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Health workers tackle SA mining’s social issues

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The health of its communities is becoming an important issue for mining companies in South Africa. Image credit: Anglo American

04 September 2020 A new initiative called the Impact Catalyst is making a difference in the mining communities of South Africa. The initiative is a partnership between Anglo American, Exxaro, the CSIR, World Vision and Zutari, who all share a vision of creating enhanced social impact in the mining communities in Limpopo and will expand to other provinces.

Impact Catalyst’s aim is to establish inclusive, collaborative, cross-sectoral platforms, initiatives and partnerships to achieve systemic socio-economic impact through public-private partnerships.

One of the first Impact Catalyst initiatives concerns Community-Oriented Primary Care (COPC). This is a joint initiative with the University of Pretoria’s Department of Family Medicine, and it has been rolled out in three communities: Mapela, Phafola and Mosesetjane around Anglo Platinum’s Mogalakwena mine in the province of Limpopo since October 2018.

The aim of the co-developed programme amongst provincial health officials, local leaders and communities is to empower Community Healthcare Workers (CHWs) to deliver medical care and education directly to communities and households as the need for primary health soared in the last few years. The COPC project aims to improve not only the health status of the people through better management of chronic diseases but also addresses other social concerns.

Arising from the success achieved in Mogalakwena’s mine communities, Anglo American centred its Covid-19 response around the COPC model across all Anglo-American mine’s sites. The WeCare programme includes a specific home-based response to its employees and contract workers through clinical associates who visit homes for screening, swabbing, contact tracing and follow-up during self-isolation. The second component is focused on supporting health facilities through a variety of COVID-related training sessions, to any health professionals at all levels, and to school governing bodies, school principals and staff, traditional and faith-based leaders, traditional healers and anyone from the community requesting such training. Other services include setting up and manning screening stations were requested and supporting the clinics where needed.

According to Sister Silvia Diase, Mogalakwena area manager for the Department of Health who is responsible for 11 clinics surrounding Mogalakwena this project has leveraged the strengths that already existed within communities to respond to specific community needs.

Numerous studies have shown that community-based services delivered by professionally supported community health workers can deliver significant improvements in healthcare at a far lower cost and can improve health literacy at the household and community level. CHWs create linkages between health care facilities and patients.

The group of 39 trained community workers adopted the premise that if the most vulnerable members of the population cannot get to a healthcare facility, they will take the healthcare facility to them.

The integration starts at a household level through CHWs driving health promotion and disease prevention, supporting patients on chronic medication, monitoring recovery progress and providing support to the patients that have defaulted on their medication. Their main objective is to prevent diseases by empowering communities through health education.

The health workers facilitate the increase of health literacy at household level through the use of a multi-disciplinary team which includes professional nurses, doctors, clinical associates, dieticians, specialists and creating integration at facility level (clinic and hospital) until the understanding of the saying ‘prevention is better than cure’ is a reality as more people manage their health better.

CHWs were equipped with the necessary skills and knowledge by the UP through a combination of weekly work-integrated learning sessions and using mobile devices to identify at-risk households. The CHWs attached to the three clinics; Mapela, Phafola and Mosesetjane in Mogalakwena have conducted 2 321 household surveys and 9 477 individual surveys to date. The process begins with a local health institutional analysis where the CHW do a mapping exercise of all the communities based on their area of work, this is a community-wide exercise with no exclusion. They identify the households, register individuals, and then conduct different health screenings for diabetes, hypertension, and other related illnesses.

This is followed by an environmental screening to see if these households have any issues with basic social services like running water and electricity. The data gathered will be used to inform future development projects and ensure new projects to address true community needs.

 “The main reason this programme has been effective is due to the creation of social capital, as social networks have been established with various stakeholders to enable health issues to be tackled as well as other social problems that the communities have”, says sister Salome Mogashoa, master trainer at Phafola Clinic.

The notion of people’s participation in development has gained momentum when it comes to community involvement and empowerment in social projects. “Due to these programmes relationships of reciprocity and trust have been enhanced, and people are more open to us rendering our services. We have seen a shift in mind-sets, showing that the people have made health a priority especially during Covid-19 pandemic, says Julia Kgaase, CHW for Rauwele Village under Phafola.

Success stories have been pouring in because of this programme. In one instance a diabetic community member was using expired medication because he could not afford insulin. “Though the COPC, the matter was reported to my supervisor and the patient was channelled through the correct process to get help,” says Seanego Sebolaishi, CHW for the Mapela Clinic.

Through the COPC programme, Mary Shikoane from the Phafola Clinic was treating a community member when she noticed that her patient did not have an ID and was not receiving any South African Social Security Agency (SASSA) grant. Through the COPC clinical associate’s involvement, he was referred to the relevant departments and is waiting for his pay-out.

The upskilling of the CHWs had a positive effect on the way they support their communities. Before the training, some CHWs did not know how to use a smartphone.  The CHWs can now easily engage with the communities independently and capture key information and data on mobile devices – a true “hi-touch, hi-tech” example.

The Impact Catalyst initiative is a perfect example of how the private sector can accelerate impact in communities when resources are combined with government sector efforts. Healthcare in the rural areas constantly suffers from a lack of resources due to many factors, and the concerted effort by these Impact partners to support the Department of Health with resources such as training, IT, internet connectivity and establishing value chains, among others, goes a long way towards creating the type of positive spin-offs such as improved relationships, connecting partners and better health literacy for individual community members,” says Dr Suzi Malan, COPC Research Unit, Department of Family Medicine, UP.

The Covid-19 pandemic has focused the attention on the importance of prevention of disease, as it showed how easily a health system can be overwhelmed when a large-scale epidemic occurs. It is for this reason that Anglo American has already approved full roll-out of COPC across all its mine host communities, to ensure better preparedness and health literacy among communities going forward. A similar programme is planned for the community of Lephalale Local Municipality in the Waterberg District with comparable results expected.

Apart from the COPC project, the Impact Catalyst partnership is conducting several feasibility studies and pilot programmes to stimulate economic development in the region and will make use of the data collected from these studies to inform future decisions. Some examples of proposed initiatives include the development of game farming, agri-processing and biofuels, laser-based refurbishment of mine equipment and the development of a fresh produce market.


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AgricultureEnvironmental Management & Climate ChangeEnergyESGInfrastructureMiningPolitical EconomyTourism and ConservationWater Management