Tapologo ART programme, Rustenburg

Tapologo , Rustenburg reports for  June – August 2012

The site has recruited 5 Caregivers for Boitekong, 4 for Kanana. One caregiver passed away in June and another was medically boarded.

A student doctor visited from WITS University and worked with Dr Van Schalkwyk at the clinics and In Patient Unit.  Students from Healthnicon (Training College) are still working in the IPU on a monthly basis as part of their training.

HIV testing is still being done on ART Clinic days so that we can collect a blood specimen for the CD4 test at the same time, so that patients do not need to incur additional transport costs.  We experience that a number of community members visit our clinics to be tested to know their status and after the HCT they refuse admission to our Programme.

Patients in our HIV Care (Outreach Programme) are being traced and monitored during home visits and also during Support Groups that are held in each community.  The importance of household screening has been reiterated as well as the accurate recording thereof on the Household forms. The referral system to Government facilities is still running well.

Tapologo continues to offer Home Based Care including support groups, and psycho-social interventions in the following community clusters: Boitekong; Chaneng which includes Robega, Rasimone and Mafenya; Freedom Park; Kanana ; Ledig; Mfikdwe which includes Bokomoso and Zakhela; Phokeng which includes Lefaragatlhe, Luka and Masosobane; Potsaneng; Tlaseng.

We continue to provide INH and TB Prophylaxis and refer patients to the DoH clinics for TB Treatment. Their treatment adherence is monitored by the Home Based Caregivers in the home.
We also encourage patient family members to be screened for TB whilst visiting their relatives / friends in the IPU.

A medical assessment day was held on 13 July at our Boitekong OVC Centre by the Tapologo Outreach Nurses to ensure that each child admitted to our OVC care and support programme was medically assessed. All the OVC Coordinators have been included on the Health and Safety Committee so as to ensure a continuum of care and referrals .

Many of our female patients are still complaining that their partners (men) do not want to be tested and that these men blame the women for infecting them.  We do however find that many of our terminal patients admitted are men due to the fact that they wait for such an extended period before consenting to HCT and finally ART.

Pregnant mothers are being referred to Government clinics for ART initiation.  We do however still undertake the PCR’s after 6 weeks.

The Service level Agreement (SLA) with the DoH in terms of supplying drugs to the Tapologo has still not been finalised.  Until the abovementioned SLA is finalised, SACBC has instructed Tapologo to transfer approximately 200 ART patients per month to the various Government Health Clinics in view of the end of PEPFAR funding in May 2013.

The HMIS team is still undertaking periodic site visits to verify the data capturing card to the patient file.  This system is working very well and we have the support of the clinical staff during these audits.  Ongoing quality improvement projects are being undertaken to determine the success of multiple dispensing, patient adherence and home visits, etc.

Various training opportunities in this period:

  • Complicated Grief presented by Nelia for 22 staff members on 15 June.
  • South African Depression and Anxiety Group provided a workshop on 10 July for 10 staff members.
  • TB Training for all the sites by choosing one representative from each site will commence in September. 2 Master trainers have already received training by HPCA. 3 OVC Coordinators have also been included – CCC for Freedom Park, Phokeng and Ledig. These will be responsible for in-service training of other staff.
  • A number of in-service training sessions take place monthly at local level (Tapologo Centres). These sessions include training on ART adherence, Genograms, TB management, counseling, paediatric patient care, infection control etc.
  • 1 Professional Nurse attended a TB Training workshop at Rustenburg Golf Club on the 25 August 2012.