)
The toll-free National HIV & TB Hotline for Health Care Workers has been operating since 2008. Based at the Medicines Information Centre (MIC) in the Division of Clinical Pharmacology at UCT, it is staffed by specially-trained drug information pharmacists who handle almost 500 clinical queries a month from health care workers dealing with HIV- and/or TB-infected patients.
Queries are answered using the latest information databases and reference sources and, where necessary, clinical input is obtained from consultants at the University of Cape Town’s Faculty of Health Sciences, Groote Schuur Hospital, Red Cross Children’s Hospital and Tygerberg.
Getting Word Out
Each year, we bemoan the fact that, despite numerous mailings of flyers, inserts in journals and attendance at conferences, we struggle to get word out to the rural clinics – those with little access to clinical support – who we think could benefit most from the service.
Lightbulb moment: We’ll go to them!
And so it came to be, that from April to September 2016 we embarked on seven trips through the back roads of South Africa, visiting clinics to spread the word: me, an information pharmacist from the MIC and Hotline, and my assistant, Gouni, as I’m in a wheelchair.
I spent weeks plotting routes, contacting facilities, researching places to stay in tiny dorps, and putting together seven itineraries. Then we spent a week to 10 days a month, in each province (excluding Gauteng and the Western Cape) over the six months.
Visiting as many clinics as possible, handing out our posters and encouraging health care workers to use the hotline, we drove 9 950 km (much of it on dust roads), visited 260 hospitals and clinics, delivered over 800 poster packs, met hundreds of wonderful health care workers and had uncountable adventures, including two flat tyres. And learnt, very quickly, that itineraries are just guidelines and Google maps aren’t always accurate!
The lovely staff of Maphuta Malati Hospital, Limpopo (Briony Chisholm©)
Our first trip, to the Free State in April, was a steep learning curve. I planned the route, phoned clinics and hospitals we hoped to visit (three a day, for five days), booked places to stay and we flew to Joburg on the Sunday, picked up our hire car and headed off to Oranjeville to be ready to start early on Monday morning.
And that’s where we learnt our first of many travelling lessons: always bring snacks. Small town South Africa closes down on Sunday evenings. We were the only guests at the hotel, and the restaurant was closed.
The lovely hotel owner offered us toasted sandwiches, but we opted to shop at the only shop open in town – a little café which provided us with bread, cheese, avo and tomato. We made sandwiches using the teaspoon provided for tea and coffee and ate them on the beautiful bank of the Wilge River. It was wonderful.
The Free State was exquisite, and we quickly realised that the busy nurses at the clinics had no time to break and chat with us, so we canned the ‘perfectly planned’ plan and instead asked in each settlement we came across where the clinic was, then dropped posters and flyers with the sisters at each one. At the hospitals, we got out and met with staff and chatted. Doing this, we reached far more clinics.
Sunset over the Wilge River, Free State (Briony Chisholm©)
In May, we headed to the Eastern Cape and drove over 1 500 km, seeing more than 50 clinics and hospitals. Our trip took us from East London up to Aliwal North, through the Karoo and back down to fly out of Port Elizabeth, over a 10-day period.
Beautiful scenery, extreme temperatures (both cold and unseasonably hot – it was 30 degrees in PE on the 1st of June!), many back roads, potholes and ‘Stop ‘n Go’s’ took us to clinics with wonderful, welcoming staff who loved the posters. Most of the health care workers we met had not heard of the hotline, so hopefully we were reaching the right target!
Cows near Alice, Eastern Cape (Briony Chisholm©)
In June, we travelled 1 300 km through northern KZN from St Lucia to Jozini to Pongola and Vryheid and then back down to the coast via Melmoth and Eshowe. Throughout our first three trips, we managed to narrowly miss service delivery protests, with tyres still smouldering at the entrance to one of the clinics near Eshowe.
We travelled through vast fields of sugar cane being harvested and hundreds of trucks carrying said sugar cane (they’re messy things, and heavy, causing HUGE potholes!) to the mills, and visited busy rural clinics with dedicated staff.
Cafe near Jozini, KwaZulu Natal (Briony Chisholm©)
Our trip to Mpumalanga in July proved to be the toughest but, hopefully, still productive. Mpumalanga is not big on signage for their clinics, so we spent a lot of time lost (despite our careful planning and maps!), and met many people, what with asking directions a million times. Regardless, we managed to visit over thirty clinics and hospitals, and travelled 1 204 km in our five days there.
From Lydenburg to Bushbuckridge, Skukuza to Mbombela, Emgwena to Emalahleni, we saw the beauty of Mpumalanga and the devastating drought and visited bustling and busy clinics both in rural and urban areas, meeting the dedicated health care workers in them. We even managed to bump into a herd of elephant on our route – lucky us!
Near Machadodorp, Mpumalanga (Briony Chisholm©)
We were busy-busy in August, visiting North West at the beginning of the month, and heading north to Limpopo at the end. We were surprised by the good infrastructure in the North West, and drove just under 900 km, visiting 37 clinics and hospitals en route.
Long, lonely roads through beautiful countryside was interspersed by huge industrial and mining areas.
North West (Briony Chisholm©)
Limpopo, too, proved to be a challenge, map-wise, but we drove over 1 000 km – much of it on dust roads – to visit 40 clinics and hospitals. The people in Limpopo were wonderful and welcoming and, thank goodness, like angels. This proved most handy when we found ourselves in the middle of nowhere, on a dust road in the sweltering heat, with a flat tyre! Along the deserted road came Agnes and Thendo, who kindly helped us, and we were soon back on our way.
Oh, dear. Somewhere near Ha-Ribungwani, Limpopo (Briony Chisholm©)
The Northern Cape was the perfect end to our road-tripping. We spent ten days there, starting with a wonderful turn-out in Kimberley – over fifty people in two sessions, including doctors, pharmacists, nurses and people from the Department of Health, at Kimberley Hospital.
From there we travelled over 2 000 km (much of it on dust roads, with another flat tyre to test our tenacity!), up to Kuruman and then down to Upington, across to Pofadder and Springbok and down to Garies, seeing 50 hospitals and clinics. We found the health care workers working hard and incredibly welcoming and made many friends along the way.
Through desert landscapes and surprisingly hilly mountain passes, we saw the end of the flower season and marvelled at the beauty and friendliness of this vast and often forgotten province.
Northern Cape skies (Briony Chisholm©)
Home again, Home again
We’ve met wonderful people and been welcomed most graciously, and the health care workers loved the posters, so hopefully the trips are having the desired effect – to get word of the hotline out there, to where it’s needed most! We’re waiting to see the stats until year-end, and then will write that up.
It was a wonderful, eye-opening experience, in equal parts devastating and encouraging. From tiny, old and desperately-in-need-of-upgrading clinics to smart, new ones, what amazed us most was the dedication of health care workers working under difficult conditions, often under-staffed and with little support and drug supply issues.
What a privilege it was to travel through our beautiful country and be reminded of how much good work there is going on out there. Hopefully the hotline will provide some relief and back-up to these amazing, hard-working health care workers.