The backbone of our health system
IN COMMEMORATION of International Nurses Day, the world acknowledges the invaluable contributions of nurses who serve on the front lines of health care, touching lives and making a difference in communities.
According to Goodman Ntshangase, Broadreach Health Development’s acting district director of Gert Sibande, this year their focus turns to the heroic nurses of rural Mpumalanga, whose unwavering dedication to ending the spread of HIV and promoting health equity has become a beacon of hope for their communities.
Ntshangase is central to this commendable initiative, articulating nurses’ roles as encompassing more than just physical care. Undoubtedly, nurses are vital to health services, especially in crucial aspects like HIV prevention, treatment, and care.
“The role of nurses is much more than just physical care, especially when it comes to HIV prevention, treatment and care in our communities. While all health-care workers play a critical part in the health ecosystem, our nurses are often the first and most consistent point of interaction for patients on the grass roots level. Nurses are seen as the backbone of the health services in our communities.
“Partnering with organisations like Broadreach Health Development, the US Agency for International Development (USAID), and the Department of Health, these nurses have been instrumental in driving public health-care initiatives in the region for over 17 years.
“Their efforts have yielded remarkable results, with significant strides made in HIV prevention and treatment,” said Ntshangase.
In districts like Nkangala and Gert Sibande, the number of people receiving HIV prevention medicine pre-exposure prophylaxis (PREP) has seen a staggering increase from 1 520 to 30 094 over the past year alone. This seen as a testament to the nurses’ dedication and effectiveness in reaching their communities.
Leslie Marbury, the USAID Southern Africa Mission director, expresses immense pride in backing the committed nurses of Mpumalanga, and their colleagues nationwide, in their tireless endeavors to combat HIV transmission.
“This collaboration illustrates the effectiveness of community-centred health-care initiatives. Nurses, (are) not only primary caregivers but also integral to fortifying robust health-care systems, exhibit steadfast dedication to community health, crucial for realising a future free from HIV for everyone
“One of the most significant achievements of these nurses is the 50% reduction in mother-to-child transmissions of HIV. Through interventions both in health-care facilities and communities, mothers are encouraged to adhere to life-saving antiretroviral treatment, resulting in a significant decrease in the number of Hiv-positive infants requiring treatment,“Marbury said.
At the outset of nurses’ involvement in the community five years ago, 251 Hiv-positive infants needed ARV medication, but this number has since halved, underscoring the efficacy of ARVS in preventing HIV transmission from mothers to their babies
Ntshangase provides historical context, stating that slightly over two decades ago, the responsibility of administering ARV drugs shifted from solely doctors, who were scarce, to include nurses. This transition marked a significant turning point for Hiv-positive individuals.
“Today nurses remain the backbone of the implementation of the
very successful ARV programme in South Africa, where in total we have 5.8 million people on treatment in the country, making it the largest programme in the world. This is a great example of how the nurse’s role within a programme can have such great impact on the community,” said Ntshangase.
In honour of dedicated Mpumalanga nurses, Dipuo Makofane, serving as the cluster team lead in the Nkangala (Witbank) district, said: “Growing up I always knew I wanted to become
a nurse. The love was brought by my late father, who was also a nurse.
“Not having any memory of the kind of person he was, as he passed on when I was about three-years-old, the stories of his contributions as a nurse gave me the courage that will forever live in me. I will forever stay in contact with what he pursued as a young man.”
Makofane said it was incredible to see, coming from an African medicine context, how the community embraced her as a positive “change
agent”. “I have built a trusting relationship by ensuring confidentiality at all costs. I continue serving the under-served, knowing the mission is greater than myself.”
During a typical day, Makofane’s duties include verifying staff attendance, assessing the outcomes of the prior day’s efforts, strategising for the day ahead, and expediting care for patients requiring immediate attention.
Ntando Godfrey Nkosi, serves as the cluster team lead in the Gert
Sibande (Ermelo) district of Mpumalanga. Nkosi was initially drawn to the nursing profession due to its myriad opportunities, combining both scientific knowledge and compassion.
“I was drawn to the nursing career because of the diverse opportunities it offers. It is a perfect combination of science and compassion. This career also lets me connect with people personally and it improves my relationships in the community.”
Nkosi admits that the life of a trained nurse can be physically, emotionally and mentally challenging, and it requires problem-solving skills in the community. It is, however, greatly rewarding.
“A pregnant woman came into the consulting room I was in and tested HIV positive for the first time in her life. We spent about an hour in counselling together. It was difficult to accept, and you could hear other patients outside the door whispering that the lady was wasting their time, but with proper counselling the lady started ARVS the same day and 10 months later she gave the baby my named, ‘Ntando’.
“The baby’s results were HIV negative. She was excited. It humbles me to protect the future of young South Africans and to see women like her taking charge of their health,“said Nkosi.
Bongani Sindane is the cluster team lead in the emalahleni (Witbank) district of Mpumalanga. His decision to pursue nursing was primarily fuelled by the desire to make a positive impact on others, particularly patients. Having experienced life in an orphanage during his upbringing, Sindane found solace in caring for the less privileged, a passion he carried into adulthood.
“I chose a career in nursing, mainly because I found it rewarding to be able to do something good for others, especially patients. Treating patients in a friendly and respectful manner goes a long way.”
Sindane loves taking care of the less privileged individuals; it was a childhood dream.
“Knowing that with my care, my touch, my voice, and my time, I can help a patient get through the night is one of the most rewarding feelings. The small things you do for someone can make a difference. Nursing has opened many doors for me like acquiring an LLB in compliance management and masters in labour law.
“Through my work at Broadreach and (providing tactical support to the) Department of Health, I have helped patients maintain their dignity during the most vulnerable times in their lives, ensuring that they have access to our health services. It is always an honour to reach out to so many patients.”
Sindane believes nursing is a calling.
“It can be physically and mentally taxing at times, but also give one an incredible sense of satisfaction and pride at the end of the day.
Working at the community level, Sindane finds joy in the hope that ARVS provide in his community.
“Nurses risked their lives to care for patients and protect their communities during the Covid-19 pandemic.
“I always ensure that health system strengthening models, initiatives, protocols, and policies are implemented by covered facilities and that facility staff continually identify and address clinical and non-medical issues, promoting the 95-95-95 HIV and TB agenda for adults and children.
“The 95-95-95 target refers to the UN goal to have 95% of all people living with HIV knowing their HIV status, 95% of all people with diagnosed HIV infection receiving sustained antiretroviral therapy, and 95% of all people on treatment having a well-managed and suppressed viral load,” said Sindane.