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Posted By Dinesh Pethiyagoda, Richard T. Clark Fellow, Merck & Co. on May 23, 2014

Labels: Africa , South Africa , Chronic Disease, Alumni, Volunteers

Informal settlements of Soweto, South Africa

Dinesh Pethiyagoda is an employee of Merck & Co. in Upper Gwynedd, PA in its Global Marketing Communications for diabetes franchise.  As a Richard T. Clark Fellow for World Health, he and Gary Zelko, Merck’s Director and Publisher of the Merck Publishing Group spent three months in the fall of 2013 visiting Project HOPE’s program sites in Africa.  The purpose of their fellowships was to develop new promotional materials for Project HOPE’s work in Africa to aid in attracting new sources of funding for our work in this region.

In South Africa, we first visited the informal settlements of Soweto on Sunday.  Although I’ve seen several slums all over the world, this was the first time I had the opportunity to walk through and observe the poor living conditions. There was a strong stench of sewage as we weaved through the so called “match box houses;” dirty water was running all over. The structures were built from most people’s garbage: cardboard boxes, old mattress springs, sheet metal, cardboard signs etc. We were taken into the guide’s home, which was very depressing. It was approximately a 12X12 foot room that was shared by 8 people (2 elderly, 1 man and 5 women). There were some communal toilets located outside and shared by the entire community. When asked about safety for tourists, the guide mentioned there has not been one incident. He said it was very safe for foreigners to walk through because the community had “Ubuntu,” which roughly translates to human kindness.

Project HOPE staff at the HOPE Centre, Zandspruit, South Africa

The next day we visited HOPE Centre located in a poverty-stricken township called Zandspruit, outside Johannesburg. The clinic was in the Emthonjeni Community Center, which interestingly enough has been visited by Michelle Obama, her daughters and mother. There were some very nice pictures of Mrs. Obama reading a story to young children. This community center has primary school classrooms (situated in donated shipping containers), a bakery running with solar ovens, a recycling program where people were provided with clothes and food if they recycled and a vegetable garden project.

Project HOPE, in partnership with Eli Lilly and the South African government has initiated a five-year program called the HOPE Centre.  Established in 2012 and already treating over 1000 patients, the HOPE Centre offers a multi-tiered approach to treating diseases including diabetes, HIV/AIDS and hypertension.

Children at the HOPE Centre, Zandspruit, South Africa

The clinic has unique features including a patient appointment system, patient satisfaction surveys, patient education in the form of medication identification, advice on diet and lifestyle changes and a peer support program. In browsing through the educational materials and watching the diabetes educators provide counseling to patients, I was very impressed. They had an especially interesting educational brochure that was in the form of a comic book.

With a shift in disease burden from infectious diseases such as HIV and TB to chronic diseases, many of the new urban poor were now encountering a “double burden” of disease. Many people were presenting at clinics and hospitals with complications from diseases that if detected earlier and managed better could have been prevented.

A man blinded by diabetes receives care through the HOPE Centre in Zandspruit, South Africa

We observed the community outreach that Project HOPE was doing - visiting homes of those in the community, providing education and encouraging them to be tested for diabetes and hypertension at the nearby clinic. One of the especially touching moments for me was visiting the home of a patient who had gone blind due to diabetes and was now under the care of HOPE Centre personnel, who would visit to check up on him and provide for his medications.  It was interesting to see how he was able to distinguish between the many medications he had just by feeling the packaging and determining which pocket or drawer he stored it in.

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