The Khayelitsha Project
Khayelitsha is an African township located in the Cape Flats, an expansive low-lying area situated to the southeast of the central business district of Cape Town, South Africa. It is reputed to be one of the fastest growing townships in South Africa. Khayelitsha has among the worst social and economic problems in Cape Town, and indeed, the country as a whole.
The major diseases of concern are HIV and tuberculosis in which Khayelitsha has one of the highest burdens of infection across South Africa and globally. At least 6% of people diagnosed with tuberculosis in Khayelitsha last year had a drug-resistant strain of the disease. However, the true figure could be double that, making it one of the highest incidences of drug-resistant tuberculosis in the world. Furthermore, the condition of around ¾ of those infected with tuberculosis, is exacerbated by co-infection with HIV. When properly implemented, a Direct Observed Therapy Shortcourse (DOTS) program for tuberculosis has a 95%+ success rate and prevents the emergence of drug-resistant streams of the disease. However, patient compliance is a major threat to the success of these treatment programs. Additionally, the medications for these diseases produce common side effects including nausea, vomiting and loss of appetite.
The Zakhele Clinic and UTH
The limited medical services in the region struggle with the widespread poverty, disease and severe shortage of funding. The Zhakhele Clinic is a primary health care centre in the region which services around 1500 patients per month. Unfortunately, the desperate necessity for services far outweighs the physical capabilities of the clinic.
In the short term, Ubuntu Through Health have provided Zakhele clinic with much required medical equipment, including diagnostics tools, blood pressure measurement devices and digital thermometers. However, Ubuntu Through Health is providing long-term and sustainable support to the Zakhele Clinic via the implementation of a Nutritional Support Initiative.
The Nutrtitional Support Initiative (NSI)
The Ubuntu Through Health NSI, based in the Zakhele Clinic, was officially commenced in February, 2012. Through the provision of a high-energy vitamin and mineral enriched meal to patients on medication for TB and/or HIV the initiative aims to:
- Increase medication compliance rates by providing a food incentive for patients to take their medication
- Increase the effectiveness of the prescribed medications by improving an individual’s nutritional status, ensuring appropriate drug absorption and decreasing medication side-effects.
- Decrease the incidence of drug resistant diseases in the community
How the NSI Works
When patients attend the clinic for their medication they receive a two week supply of nutritionally enhanced maize meals called e’Pap. e’Pap is a pre-cooked porridge with soya protein fortified with 28 nutrients. The recommended serving size of e’Pap is 100g. 20Kg bags of e’Pap can be sourced for a little over $60 AUD. This equates to around 32c for a meal or a $1.60 to feed a patient for a week
Providing patients with e’Pap decreases the amount and severity of side effects of the relevant medications they are on as well as increasing the efficacy of their treatment.
The progress of patients is closely monitored through clinic officers who interview the patients every time they receive their fortnightly E’pap supply. We are able to determine whether they have taken their medication, the intensity of their side effects and the current state of their disease.
Help on the Ground
The program is supported by the Cape Town registered NGO, Tb/HIV Care. Started in 1929 the NGO aims to decrease the incidence of Tb and HIV across South Africa and critically, participate in research and develop monitoring and evaluating system to improve Tb and HIV prevention and care. Ubuntu Through Health are fortunate to have such knowledgeable partners on the ground.