‘Being able to service this community is a great privilege,’ says Nokuthula Kwinda, the nurse-owner of Unjani Clinic Middelburg, one of several new private clinics made possible by Mediclinic’s Southern Africa operations.
As primary healthcare facilities, the clinics offer high-quality care in communities where doctors are few and far between. The need to improve access to healthcare in South Africa is indisputable.
I am contributing towards making the community a healthier place.
Nokuthula Kwinda, professional nurse
The overburdened state facilities service more than 80% of the population and there is just one doctor for every 1 000 people. Patients commonly encounter long waiting times or have to travel considerable distances for medical attention.
Around 16 million South Africans are employed but do not have health insurance, putting them in a particularly difficult position. Without medical aid, going to a private general practitioner (‘GP’) is expensive, while getting healthcare through the state takes time they can ill afford. Unjani Clinics fill this gap. Operated by professional nurses, they provide essential care at a more affordable fee of ZAR300 per consultation, medication included.
The clinics are typically situated in rural and semi-rural areas where residents do not have easy access to healthcare. Because the nurse-owners are drawn from the community, they know the people who look to them for care. Their clients are working people who cannot sacrifice a day from their jobs, pregnant women and moms seeking care for their kids, and people with chronic conditions who need regular medication. When they go to an Unjani Clinic for their primary healthcare needs, it frees up capacity in the state sector so others can get help more quickly.
‘In Unjani Clinics, we have found a partner that is also committed to improving access to healthcare,’ says Gale Shabangu, the Chief Transformation Officer for our operations in Southern Africa. ‘In this way, we as Mediclinic can meaningfully contribute towards ensuring that more and more people get access to healthcare at minimal cost.’ Backing the initiative is the non-profit organisation (‘NPO’), Unjani Clinics, which identifies suitable professional nurses and helps them establish their own clinics.
The NPO depends on funding from companies like Mediclinic to finance the facilities and initial operating costs. The clinics are managed and owned by black female nurses, a segment of society sidelined from economic opportunity for too long. ‘Unjani Clinics help me focus on my core skill, which is nursing. They assist with legalities and practical business assistance, while I focus on my clients,’ explains Nokuthula.
Like the other Unjani Clinics, Nokuthula’s clinic in Middelburg is housed in a refurbished shipping container. It has been cleverly designed to include a reception, two consulting rooms, medicine storage area and a small bathroom, with everything in place to provide fundamental care such as diagnosis and treatment of minor ailments, wound care, family planning, baby immunisations, and HIV counselling and testing. Thanks to its location in the community, Unjani Clinic Middelburg offers clients convenience and accessibility, along with affordability and trustworthy treatment.
Transforming Community Care
Unjani means ‘How are you?’ in Xhosa and Zulu – a clue to the relationship the clinics look to develop with community members. By making it simpler and less costly to get risk indicators like cholesterol and blood pressure levels checked, Unjani Clinics enable residents to take charge of their health. Clients can also get referrals for more specialised treatment, fast-tracking the healthcare process. Previously, many people would have put medical appointments off until things got serious. Now the nurse’s presence and standing in society promote an ongoing conversation around health. ‘I am contributing towards making the community a healthier place as I am able to offer health education,’ says Nokuthula.
The clinics impact the community positively not only through improved healthcare but by unlocking economic opportunity. We support Unjani Clinics with funding that is split between a grant for operational expenses and an interest-free loan for infrastructure. The development loan is repayable over five years, empowering the nurse-owners to get their business off the ground and build a sustainable future. With every clinic holding the potential for five jobs, these ‘nursepreneurs’ plough back into their communities. ‘In addition to expanding access to healthcare, we develop entrepreneurs and enable job creation. Those three aspects are perfectly aligned to Mediclinic’s goal of meaningful transformation,’ says Gale.
The first three clinics that were opened with our support started operations in 2020 and are already financially sustainable. Thanks to their success, we opened a further four Unjani Clinics in 2022. We also funded two health pods, i.e. fully kitted trailers that enable nurses to operate mobile health clinics in outlying areas, which were deployed in March 2023.
The service provided by Unjani Clinics continues to evolve. Through Intercare, the healthcare organisation in which Mediclinic holds an ownership stake, the clinics offer on-demand virtual GP consultations. If the nursing practitioner determines a need, she can connect her client with an Intercare doctor online to obtain additional diagnostic and therapeutic care in real time. This allows the clinics to broaden their scope of care and provide clients with a cost-effective and convenient solution.
From Mediclinic’s perspective, the clinics enable us to reach a clientele in areas where we do not have hospitals. This initiative also prepares us to serve different clients in different modes, adapting to the evolving healthcare landscape. It is a journey of growth, of helping people take their health into their own hands and build sustainable futures.