A Clear Blue Vision Of The Future

A blue train is slowly chugging around South Africa but Phelophepa is no ordinary train, reports Mapula Sibanda. It brings primary health-care to thousands of rural people

AFTER the spectacles were placed on her face, the old woman blinked, then beamed with joy. Earlier she could not even see the letters on the board used to test her eyes.

“Now that I have my eyes back, I can start weaving my mats again,” said Sophia Leshega (70). A farm labourer from Roossenekal, Eastern Transvaal, she is one of thousands of mostly rural people who have benefited from a unique initiative, Phelophepa, the world’s only primary health-care train.

Phelophepa — which translates into “clean health” — started tracking across the country last January. Custom-built by Transnet as part of its social responsibility programme, Phelophepa began life as three coaches devoted to providing eye-care. Some 30 000 people, mostly elderly with cataract problems, received treatment between January and June. Now, more coaches have been added to offer a range of health services.

When Phelophepa pulled into the Eastern Transvaal town of Roossenekal last week, it looked just like an ordinary train — except for its bright blue paintwork. But a tour of its 13 coaches revealed a hospital on wheels.

There are two eye-care coaches and a pharmacy coach, which has specially fitted cabinets to store medicine safely while the train is moving. Two other coaches, their walls plastered with posters, serve as clinics. Others provide storage, space for staff to eat, sleep and do administrative work, a laundry, a kitchen and power for electricity.

“I can light up the whole of Johannesburg with these generators and the two diesel tanks that you see in this power car,” said train manager, Ginger Terblanche, with pride.

Apart from Terblanche, the train is home to about 30 people, including 10 trainee community nurses, 17 final-year optometry students from the universities of the North, Durban-Westville and RAU, a lecturer and a full-time community nurse. All are looked after by eight Transnet employees, including a cook who used to work on the Blue Train.

Outside, shaded from the winter sun by a blue tent, a handful of patients sat waiting to be seen to. “This is the poorest attendance since the train began its trail,” said community nurse Marietjie Bester. “At all the other stations there were about 200 people a day.”

But for the people of the area, Phelophepa was answering a much-felt need for health facilities. Most of those who visited the train on Friday had walked from farms as far as 20km away. Usually, residents of the district are forced to travel up to 50km to Middleburg for medical attention.

Sophia Leshega paid R40 to have her eyes tested and the price included the cost of the spectacles she was given to correct her vision. Immunisation, health education and basic tests are carried out for free, while medication is dispensed at a flat rate of R5. Serious cases are referred to the nearest hospital.

While Phelophepa has touched the lives of people living in remote rural areas, it has also touched the hearts of those working on it.

RAU final-year optometry student Karen Vorster (22), told how she joined the train’s team because she thought it would be an adventure; she also had to do a compulsory practical to finish her degree. “It was only after being on the train that I realised the need for health care facilities in rural areas,” she said. “The appreciation that people display after you put the spectacles on their faces is quite amazing. I have seen old people get down on their knees with gratitude and was deeply touched by the gesture.

“Phelophepa has touched the lives of so many people, including myself. “My attitude towards black people warmed when I learned from them the beauty of appreciating the small things in life.”

During her days working on the train she’s also seen something of the countryside — and eye diseases she’d only learned about in theory. “Many are caused by the pollution (from fires and dusty conditions) in rural areas,” she said.

After stopping at more than 24 stations across the country, testing an estimated 23 000 patients and issuing 11 721 pairs of spectacles, Phelophepa is still to visit 10 more areas. Journey’s end will come in September, when the train will be sent to Transnet’s engineering wing in Bloemfontein for renovations and refitting in preparation for its next journey, planned for 1995.

Phelophepa provides more than basic health-care for people in far-flung rural areas. For people like Sophia Leshega, who can now see to weave the mats she sells, it brings a new vision of the future.

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