In our remote rural community, healthcare access has been a significant challenge. The nearest clinic is five kilometres away, but due to the rugged and expansive terrain, this journey can take over three hours round trip. While criticising the government and insisting on building more clinics seems like a solution people often latch onto, it is impractical in our context. Building enough clinics across such a vast area is neither feasible nor sustainable. Instead, we bring healthcare to the home, thanks to our dedicated team of community health workers, known as Nomakhayas.
Our Nomakhayas are qualified and trained to offer a range of primary healthcare services, focusing on maternal and child health, early childhood development, chronic conditions, care for the elderly, and support for people living with disabilities. Since we did not have a high school in our area before 2019, only a handful of people in our community have a Matric certificate. Consequently, most of our Nomakhayas do not have a Matric degree. All our Nomakhayas have been trained through accredited courses and extensive on-ground experience.
The true power of Nomakhayas, however, lies in their ability to build strong interpersonal relationships. Nurses and doctors often see dozens, if not hundreds, of patients a day and may not have the time to build personal connections. Additionally, the impacts of poverty have created a deep internalised sense of inferiority among many community members, making healthcare providers in positions of authority seem intimidating and unapproachable. This often leads to hesitancy in seeking medical help or fully disclosing health issues.
Nomakhayas are different. They are from the community and have spent many years developing deep relationships with their patients. There’s a real sense of familiarity and comfort that significantly enhances healthcare access. Unlike clinical or hospital settings where the environment can be sterile and rushed, Nomakhayas visit homes and spend meaningful time with each patient. This home-based approach allows them to observe and understand the living conditions and social dynamics that might impact a patient’s health.
The intimate and personal interactions Nomakhayas have with community members creates a level of trust that is not often seen in conventional healthcare settings. Patients are more likely to share sensitive information and adhere to medical advice when they feel understood and respected. We have found that this trust is crucial for managing chronic conditions, ensuring medication compliance, and promoting preventive health practices.
One powerful example of the impact of Nomakhayas involves a routine home visit where a Nomakhaya noticed that an 18-month-old child was underweight and sickly. The child’s mother was away for work outside the community, and the child was in the care of her grandmother, who was unaware of what was wrong. The Nomakhaya made a crucial phone call and learned that the child was HIV positive and had not been receiving her antiretroviral medication because her grandmother was unaware of her status. The mother had kept this information confidential but trusted the Nomakhaya to handle the situation appropriately.
Thanks to the Nomakhaya’s intervention, the child was immediately referred to the hospital for emergency treatment. The child recovered, and the hospital requested the Nomakhaya to visit the home twice daily to administer the HIV treatment. This intervention not only saved the child’s life because of the trusted relationship with the Nomakhaya but also highlighted the critical role of trust between the community health workers, families, and healthcare providers.
Our community’s healthcare efforts would be far less effective without the dedicated team of 20 community health workers. Their dedication and hard work ensure that healthcare reaches even the most remote households. Nomakhayas make sure nobody gets left behind, making accessing healthcare truly universal.