Just what the doctor ordered
The health status of people in rural communities is generally worse than those in urban areas. The reasons are many and varied, but poverty is a major factor. Often the facilities, services and personnel for effective health service delivery are lacking.
It is against this backdrop that the Ukwanda Centre for Rural Health was launched in the Boland and Overberg regions of the Western Cape by Stellenbosch University (SU) in 2001. Now an ambitious expansion programme that will lead to the establishment of a fully-fledged rural clinical school has been developed by the University’s Faculty of Health Sciences, in partnership with the Provincial Government of the Western Cape.
The idea is to extend health sciences education away from the Faculty’s predominately hospital-centric setting in Tygerberg, Cape Town, out into underserved and rural areas.
“Our students will get crucial rural experience and local communities will receive high-quality healthcare in the long term,” says Dr Therese Fish, Deputy Dean for Community Services and Interaction.
The foundation has been laid by the Ukwanda Centre for Rural Health. Ukwanda is a Xhosa word that means to “develop” and “grow” in the community. The Centre operates in a number of towns and other rural settings across two provinces. The Worcester Regional Hospital in the Western Cape and the Madwaleni Hospital in the Eastern Cape are key sites.
The Ukwanda Rural Clinical School will enable the University to produce more healthcare professionals by focusing on underserved rural sites. International experience indicates that recruitment and retention rates are higher if you immerse students in rural life during training and recruit students from rural areas.
A hub-and-spoke model is being envisaged. The Ukwanda Rural Clinical School will have its main hub in Worcester, and initially spokes in the towns of Caledon, Ceres, Hermanus, Robertson and Swellendam.
Currently, health professional students undergoing rural training stay out in the region for two to six weeks. In the expanded model some students will spend a year out there, doing three-month rotations at Worcester Regional Hospital. Others will go to district hospitals situated in the spokes, where they will receive training under the guidance of a specialist family physician with support from other specialists. At the same time, a number of students will continue to do shorter clinical training rotations.
Through their experiential training, SU students assist local health practitioners to provide health services in community health centres, general practices, mobile clinics, schools, old age homes and private residences.
“The advantage of exposing students to rural life is that they get to experience a diverse range of conditions in which to learn and develop. This provides them with skills well-suited to the development needs of South Africa and other African countries,” says Prof Hoffie Conradie, the Director of the Ukwanda Centre for Rural Health.
In South Africa, approximately 46% of the population live in rural areas, and this figure is higher elsewhere on the continent. For rural communities, the main benefit of initiatives like these is greater access to healthcare.
“The Ukwanda Centre for Rural Health and the new Ukwanda Rural Clinic School are in line with our commitment to promoting human dignity and health,” says Prof Russel Botman, Rector and Vice-Chancellor of Stellenbosch University.
“These projects demonstrate how practicing science for society can make the world a better place. We hope that they will serve as models for similar initiatives all over South Africa and elsewhere on the continent.”