How South Africa's health train is becoming a boon for residents in rural areas

What do you do when you are sick or need medical assistance? Most of us rush to a doctor, consult a physician or head to a nearby hospital. But in South Africa, most of people head to a train station. Wondering why?

In South Africa, there runs a passenger train that has been transformed into a mobile health facility.  

But why don’t people visit a doctor nearby?

This mobile clinic travels throughout South Africa for much of the year. On its journey, it provides medical attention to the sick, young and old who often struggle to receive the care they need at crowded local clinics.

The passenger train, known as Phelophepa — or “good, clean, health” in the Sesotho language — had been in operation for 30 years -ever since South Africa’s break with the former racist system of apartheid.  

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With doctors, nurses and optometrists on board, the train chugs through some of the most rural villages, where residents struggle to get proper primary healthcare due to overcrowded and under-resourced clinics.  

The Phelophepa train not only serves locals but also provides a safety net for travellers as it ensures those visiting remote areas access to basic healthcare services.  

Each year, the Phelophepa train serves around 375,000 people, offering free healthcare to them which is in contrast to South Africa’s overstretched public health care system on which about 84 per cent of people depend upon.

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No lines, treatment for free

This mobile clinic offers free treatment. Also, there are no long queues, no medicine shortages and nurses are not rude which is allegedly a pertinent challenge at the clinics that cater to patients in Tembisa, east of Johannesburg.

“There we are not treated well,” a report by The Associated Press quoted Thethiwe Mahlangu, a patient, as saying.  

“We are made to sit in the sun for long periods. You can sit there from 7 am until around 4 pm when the clinic closes. When you ask, they say we must go ask the president to build us a bigger hospital,” said Mahlangu, who was among hundreds who walked away satisfied with its services and already longing for the train’s return next year.

Another patient, Jane Mabuza, got a full health checkup along with dental services. She said she hoped the train would reach many other people.

“Here on the train you never hear that anything has been finished,” Mabuza said.

Who operates this health train in South Africa?

The health train is run by the Transnet Foundation, a social responsibility arm of Transnet, the state-owned railway company.

It has grown from a single three-carriage operation over the years to two, 16-carriage trains. They address the booming population of South Africa’s capital of Pretoria and nearby Johannesburg, the country’s economic hub. One would spend two weeks in Tembisa alone.  

The train began as an eye clinic in 1994, but soon started offering treatment of other health ailments.  

As per the AP report, health care reflects the deep inequality of the country at large. Merely 16 per cent of South Africans are covered by health insurance plans that are beyond the financial reach of many in a nation with unemployment of over 32 per cent.  

The government started to address this gap from this year. In May, President Cyril Ramaphosa signed into law the National Health Insurance Act, which aims to provide funding so that millions of South Africans without health insurance can receive care from the better-provisioned private sector.

But the government has not mentioned, so far, how much it will cost and where the money will come from.