New life and opportunities

2012-11-29 00:00

DRIVING to Hlabisa Hospital takes you through the Hluhluwe-Umfolozi Game Reserve. Seeing elephants on the road serves to emphasise the hospital’s location in a deep rural area of Zululand.

Now in his fourth year at Hlabisa Hospital, Sicelesihle Mngomezulu is quality assurance manager, ensuring the protocols of the National Core Standards are implemented.

A qualified nurse with a Master’s in public health, Mngomezulu was born and grew up in Mkuze. “I was never exposed to urban life,” he says. But he was interested in pursuing a career in health and was selected as a candidate for support by the Umthombo Youth Development Foundation.

“Umthombo covered everything: tuition, accommodation, meals — even pocket money. I was financially stress-free and able to concentrate on my studies.”

Dentist Skhumbuzo Mbelu, who hails from Jozini, tells a similar story. “Being a dentist was a long-time dream,” he says. “I was ambitious to become one.”

As assistant to the senior dentist at Hlabisa, Mbelu services the hospital as well as 16 clinics in the area. He and Mngomezulu are just two of the 116 qualified health-care professionals in 16 different health-care disciplines who have benefited from support by Umthombo, and are applying their skills in a rural area.

Investment in rural health lies at the heart of the Umthombo Foundation, the origins of which are to be found at Mosvold Hospital at iNgwavuma in the Umkhanyakude District of northern Zululand.

In the early nineties, there were five doctors working at the hospital, one of whom was Andrew Ross, the medical superintendent. Three of those five doctors were due to leave. The authorities promised they would be replaced. When they weren’t, Ross took the initiative to try to attract doctors. Advertisements were placed in the SA Medical Journal as well as the British Medical Journal.

“We were trying to attract British doctors who were after a bit of travel,” he says.

Vacant posts were filled, but only temporarily. “We were always looking for staff,” recalls Ross. “Then someone said that studies done in Canada and Australia had found that local graduates were much more likely to return to work in rural areas.”

Ross decided to start a bursary programme in order to recruit locally. He met with little encouragement. “He was told that he would barely find anyone in the area who could get to university,” says Umthombo director Gavin MacGregor. “And if they did, their chances of success were next to nothing, and if they did they would never come back to a rural area.”

But Ross persisted and set up a scholarship scheme under the banner of the Friends of Mosvold Trust. “To qualify for consideration, candidates had to be from the area,” says Ross.” They had to get a place at university and had to be aiming for a career in health science so they could work in a hospital when qualified — medical research in a laboratory did not count. And they had to sign a work-back contract.

Ross contacted British doctors who had previously worked at Mosvold Hospital for donations to support students, and an agreement was made with Medical Education for South African Blacks (Mesab) to fund half of the university fees.

To publicise the scheme, open days were held at the five hospitals in the Umkhanyakude District. “We had 100 kids visit Mosvold,” says Ross, “and we divided them into groups and rotated them through departments — X-ray, pharmacy and out-patients. When children think about hospitals and possible medical careers, they think ‘doctor’ and ‘nurse’, but there are lots of other health-care opportunities.”

Then it was a case of waiting to see what would happen. “One day three guys arrived and said ‘right, here we are’,” says Ross. “And we decided to go for it.”

Each year brought more applicants and as the student numbers grew, so did funding requirements. By the end of 2007, 55 students were being supported and the trust had produced 33 health-care professionals.

Ross continued to run the project, raising funds and mentoring students, but he was now working at the University of KwaZulu-Natal (where he is now a senior lecturer in family medicine) and clearly over-extended. Fortunately, in 2007, the trust received a Discovery Foundation Excellence Award worth R1 million, which allowed Ross to step back from the fundraising treadmill and employ a consultant to assess the way forward. There were two options: close down and hope someone else picks up the baton, or employ staff to develop it further.

