The Rural Challenge

The founding hospital of the FOM Scholarship Scheme is the Mosvold Hospital in Ingwavuma, KwaZulu-Natal.

Mosvold Hospital is one of five district hospitals providing health care to over 550 000 indigent people in the Umkhanyakude District situated in northern KwaZulu-Natal Province. The district is remote and shares borders with Mozambique and Swaziland.

Most of the inhabitants do not have access to electricity or piped water, and live in scattered homesteads, eking out a living by subsistence farming supplemented by income from old age pensions, disability grants and wages from migrant labour. Unemployment is high and job opportunities are scarce. The community itself has little infrastructure (transport and communication), schools are overcrowded and there is a poor standard of education. In some schools certain important subjects are simply not taught to learners for lack of resources.

The major health problems affecting people in this district include malaria, TB, HIV/Aids and gastroenteritis. Other third world health problems are also common including malnutrition, poor hygiene, lack of clean water, illiteracy, high birth rate and high teenage pregnancy rate. Parasitic infestations are widespread in children. Sexually transmitted infections constitute a major epidemic with sero-positive prevalence for HIV of up to 38% of women presenting to antenatal clinics. New Aids cases are seen daily at the hospitals and up to 80% of the patients in the TB wards are HIV positive.

Over the years health professionals have been recruited to the hospitals from overseas, but few of these people make rural South Africa their home over the longer term. Innovative training programmes have been established in an attempt to encourage South African graduates to work in the district, however for young people who have grown up in a city, a rural lifestyle has little to offer. As is the situation with many state health facilities country-wide, all of the hospitals in the district have struggled to retain professional staff to work at the hospitals and this has often compromised the quality and type of service provided. A situational analysis done in the district in 2006 by the Centre for Rural Health showed a 46% vacancy rate for Professional Nurses (1171 vacancies of 2546 establishment posts), a 41% vacancy rate for Medical Officers including community service officers (CSOs), and a 55% vacancy rate for Senior Medical Officers and higher.

A pitifully small number of learners coming from the district go on to do tertiary education and training. Apart from nurses, few of the health professionals working in the district hospitals actually come from, or grew up in, the district. This is in part due to the:
· poor local standards of education;
· high cost of tertiary education — up to R50 000 per student per year — in an area with a high level of unemployment; and
· lack of appropriate role models.

It is in the context of these rural challenges that the FOM Scholarship Scheme is operating and also changing lives. Read about How We Work...