Médecins Sans Frontierès

Since 2000 MSF has been working in South Africa, primarily in response to the HIV and TB epidemics and working to increase access to healthcare for vulnerable migrants.

XDR-TB survivor and peer counselor, Xoliswa Hermanus, helps a family member fit a mask to prevent TB infection during a home visit and group counseling session.Photo: Jose Cendon

HIV&TB | Khayelitsha & Eshowe
In Khayelitsha, the largest township in the Western Cape, MSF has worked with the provincial authorities to pioneer comprehensive HIV treatment, including antiretroviral (ARV) medicines, at a primary care level. Today, these clinics support over 15,000 people on ARV therapy.

MSF has pioneered innovative approaches to decentralising these comprehensive HIV treatment strategies that also integrate TB treatment in Lusikisiki in the Eastern Cape  and Lesotho. During 2006 in MSF and the Lesotho health authorities started a pilot nurse-based programme to provide HIV/AIDS and TB care. In less than two years, nearly 2,000 people had been initiated on ARV treatment.

Together, these programmes have done more than simply treat patients. They have provided vital lessons about how comprehensive treatment for HIV can practically be delivered both in rural and urban settings. At the same time, MSF has been lobbying, with many other organisations, for cheaper medicines, more global funding for the HIV crisis and changes in policy towards the epidemic.

Despite the successes, many challenges remain, such as the problems of TB and HIV co-infection, drug-resistant strains of TB and the issue of long-term adherence to ARV treatment. MSF works with patients, academics, local health authorities and international experts to find innovative and practical solutions to these problems.

Migrant Healthcare | Johannesburg & Musina
In 2007, massive numbers of Zimbabweans started seeking refuge in South Africa, mostly illegally, due to the collapse of the economy and the political violence nationwide. MSF launched two projects providing humanitarian relief and medical assistance to the refugees at the end of 2007 in Musina and Johannesburg.

Johannesburg. Migrants from Zimbabwe sleeping in the stairwell in the at the Central Methodist Church. Photo: Austin Andrews

In Musina, the northernmost town of the Limpopo province right across the border from Zimbabwe, MSF provides medical care for the new arrivals, collaborating with the public hospital to refer patients for secondary level care, chronic patient assessment and treatment of HIV and TB.
 
In Johannesburg MSF started its medical intervention in downtown Johannesburg next to the Central Methodist Church where migrants sought refuge despite the appalling living conditions. Over time MSF extended its medical and outreach activities to inner city slum buildings to provide health promotion services, counselling, medical screening for HIV and TB as well as referrals to city clinics and hospitals. This is done, in partnership with the city’s Department of Health. MSF also assists residents with organising clean-ups in their buildings, and provides materials to repair building, as well as contracting of waste management services.