With its signature rainbow banner, the Desmond Tutu HIV Foundation’s mobile fleet (Tutu Tester, Tutu Teen Truck, and Tutu Kwik Testers) bring essential healthcare services straight to communities in Cape Town where levels of HIV are high, but levels of treatment are low. In fact, around a fifth of South Africans between 15-49 have HIV. Communities most vulnerable to HIV and TB are remote and densely populated. Medical clinics are often far away and the time and cost involved make it difficult for people to access healthcare.
This is where the truck rolls in.
The Tutu Tester goes directly into the communities where there are the highest levels of HIV and TB in Cape Town. Phillip Smith, the mobile services manager, commented that “These people don’t come in on their own steam, so we take the service to them.” Whilst the tester specialises in HIV testing, it also offers a wealth of other essential services for free: including blood pressure, family planning, and TB testing. TB is the main cause of death for HIV-positive people, so this is an essential service to stop both.
What’s more, the service is accessible. Parking near schools or shopping centres, the Tutu Tester tries to ensure that there is no extra cost for a visit. Additionally, the truck stays open until after school has finished, ensuring that patients can find care without missing school or work. This service is especially important for empowering women who are seeking contraception. According to the 2016 annual survey, about 16% of women aged 15-19 years have begun childbearing. Some of these girls have to drop out of school, so the Tutu tester is essential to lowering this number and giving women the power of choice over their bodies.
There are two clinics-on-wheels in the Tutu Fleet!
The first clinic was started in 2008 and since then has seen over 50,000 patients! The primary focus of the project was to reduce the risk of HIV acquisition and transmission in all tested clients irrespective of a positive or negative HIV status.
Tutu Teen Truck
By the age of twelve, South African children can seek medical attention on their own without parental consent. The Tutu Teen Truck facilitates these students in an adolescent-friendly environment and ensuring that they can seek help outside of school-hours. This service is important for women who want to complete their education but also not compromise on accessing contraception.
Smith notes that the Tutu fleet sees a completely different demographic to traditional healthcare facilities. Mobile services are unique because they promote health seeking in men and young people. Around half of the Tutu Tester clients are male, and a quarter are under the age of 25. Smith also notes that “Our research shows that mobiles diagnose HIV at an earlier stage when compared with traditional facilities.”
The patients themselves (who have been anonymised to protect their identities) said that the Truck is great because it is well-placed outside a school, and they receive a WhatsApp message every time it will be nearby. One participant confessed that they did not know where their nearest clinic was and the truck was greatly convenient.
Aside from being an appreciated service, the Tutu Truck fleet are embellished with the zest and spirit of the staff. One patient, who had been coming for nearly a year, said that at first, she felt a bit shy but quickly began to feel comfortable to laugh with them. Closing hours are technically six pm, but she recounted an occasion where she needed the service and only arrived at closing time. “They stayed open to see me, and I really needed that.”
The WHO identifies that a key factor that influences whether adolescents seek health care is whether they could get into trouble with their parents or guardians. Strong societal expectations may be placed on youths to avoid premarital sex. This alone can deter adolescents from even seeking help for sexual health problems. Dorothy Zakariya, a clinical nurse on the Tutu Teen Truck since it launched in 2015, commented that “Our clients need an environment where they feel safe to share and that is what we are trying to provide for them.” The staff often hear heart-wrenching stories of rape, relationship violence and peer pressure, which Zakariya adds makes the judgment-free environment at the Tutu Teen Truck all the more important.
Naturally, there are challenges involved with a driving clinic. When strong winds and rains hit it can be tough to attract the same crowd, but The Tutu Tester is always there to treat patients whatever the weather. Other challenges arise from how isolated their clients are. Normally, the staff follow up on clients through a phone call, however, some clients don’t have access to a cellphone.
However, this doesn’t stop word of the services spreading through the community. New clients sometimes report that a friend told them about the service and they thought they would come along. Thando Xeketwana, an HIV counsellor, been in the Tutu Teen Truck for 11 months. He commented that the adolescent-exclusive service was an essential service “Because we offer a friendly youth service to them they respond well.“
The Tutu fleet is an essential service that reaches isolated communities, helps keep women in work and school and also access contraception, and is essential in treating demographics that are otherwise missed in traditional health clinics. If you want to help keep the wheels turning, then click here to donate. Tutu Kwik!