Hlokomela - A case study in partnership excellence

 

In March 2019 Discovery hosted a conference aimed at encouraging fellow corporates to join in pooling resources for social impact. In this series, we look at the profound transformation that occurs when companies and organisations become partners for social good.

Arguably the most impressive demonstration of the power of strategic partnerships is the Hlokomela Programme, built around the historical passion of Christine du Preez, a nursing sister married to a Limpopo fruit farmer. Puzzled by the deteriorating health of 25 local fruit pickers at her first-ever farm clinic, she tracked their health for 10 years from 1991. Despite her best efforts, every one of them died.

“No matter what I did, I just couldn’t get them better. They were mothers and fathers and left many orphans behind. I was with the province at the time but was authorised to do outside work. I’d approached a farmer on Richmond Estate in our Hoedspruit district to start a local clinic. He gave me a room in a farm village house and I began working by candlelight there at 5.30am every day. Those 25 HIV/AIDS deaths are why I started the Hlokomela Programme,” the demure but indomitable wife of a citrus and mango farmer reveals.

Hlokomela means to care in Sephedi and it’s a life-long vocation for Christine who grew up with patients knocking on the door of her family home at all hours – her father a doctor on the mines at Virginia in the Free State and her mother a nurse. She married Johann whom she’s known since they were Head Boy and Head Girl respectively at the Sentraal Hoërskool in Bloemfontein in 1977, both going on to study agriculture and nursing respectively at the same university. Today Johann manages the Bavaria Fruit Estate in the Hoedspruit district and Christine voluntarily oversees the HIV/AIDs prevention, care and treatment of an estimated 30 000 farm workers and their families on 72 sites in the surrounding community. Her multiple and international award-winning program also cares for the staff of several local private nature reserves adjoining the Kruger National Park, plus hundreds of foreign migrants. An estimated 1 700 clients benefit from Hlokomela’s HIV testing services while 2 000 receive ante-retroviral therapy (ART) at three Wellness clinics and seven mobile sites. None of this would be possible without the financial, logistical and intellectual input and partnership of nine other outfits over time, ranging from a global migration body to the provincial health authority, two farmers organisations, a major pharmaceutical, two philanthropic health foundations and two major corporations, including the Discovery Fund.

Responding rationally to dire ART need

Real caring means doing the right thing regardless of adversity. Christine was a pioneer in dispensing anti-retro-viral drugs at a time when doing so risked government sanction and victimisation at healthcare facilities across the country.

“Other farms and game lodges began asking me to help. There were no ARV’s to begin with - we were doing family planning, immunisation, breast feeding and STI’s. After appointing a nurse to run my clinic for a while, in 2002 I quit working for the province at primary healthcare clinics and expanded our farm clinics to six in the Maruleng District. With so many migrant workers in the area, the International Organisation for Migration, (IOM), approached me, wanting to research condom use among farm workers. In 2005 they offered to fund us. That’s how we began as the Hoedspruit Training Trust, using Nompilos or caregiver peer volunteers.”

The IOM funded healthcare awareness, memorandums of understanding with local farmers and helped develop progressive workplace policies, unwittingly helping Christine set the groundwork for Hlokomela, which she founded in 2005. As a result, local farmers today both understand and enthusiastically support her work.

“I realised people were dying all around us and nobody knew what to do. So, I went to the Right to Care people in Johannesburg and asked for help. They began to courier ARV’s to me in 2007. I started with 50 people. They’re all alive today. After three years, the Limpopo provincial department of health asked me to show them how to do ART. They accredited our clinics long before their own,” she says. Hlokomela also has 2 peer educators assigned purely to sex workers and their clients at busy local transport hubs and fruit/vegetable markets.

Fast forwarding three years to 2010: by now Christine’s sterling work was being noticed, including by Discovery Health executives who were simultaneously watching Limpopo Province battling to respond to the now-rampant HIV pandemic.

