5) Description of health product/service offering: Delivering affordable medical care and providing education to the communities it passes through in basic health and HIV/AIDS. Services rendered on the train includes: health screening, cancer screening, diabetic screening, eye testing and provision of spectacles, oral health education, dental restorative processes and extractions, individual counselling therapy and community counseling workshops.

6) Description of innovation: There are no similar programmes, it is the only one in the whole world. The train is equipped with its own power car (generator) to provide electricity whilst stationary at a place for five days.

7) Operational model: Phelophepa visits 36 stations per annum to render basic healthcare. At each stop approximately 4000 individuals are treated/reached. To involve so many patients a detailed marketing/information giving programme has been developed where communities are informed up to three months before the train's arrival on services available. The train only comes back every two years and therefore so much effort is put into it to make sure that those requiring the services will be able to visit the train to be seen by one of the clinic managers.

8) Human resources: A 17 member team live permanently on the train while a stream of 37 university students come to assist for two weeks at a time. 4 office staff which provide services from administration, logistics, financial management, marketing and strategic management.

9) Key operational partnerships: Internal Transnet Business Units: Spoornet, Transwerk, Transtel;External Partners:Roche Products, Colgate-Palmolive Foundation, The Canon Collins Educational Trust for Southern Africa (CCETSA) Arivia.kom;Government Partners:Department of Public Enterprises, Department of Health, Department of Safety and Security, Department of Social of Welfare, Department of Education

10) Financial Sustainability

          • Fees charged to clients?: Yes

          • How do you assure affordability?: A small fee is charged - maximum between R5 to R30 depending on service provided. This patient income totals approximately R600 000 per annum against the total operational costs of R25 million per annum this it is not a sustainable income. Those that cannot afford the minimum fee are sponsored by various individual small donors.

          • Earned incomes as a percentage of operating costs: 52%

          • Other funding sources: It is financially sustainable based on the income received from Transnet and external sponsors. It is not profitable as this is a social responsibility programme.

          • Strategy for long-term sustainability: To market the programme to corporate business both local and international. Since inception in 1994 almost 12 million patients have been reached. Because of this high success ratio as well as enormous value added to communities, the train is regarded as a flagship programme in South Africa.

11) Current and Future Impact

          • Total number of clients: 13,233,329

          • Clients in the past year: 900,318

          • Percentage of low-income clients: 100

          • Impact: Each year during its 36 weeks operational period, volunteers are trained in our basic healthcare programmes. Since inception more than 8,000 were trained. If they in turn reach 4 every week with this message of basic health care principles and solutions a staggering total of more than 8.6 million people have been reached. This implicates 8 million plus people who are empowered to enhance their quality of lifestyles.

          • Overall "market": Every week 1,280 patients are registered at the train while more than 4,000 are reached through outreach programmes from the train each week. Most of the African countries can benefit from a similar programme i.e healthcare train at most countries there are huge sections of maintained railway lines.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: 1. To build a second train. 2. To introduce a mobile eye clinic unit going to schools to test eyes and provide spectacles. Envisaged number to be reached +-5,000 per annum. 3.Busy revising basic health care programme with support from South African training institutions and Department of Health in order to enhance quality of basic health education 4. Introducing tele medicine technology on the train

13) Policy change: Accessibility to all railway lines in rural areas

14) Origin of the initiative: A request was received from a training institution to refurbish three coaches to use as a mobile eye clinic. Dr. Lynette Coetzee in 1994 whose who had to manage these three coaches realised that there was no financial support from the training insitution and had requested Transnet to fund. She then realised the potential to build a fully fledged healthcare train of thirteen and later 16 coaches which today is Phelophepa. She is still the Project Manager.

Contact Information:
Lynette  Coetzee
Portfolio Manager: Health
Transnet Foundation
(Government (Parastatal))
Postnet Suite 244, Private Bag x 2226, Johannesburg 2000
South Africa
Tel: 27+11-308 2495
Fax: 27+11-308 2574
Email: Lynette.Coetzee@transnet.net
Website: www.phelophepa.co.za