Dr. Hugo Tempelman, who opened the 24h Mother and Child Clinic in 1998 and has been running the PMTCT program (Prevention of Mother to Child Transmission of HIV) since 2003, explains in an open letter:
Dear donors and people who have a big heart for Ndlovu,
It is with great regret, but in good spirit, that we would like to inform you that the 24-hour mother and child clinic at the Medical Center in Elandsdoorn is closing.
We have been informed by the Ministry of Health that the private clinic license for 24-hour operation will not be renewed unless extensive investments are made. It was never our intention to become a private clinic, but offering a 24-hour service puts us in that category. Therefore, we are held to the same standards as large for-profit private clinics such as Netcare, MediClinic or life science hospital chains.
We were therefore forced to realistically examine the viability and functionality of the 24-hour mother and child clinic before deciding to make extensive new investments.
When we started offering antenatal care in 1998, Ndlovu Medical Center was the only clinic in Moutse for a total population of 120,000. Over the years, the Ministry of Health has improved the situation here locally and opened two new clinics, Marapo and Ntwane, both offering antenatal care. As a result, we at Ndlovu have seen a decrease in deliveries at our facility over the last five years, from around 500 a year to 183 in 2015.
With regard to our unique PMTCT program with a mother-to-child HIV transmission rate of less than 1% since its initiation in 2003, we can state that we have also achieved our goal here: The Ndlovu PMTCT protocol has been adopted by the Ministry of Health and all clinics in South Africa now have a very low mother-to-child HIV transmission rate. The Ndlovu Care Group has always presented its research and treatment results to the national PMTCT committee and has thus made a significant contribution to improving the national protocol. We have achieved our goal.
The Ndlovu Care Group Board continues to state that maternity care and birth services pose a major risk to the entire organization in the changing medical liability environment. Twice in the past, Ndlovu has been involved in legal disputes, and although these have been settled before trial, they have posed a risk to the organization in all its areas. These cases of medical liability justify the need for extended medical insurance cover for Ndlovu Care Group doctors. The additional insurance cover costs approximately R 130 000 per year per doctor. Ndlovu Care Group employs three doctors to cover the 24-hour clinic service.
All in all, we have decided not to go against the decision, but to abide by it and close. Ndlovu Care Group will take care of its employees and we are in the process of working out a plan that will be as fair as possible to everyone. Many internal positions will be filled by staff from the 24-hour clinic. Positions for new programs such as the Disability Rehab Program will also be advertised and filled internally.
On Wednesday, April 13, the Board of Directors met with the Board of Trustees of the Ndlovu Care Group and after lengthy discussions, it was decided to close the 24-hour clinic with immediate effect in accordance with the letter from the Ministry of Health.
A comprehensive meeting with all stakeholders, employees, the community, politicians and political parties, traditional leaders, religious groups and the Ministry of Health has taken place over the past few days. Everyone was informed about the background to our decision and showed understanding.
The Ndlovu Care Group and all its patients, the thousands of children born at the Colombine Maternity Unit without HIV infection, all the staff, the Board and myself would like to thank you for your support, the funding, the warmth of heart that has been shown to us in our efforts to fill the medical gap that existed in the area.
As an NGO, we filled a gap here until the government itself was able to take over. That is what an NGO should do.
We can proudly say that we have given our best and are now handing this over without hesitation, as the care of our community will continue without interruption.
Yours sincerely
Hugo Tempelman
=== Addendum ===
The pictures were taken during the Cosatu strike (Congress of South African Trade Unions) in 2010. The clinic was so overcrowded that expectant mothers had to wait on mattresses in the corridor for their delivery. Newborns lay in pairs in incubators because there were not enough available.
Of course, we will continue to keep you informed about the work of Hugo Tempelman, the many new programs and projects not only for the community, but above all for the children and young people in the area. Hugo and the Ndlovu Care Group are now concentrating more on these projects and are continuing to work on them without restriction.
