Letlhabile

The setting for today's adventure was the rural township of Letlhabile in the North West Province of South Africa. This place was much different from yesterday's township of Laudium, which is considered a more wealthy township. Letlhabile was marked with crowds of shacks made from thrown together sheet metal built on what amounted to big patches of dirt. While Laudium is in the Guinness Book of World Records for having the most Mercedes in a small community, a common mode of transportation in Letlhabile was a donkey cart. Our job today was to continue working to get this clinic completely on the SOZO patient management sytem, as up to date it was way behind with only about 400 hundred of the 4,000 patients on the system After about an hour and fifteen minute drive from the FPD headquarters, we arrived at the Letlhabile clinic to the sight of swarms of patients packing themselves into this small rural clinic. There was a pervading sense of hopelessness that seemed evident at the clinic amongst both the patients and the clinic staff. The space and the manpower of this clinic just didn't seem to have that capacity to handle these huge numbers of sick patients. It gave us a really good sense of the magnitude of this AIDS epidemic that has been tearing apart the country of South Africa for years. Anyways... shortly after arriving on the site our team hit a speed bump when the facilities manager of the clinic stopped us and asked us what we were doing there, having no idea who we were. After an hour or more of discussion, we finally got the go ahead to start working. From here on, despite a brief lunch break at the local KFC, our day consisted of searching through piles of patient files to find the information needed to enter these patients into the SOZO system. Necessary data included things such as a patients name and address, the date of his first visit, the date he started ARV treatement, and his baseline CD4 counts and HIV viral loads. The work was tedious and much of the time very frustrating. Ineffieciency seemed to be the word of the day. These files were just piles of scattered medical information that were thrown, on a good day, into big file cabinets. After several hours of work, our team of 7 was only able to piece together 70 patient files! For solid work to be done at clinics like Letlhabile and for treatment of over 4,000 patients to be successfully carried out organization is paramount. We seemed to agree that thse clinics are in desperate need of a motivated, intelligent clinic manager, whose job is to be availabe on site at all times to manage all aspects of patient treatment. The number of people capable of this type of postion seems to be in short supply around South Africa, so these organizations make do with the resources they do have.



All complaints aside we had a great day, and we really learned a lot about the treatment that goes on at these clinics. As we flipped through mounds of treatment records, we could really see first-hand how the system of treating large numbers of patients with HIV using ARV's works. After a day of hard work we are looking forward to a day off tomorrow, and we are excited about what new opportunites await us.