Description: Many rural parts of South Africa comprise of the former Bantustans and were poorly serviced during the apartheid period, since 1994, these areas had to be serviced. The Phelophepa Healthcare Train Project is once such attempt and was established in 1994 by the Transnet Foundation. The train consists of a power car equipped with its own power generator that provides electricity to the train when stationary, laundry/storage coach, kitchen care, dining care, four accommodation coaches, two eye clinic coaches, one dental coach and one coach shared by the dental and counselling clinic, health clinic, pharmacy and office/edu-clinic. Partnerships between various government departments, the private sector and the Canon Collins Education Trust of Southern Africa allows for the delivery of medical care, basic health and HIV/AIDS education to disadvantaged communities through which it passes. This service includes, health, cancer, and diabetic screening, eye testing and the provision of spectacles, oral health education, dental restorative processes and extractions, individual counselling and community counselling workshops. In the Eastern Cape the train provides additional services such as home based care training, HIV/AIDS awareness programmes, Child/Orphan registration for receiving grants, TB screening and trains people to start their own food gardens.
Innovation: This project is the only one of its kind in South Africa and because it has its own power car it can provide electricity whilst stationary for five days. This is crucial to providing dental services to people where there is no electricity. As a norm, a locomotive generates power to coaches whilst in operation on the railway lines, i.e. travelling from one station to the next.
Effectiveness: Seventeen specialists are employed on a full-time basis while, 37 university students come to assist every two weeks. Since inception 1, 5 million people have been reached, 227,711 school children visited the train. Of these 162,883 children were screened, while 390,882 received basic health care education. Counselling workshops were held with 117,553 adults and 145,581 children. Where applicable patients are charged between R5-30. Since 2002 1,443 people received home-based care training, while the AIDS Action programme has educated 719 volunteers who educate their communities about HIV/AIDS.
Poverty Impact: At each stop 58-56 locals support the staff and act as interpreters and cashiers and receive an incentive of R30-60per week. The project has a major impact on the lives of the poor as it reaches people who do not have access to these services. People who use the service pay R30 for spectacles and R10 to have a tooth extracted, while receiving free counselling, where appropriate.
Sustainability: The total cost of the programme is ± R25 million per annum. Cost per head is ± R20 and is based on the number of individuals that are reached annually. Transnet Foundation provides 45% funding and the balance comes from external donors. Funding is secured for the next three years.
Replication: The Minister of Public Enterprise has requested the building of a second train to be operational by 2008. This model has proved itself since inception and similar models can be executed in other African countries where health infrastructure is either not in place or not fully equipped. A second train will allow Transnet to reach an additional ± 2 million people per annum.