Having gone for option two, MacGregor, previously with Heifer International, was brought on board as director. A broader vision was developed and, as the original name of the trust was no longer appropriate, it was changed to Umthombo Youth Development Foundation. Umthombo is a Zulu word for well or spring. “Just as a well provides life-giving and refreshing water to sustain a person, so our work offers new life and opportunities for rural youth,” says MacGregor.

Today Umthombo supports 181 students at 14 academic institutions, and has extended the scheme to 11 KZN hospitals and two Eastern Cape hospitals.

According to MacGregor, there are several key elements that explain Umthombo’s success. Firstly, identifying youth with potential, which means creating awareness at school level about career opportunities in health.

“The interested pupil has to do the right subjects and get good marks,” says MacGregor. “If they show real interest, we invite them to attend the hospital open day to meet some of our graduates, who can share information about their job and how they got there.”

The potential candidates then apply to university and, if they are successful, can apply for support from Umthombo. This sees them undergo selection by the local hospital committee consisting of hospital representatives and members of the community.

Successful candidates get full support, says MacGregor. “It’s not a partial bursary towards their studies, but all of it — the full tuition and accommodation, a book and food allowance — and if they need anything else, such as a stethoscope.”

High standards are expected of Umthombo graduates — pass marks must be over 80%. “Currently, the average stands at 88%,” says MacGregor. “They are allowed to fail one year and we will continue to support them, but only as long as they have shown commitment.”

Monthly mentoring sessions are another key to Umthombo’s success. “All students receive mentoring support,” says MacGregor. “There are local mentors on every campus and they deal with the academic and social issues the students face.”

Umthombo is not just about financial support, but also helps students deal with the stresses they encounter coming from a rural area to study at a university in a big city.

“It’s a huge adaptation going from rural iNgwavuma to Wits, where everyone’s cool and smooth, and has got the right cellphone,” says MacGregor.

According to MacGregor, one of the biggest obstacles is language. “At rural schools, learning is in Zulu. But at university, the teaching is all in English and, as one student said: ‘They speak so fast and each one has a different accent’. After lectures, they have to pull out their books and catch up on what they have been taught.

“They are effectively learning a third language, as this is medical-scientific English, full of medical terms.”

There are often family pressures back home. “Families expect children to get a job and contribute to the family once they have left school,” says MacGregor. “They don’t see the value of four to six years spent getting a degree. They see their child getting a food allowance while those at home have nothing.

“When students are faced with big issues, we help them see the bigger picture,” says MacGregor. “‘If you go back home now, you go home with nothing’, we tell them. ‘If you stay and qualify, you go home with a job for life and you can help your family forever. You are role models who can change your community.’”

After graduation, they return as professionals, contracted to stay for as many years as they received support from Umthombo.

“But it’s not just a contractual obligation; you also stay because your roots are here,” says Sphamandla Mngomezulu, Umthombo graduate and clinical psychologist at Hlabisa. “There is a sense of connection. You are back with your family.”

Sphamandla Mngomezulu grew up in iNgwavuma, where his mother was a community health-care worker at Mosvold Hospital. “Chronic TB and diabetes patients would come to our home for medication,” says Mngomezulu. “If she was not there, I would give them their tablets — I was 15 or 16 — and I would chat to them about the need for compliance when it came to taking their medication.

“I also did voluntary work at Mosvold Hospital after I got my matric in 2002. Dr Ross suggested I do psychology.

“Coming from a rural area, my English was poor when I got to university,” says Mngomezulu, who studied for four years at the University of Zululand and then did a two- year Master’s degree at the University of Johannesburg, followed by an internship in Bloemfontein. He now speaks English, Afrikaans and Sotho, as well as Zulu, and is currently working on a Phd on rural mental health. He is also the chairperson of the Umthombo Alumni Association and mentors two interns and three students.

“Umthombo is not just a health-care exercise, but a community-building exercise,” he says. “The next generation after me will not suffer from illiteracy.”

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