In July, MSF opened the Kgomotso care centre to provide emergency medical and psychosocial care to victims of sexual violence in Rustenburg, a large town in the ‘Platinum Belt’ mining area of South Africa.
In Rustenburg, one in three women reports having been raped at some point in their life. Since the project opened, MSF health promotion teams have spoken to over 25,000 adults and high school students about sexual and gender-based violence. MSF aims to use this project as a model for providing comprehensive care for victims of sexual violence in South Africa, and to advocate for a primary care-level response run by nurses and psychologists instead of a centralised physician-led service. Raising public awareness and encouraging women to break their silence is also extremely important, as the preliminary results of an MSF survey show that up to 30 per cent of women do not seek medical care after a sexual assault.
Emergency intervention in Durban
In April, an emergency team from our Eshowe project responded to an outbreak of xenophobic violence in the coastal city of Durban. Over 7,000 migrants, mainly Malawians, Zimbabweans, Mozambicans, Congolese and Burundians, fled and sought refuge in three hastily erected displacement camps. MSF provided medical care, psychosocial counselling, water and sanitation logistics, and helped coordinate the response with other organisations like the International Committee of the Red Cross and UNHCR, the UN refugee agency.
The Stop Stockouts Project (SSP) is a civil society initiative in which MSF, in collaboration with other organisations, monitors availability of essential drugs in clinics across the country, engages with health authorities to monitor stockouts, and pushes for shortages to be resolved more quickly. Published at the 7th SA AIDS Conference in Durban in July, the second SSP report revealed that one in four clinics surveyed experienced shortages of medicines, thereby confirming that drug stock outs are a threat to public health and could undermine the progress made in South Africa’s antiretroviral (ARV) treatment programme, which is the largest in the world, reaching over 3 million patients.
In Khayelitsha on the outskirts of Cape Town, MSF’s oldest HIV project in South Africa continues to provide specialised treatment for children failing first-line ARV treatment, as well as develop innovative ways to support HIV-positive young people and pregnant women, and is at the forefront of operational research to diagnose and treat HIV-infected infants at birth. MSF provides testing and treatment for HIV and also tuberculosis (TB), as co-infection rates are high. Recently, for the first time in South Africa, a patient with extensively drug-resistant TB was started on a combination of drugs including delamanid and bedaquiline, the only new drugs developed to treat TB in the last 50 years.
MSF’s HIV-TB programme covering Mbongolwane and Eshowe in KwaZulu-Natal continues to ‘bend the curves’ of the epidemic. In 2015, more than 60,000 people were tested for HIV, 750,000 condoms were distributed and over 3,600 men underwent voluntary circumcision, which is proven to decrease the risk of HIV transmission.
No. staff in 2015: 242 | Expenditure: €8.6 million | Year MSF first worked in the country: 1999 | msf.org/southafrica
Thembisa – 24 years old, from Khayelitsha
"Coming from the clinic that day in 2008, I felt like everyone could tell I was HIV positive. I didn't know whether or not to cry. Not everyone in Khayelitsha has a problem with people with HIV. But some people are judgmental, of course, and will not want to speak to you or date you because they don't even understand how people get HIV. I want people to know my status, because hiding it doesn’t help. I volunteered to be on the mural because the youth don’t have much courage like I do. I'm hoping the mural will help young girls to not feel alone once they've found out about their status and that they build courage from my bravery. When they see that it's a young woman in the mural, they can find hope that they can still live for many years."