South Africa’s health train offers free care to remote communities

For the past 30 years the Phelophepa train has been circulating South Africa to provide free medical attention to the young and old who live in remote communities.
The health train has grown from a single three-carriage operation to two 16-carriage trains.
Patients struggling to see health professionnals at crowded or too-far-local clinics line up.
Today it stopped in Tembisa, a township east of Johannesburg.
“I’ve been suffering a lot from my eyesight,” Thabang said.
“I heard that it is a train coming here, coming to assist people. So they take like, 150 people per day and come assist them tomorrow. So some of them and some of us we sleep here because we live far.”
The free care it delivers is in contrast to South Africa’s overstretched public health care system on which about 84% of people rely.
Health care reflects the deep inequality of the country at large. Just 16% of South Africans are covered by health insurance plans that are beyond the financial reach of many in a nation with unemployment of over 32%.
In addition to health professionals, the Phelopepa train also +carries managers, translators and security staff.
They are run by the Transnet Foundation, a social responsibility arm of Transnet, the state-owned railway company.
When the train began in 1994, many black people in South Africa still lived in rural villages with little access to health facilities.
The train began as an eye clinic, but it soon became clear that needs were greater than that.
Now both trains address the booming population of South Africa’s capital of Pretoria and nearby Johannesburg, the country’s economic hub.
One would spend two weeks in Tembisa alone.
But the traveling clinic is far from the solution needed for South Africa’s healthcare problems.
Public health expert Alex van den Heever said there have been substantial increases in the healthcare budget and the public sector employment of nurses and doctors since the country’s first democratic government in 1994.
The health department’s budget in Gauteng province, which includes Pretoria and Johannesburg, has grown from 6 billion rand ($336 million) in 2000 to 65 billion ($3.6 billion) rand now.
But van den Heever blames the African National Congress, the ruling party since the end of apartheid, for the state of the public sector.
For South Africans who have witnessed the decline firsthand, it can be a relief when the health train pulls into town.
Thethiwe Mahlangu visited the clinic to get her eyes checked and have a pap smear and was among hundreds who walked away satisfied with its services.
“This train is helpful to us. It truly, truly, truly helps. All I ask is that it doesn’t end here, today. They must come back again and help us even if it’s next year. There are so many of us out there who are really sick,” she said.