Alime's Story: Equal Access to Medicine in South Africa

Alime's Story: Equal Access to Medicine in South Africa

 Cynthia (left) cares for her grandson, Alime, orphaned to AIDS and living with HIV, in East London, South Africa.

This post is an excerpt from "Medicine Movers," written by Daphne Northrop, and videos by Emily Judem

EAST LONDON, South Africa -- Nine-month-old Alime and his grandmother Cynthia sit at a table piled with pill bottles, cardboard cartons, and syringes. There are 19 items in all. 

The squiggly Alime, who traveled that morning on his grandmother’s back to the hospital, happily munches on a cookie while the pharmacist counsels his grandmother on when he should take each of his medicines and how much to give him. It’s hard to believe such a tiny boy needs so many pills to survive.

Alime has been HIV-positive since birth. His treatment seems to be working. His weight has doubled, and as he smiles and gurgles quietly in Cynthia’s arms, he looks like a healthy toddler. He rarely takes his eyes off his grandmother, and he reaches out to touch her face as she talks.

Alime’s mother died of AIDS when he was just five months old, Cynthia says, her voice catching and grief pooling in her eyes. Now it’s up to her to care for her grandson.

So each month, they come here to Frere Public Hospital in East London. The trek takes most of the day, but Cynthia says she doesn’t have to wait long to see the pharmacist, and she always returns home with the medicine Alime needs.

She doesn’t know it, but one of the reasons for this is a tool called RxSolution.

Though invisible to patients, it has transformed their experience at Frere and many other South African public hospitals, which treat the neediest and most vulnerable and were long-neglected during the country’s 46 years of apartheid.

Developed by MSH with funding from USAID and the Eastern Cape Department of Health, RxSolution helps pharmacists easily monitor inventory, track patients, and aggregate data for planning and purchasing. It relieves pharmacists of time-consuming paperwork and allows them to spend more time with their patients.

Sammy Meintjes, lead pharmacist at Frere, still marvels that record-keeping tasks that used to take weeks can be accomplished in less than five minutes. He sees a direct connection between that and the quality of care patients receive.

"The more time you spend on a prescription, the less time you have to spend with the patient,” he says. “I think the system has really taken us to another level … we are moving in the right direction.”

Rolled out in 2004, RxSolution has been endorsed by the National Department of Health as the preferred monitoring system. It is used in more than 400 facilities across South Africa, including hospitals, community health centers, and primary health care clinics. Fifty-one percent of South Africa’s public hospital pharmacies have installed it, and almost 800 pharmacy staff members have been trained in its use.

On July 14, 2016, MSH reached an important landmark: officially handing over RxSolution to the government to be employed and sustained nationwide. Hospitals in five other nations -- Haiti, Namibia, Rwanda, Swaziland, and Uganda -- have also adopted the tool.

And the timing is propitious. Public hospitals are now in the spotlight, as they will form the backbone of the pending National Health Insurance plan that aims to provide access to quality health care to all South Africans.


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