In an opinion piece, Neil Tabatznik reflects on how starting the Tshemba Foundation reignited his passion for his native South Africa.
South Africa is not only the most unequal country in the world, it also does not care well enough for its weak and sick. Its inequitable access to healthcare is iniquitous in many parts of the developing world. But to me, a former South African who left the country during one of South Africa’s darkest periods in history, which was rife with government oppression at the time, it reflects the legacy of apartheid.
Having departed for England in 1971, where I practiced law before leaving for Canada, South Africa became a distant and awful memory: I had planned to leave and never come back.
I stayed away for 36 years and cut all ties with the country.
However, seventeen years ago, I returned to South Africa, for personal reasons: my son’s bar mitzvah. With family dispersed across North America, Europe and Australia, South Africa felt like a central place to congregate. It was during the new, post-apartheid period in South Africa that I fell in love with the country all over again.
I started the Tshemba Foundation in Hoedspruit, Mpumalanga, out of complete selfishness initially: It was an excuse to come back to South Africa, while doing good.
At the time, The Tshemba Foundation approached the provincial health department, pitched the concept and offered to bring skilled medical volunteers to the region – and a partnership was born.
The Foundation operates a medical volunteer programme that serves as a model of public-private partnership in the healthcare sector. Initially, I had reached out to colleagues and friends approaching retirement in the UK and Canada, recognising that they had immense skills, time on their hands, and could easily be enticed to come and help while staying at a lodge we had set up on a game reserve in South Africa. The Health Professions Council of SA (HPCSA) proved to be a barrier to this idea, because they refused to register any doctor who had left SA during the Apartheid era (intending never to return) demanding that they pay membership fees accruing during the intervening years. Although this barrier remains, we have still been able to recruit hundreds of volunteers from South Africa and abroad.
Designed to connect skilled professionals from the medical and allied professions with a desire to give back to rural communities in need, we have operated out of the Tintswalo Hospital, a 423-bed public hospital, and surrounding clinics, since 2017.
The Foundation relies on medical volunteers to bridge the gaps in patient care in rural Mpumalanga: Professionals who give up their time and expertise to bring value to underprivileged and underserved communities, while supporting existing staff with training, educational opportunities and fresh perspectives. We assist volunteers with HPCSA registration, to allow them to volunteer in South Africa, but they have to make their own way to Mpumalanga and are provided with free lodging.
Tintswalo Hospital is one of the biggest in the province, serving a rural, underserved population of about 300 000. The hospital has no specialist doctor posts, and if any staff member leaves, from groundsman to senior doctor, it is extremely difficult to replace them due to severe budgetary constraints.
Our “leave of purpose” programme recruits both local and international medics to volunteer their services in these rural areas. They cover a wide range of disciplines, from generalists and dentists to ophthalmologists that perform cataract surgeries and specialist researchers who are spearheading a rural ultrasound project.
Our flagship projects, offered in partnership with the Mpumalanga Department of Health and Tintswalo Hospital, are a state-of-the-art eye clinic and cataract operating theatre, which screens and remedies common, treatable eye diseases, and the Hlokomela Women’s Clinic where pap smears, cryotherapy, and breast, pelvis, abdomen and pregnancy ultrasounds are offered. Women no longer need to travel vast distances to receive screening and treatment: they can get such specialist care at Tintswalo.
Tshemba’s eye clinic volunteers have helped over 700 elderly patients – many of whom were being cared for by grandchildren and other family members, thereby depriving them of access to education and employment.
The programme would not have been possible without the cooperation and enthusiasm of medics, the community, the Mpumalanga Department of Health and international benefactors.
To date, we have attracted about 200 local and global volunteers, mostly from the US, Canada, Europe and Australia, who have devoted the equivalent of over 9,000 healthcare professional days, treated 19,630 patients and held 294 training sessions. These training sessions not only assist local healthcare professionals with continuing professional development and informal clinical teaching, but they also ensure that the Foundation makes a lasting and sustainable impact on the quality of rural healthcare.
Now, the challenge is to make The Tshemba Foundation sustainable. We are registering it as a charity in the UK, Canada and the United States, but we need more support.
We hope to strengthen our relationship with the province to improve healthcare, without flooding hospitals with volunteers. Instead, we would like to build on the power of the clinics by posting medics to smaller healthcare centres.
Our work makes a real difference, not only in the lives of the communities who lack access to healthcare that people in urban centres take for granted, but also in the lives of those who volunteer their services.
