Case Study: Developing Health Systems Resources

Transnet-Phelophepa Healthcare Train, Roche


In rural communities in resource-limited countries where there is usually a very poor doctor-to-patient ratio, people travel long distances to receive even basic healthcare provision. Transnet-Phelophepa aims to address this challenge by travelling to over 70 remote communities to bring healthcare services directly to the patients. In addition, the clinic helps train local student doctors and nurses.

Transnet-Phelophepa is a healthcare clinic on wheels that travels into areas of rural South Africa to provide general healthcare services, disease awareness, health education, counselling sessions and group workshops.

The train also houses a special coach where education on general health issues including nutrition, hygiene and dental health are provided to the local communities which the train visits, along with specialist services, including diabetes prevention, hypertension and cancer screening, with free pap smears and prostate screening provided in a tent set up on the train’s platform at some stops.

Phelophepa is owned and operated by Transnet Limited – South Africa’s biggest state-owned freight transportation and logistics company.

Lessons Learned

The result of the broad reach of Phelophepa is better awareness of common health issues within these remote and often poorly educated communities, meaning that there is an increased likelihood of people presenting for examination and consequently more chance that patients can receive appropriate treatment. Ultimately the outcomes of Phelophepa are driven by the focus on ‘good, clean health’. Health inspires productivity, productivity generates growth and growth inspires prosperity.

Results to Date

  • Since its inception in 1994, over 5.8 million people have been reached, including those impacted by two large-scale HIV/AIDS education programmes.
  • The Phelophepa train has treated over 800,000 patients and reaches around 375,000 people annually through the trains various services.
  • Each year, both trains handle an average of 120,000 registrations, sees over 90,000 patients and dispenses close to 40,000 prescriptions.
  • Contributions include strengthening Health System Infrastructure and supporting Prevention/Awareness/Outreach programmes:
    • Over 20,000 student doctors and nurses have had the opportunity to hone their skills on Phelophepa.
    • Six clinics or health care facilitates have been built.
    • Each year close to 600 volunteers selected by their communities are educated on general health.
    • The Health Clinic team has visited over 25,000 local schools, providing vital health checks, screening and health education.
    • A further 100,000 children and adults are reached annually through the Outreach Programmes.
  • The second train - Phelophepa II - was officially launched in March 2012 and mirrors the capacity of the first train but with enhanced benefits of updated technology.
  • Both trains travel for 36 weeks of the year, cover over 117,000 miles and visit a different community every week (see around 70 communities each).
  • Each train is run by around 20 resident staff, supported by up to 40 South African student interns, preparing for careers in a variety of health-related fields. In addition to this, the train employs local people for tasks such as translating, cooking and construction work.

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