Christine recalls; “The Discovery person suggested I chat to a doctor at the Tintswalo District Hospital in nearby Mpumalanga where they’d put in aircon units and awarded her a bursary. The Tintswalo doctor said I should apply for the salaries of my caregivers and my operational costs. We had eight clinics and some 42 Nompilos dispensing mainly ARV’s, doing HIV testing, awareness and compliance. Discovery gave us an initial R150 000 and took myself and Antoinette Ngwenya, my program manager, on a leadership course in Sandton. It changed our lives. We did these personality tests and I found out that empathy was my highest attribute, but that I needed to learn to say no!”.

Province withdraws HIV care – Discovery plugs the gap

After several years of ongoing Discovery funding, the major boost came in 2017, ironically in response to the Limpopo Department of Health sending Hlokomela a letter informing them that they were stopping all NGO funding – including ARV’s and other medicines, (Hlokomela being their primary HIV/AIDS service provider), from June 1st, 2018.

“So, I told Ruth Lewin (Discovery’s Head of Corporate Sustainability) that I’ll have to close our clinics. The (provincially-funded) budget then was R3,6 million for our 10 clinics and the Nompilo’s stipends. Ruth called me to say Discovery would contact 40 companies, asking them to support us. A fee-for-service system was mooted but the stakeholders soon realised that Hlokomela was the de-facto local HIV/AIDS service provider, with patients travelling from across the province, Mpumalanga, Mozambique and Zimbabwe for ART.

Discovery facilitated meetings with AgriSA and Adcock Ingram. The purpose of these meetings was to build relationships in which longer-term support could be provided. It was decided a delegation from Adcock Ingram and Discovery should travel to Hoedspruit during the first week of February 2018. The pharmaceutical executives were so impressed that they upped their initial R1 million offer by R500 000 in annual funding for three years – which Discovery matched. Christine is proud to say that the Hoedspruit farmers have made up the R600 000 per annum budget shortfall.

Christine’s greatest satisfaction comes from watching her Nompilo’s self-esteem and confidence grow by leaps and bounds and the farm workers who so deeply appreciate their efforts. “The other day I want into a village and a guy came over to me and said I once came to his house years ago and helped him. He said I saved his life – and I didn’t even recognise him, but I really got his gratitude!”.

Leveraging Discovery networks to benefit patients

While partnering with the Themba Foundation which co-ordinates medical professionals to help communities self-identify needs and empower themselves, including via its women’s health clinics, Christine became aware of the dire circumstances of women with breast cancer and their lack of access to chemo-therapy. Discovery, through its hands-on approach and links with the one of South Africa’s top breast cancer experts, Dr Carol Benn and her Breast Health Foundation, (BHF), donated ring-fenced funds to the BHF to pay for world-class treatment of Hlokomela-referred patients and to raise breast cancer awareness in the region. Discovery also funded travel to Johannesburg and accommodation for patients and their closest relatives. By early 2019, raised awareness and screening helped detect breast cancer in 12 farm workers, seven of whom were commuting the 400 km to the Helen Joseph Hospital’s Breast Care Centre where Professor Carol Benn consults. With an additional R600 000 Discovery BHF funding injection, Louise and Christine are probing the design and equipping of a mobile oncology unit to serve the nearly two million people in the Hoedspruit and Bushbuck Ridge districts. The intention is to screen patients for initially for breast cancer but eventually for all cancers, enabling detection, treatment and referral, plus delivering “home-based” chemotherapy – by 2020.

For Christine, Hlokomela is morally and spiritually self-sustaining.

“I remember saying to our very despondent financial lady when we were considering shutting up shop in October 2017; ‘While I’m living, I can’t stop it. If I just close our doors, you all don’t have jobs. What about the farmworkers and the lives we’re saving? I can’t leave it for government we must take hands!”

Which just about sums up how inspirationally South Africans collectively pull themselves back from the brink every time things seem hopeless.

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