South Africa has an estimated 5.7 million people living with HIV or AIDS, which is the largest population of infected people in the world. The Desmond Tutu HIV Foundation (DTHF) has been central in the fight against the HIV and AIDS epidemic in South Africa. Since its inception, it has become an innovative source of advice for medical practitioners, support for people who need testing, treatment or counselling, and a leader in preventative education.
In 2008, the DTHF continued its fight against the HIV epidemic by launching the Tutu Tester Mobile Clinic. The antiretroviral clinic collected data that confirmed individuals in Cape Town accessed HIV testing only after complications had occurred, which led to unnecessary overburdened hospitals and higher mortality rates. The new mobile clinic offers accessible, free, and efficient health screening to communities, encouraging them to know their HIV status before becoming symptomatic. “Because people weren’t coming forward for testing, and especially in hard-to-reach wards, the idea surfaced for us to build a mobile unit that could specifically go into under-served communities, let them get to know us and come on a reasonably regular basis. We developed the developed the design and the first vehicle…was built – the Tutu Tester,” explains Project Leader, Anna van Esch.
The Tutu Tester is a brightly coloured mobile clinic that parks in areas like Khayelitsha, and Mitchells Plein. It is equipped with sophisticated testing technology and trained staff – including a nurse, a counsellor and an educator – into areas that do not have adequate health services.
The mobile unit has a CD4 machine and a PIMA tester that enable the team to provide clients with HIV test results and CD4 counts in less than 20 minutes. Liz Thebus, a Clinical Nurse, has been working in the Tutu Tester since inception and explains how beneficial having these devices are; “When we got the CD4 machine I was very very excited…it restored my faith in point-of-care because, at last, I could compare my clinical findings to what the machine was saying.”
Another healthcare worker, Sharon Jenekar, said, “It is a big help for us, really. Because here you can tell the person you are HIV-positive instead of going to the clinic and waiting two weeks for your CD4 results. We come in with the PIMA, do the CD4 count and we know exactly whether the person needs to start on ARVs.”
Apart from HIV and TB screening, information on sexually transmitted infections; diabetes; hypertension; obesity; cervical, breast and testicular cancer screening and comprehensive health advice are also provided. Not only this, but the mobile clinic also does risk reduction counselling, wellness promotion, education and provisions referral letters to the nearest clinic to facilitate clients’ linkage to care.
To date, the Tutu Tester has provided services to over 35 000 individuals around Cape Town, predominantly in previously disadvantaged areas. Of those who tested positive, 53% were linked into care and received treatment. In 2012, a client satisfaction survey was conducted among 294 individuals, of which 95% of clients indicated they were happy with the services provided by the mobile clinic. 78% of the clients said they shared the information they learnt at the clinic with others, and 85% rated the service as helpful, friendly, and enjoyable.
The Tutu Tester also keeps an electronic database of all their beneficiaries. When a client arrives at the clinic their fingerprint is scanned, and all their medical information is linked to that print. By doing so, all information on previous tests and medical conditions are recalled automatically upon the beneficiaries’ arrival. The information is also used to measure the impact of the clinic.
The project’s budget is R250 000, however this is a portion of a larger intervention calculated at about R1.1 million. The programme is ongoing, and most of additional funding has already been secured. Overall the project will reach approximately 1575 people, at an estimated cost of R725 per person.