Primary Health Care and Community Monitoring

In Jonny Steinberg’s book on HIV/AIDS, “Three Letter Plague”, he follows the life of one young man who refuses to get tested. His life is contrasted with a project initiated by Medecins Sans Frontiere (MSF) and its champion, Herman Reuter, who believes that access to health care is the core problem, rather stigma over the disease. 

What I learnt most from the book was the work from the MSF project.

First, there should be a refocus of health care policy towards primary care. South African health care is vastly under-staffed and under-resourced. However, you don’t need to a doctor to diagnose and treat TB or HIV; you need a nurse or a trained volunteer. Furthermore a nurse is worth more in a rural clinic than in a hospital. The poor living in rural areas do not have access to hospitals. They can only afford to visit a hospital when they are very sick, by which point it is often too late. A lot of prevention and care could be done in clinics.

Second, there is great capacity for communities in South Africa to play a more active role in demanding good quality health care. In the health care project mentioned in the book, MSF initiated HIV/AIDS support groups. These support groups not only provided each other with support, but placed pressure on clinics to supply medicine and provide quality care. More on this, in my next blog