I have never seen so many buzzards and vultures – the sky is filled with them, circling on the breeze like ancient pterodactyls.  It’s no wonder, because directly in front of us is a lion kill.  The lion king has his paws and jaws encircling something that looks particularly large, meaty and bony, whilst the ladies, the hunters, settle in, waiting a few metres back.  The latter are well hidden and can only be spotted for the glint of those golden eyes.  When I ask Dr Carl Fatti, what the lion kill reminds him of he shoots off, “a bone drill”.  It’s a case of an environmental Rorschach test, but it certainly tells us where the good doctor’s mind is.  Dr Fatti is a retired practitioner and a medical volunteer with the Tshemba Foundation. The bone drill is an instrument that is much needed at the Tintswalo Hospital where he volunteers.   

Tshemba Foundation is an initiative that talks to an offshoot of the tourism sector – voluntourism. The brainchild of philanthropist Neil Tabatznik and Godfrey Phillips, it was founded in 2014, and opened in 2017, offering medical practitioners the opportunity to volunteer their skills in a deeply disadvantaged community, whilst ensuring they have a place to retire to and relax, after their daily work is done.

Voluntourism is a fast growing industry globally.  “Travel is something that should improve rather than exploit a destination,” according to the thoughtful travel journalist Linda Markovina. Indeed Tshemba Foundation’s offering is voluntourism of the highest kind, highlighting a vision of equitable and fair health care in areas that have overworked medical staff, and few resources.

The initiative has its base in a purpose-built Volunteer Centre near Hoedspruit, and currently serves communities in Limpopo and Mpumulanga. The Centre provides a place of nurturing and relaxation. It is set in Moditlo Private Game Reserve; a space to which medical volunteers can return after a challenging day at the Hospital.  The residence is perfectly designed – the central area boasts an excellently kitted out kitchen, lounge and dining area, the rooms are perfectly designed, with private relaxation areas, and windows that open onto the reserve.  It’s the little touches that always impress and delight me –  flowers in a medical beeker (seems appropriate!), locally made coffee, beautiful linen, a space that talks to both simplicity and luxury.  Outside to perfect the offering, there’s a boma area and a small plunge pool.   Nine rooms mean that nine couples, or even small families, can stay, learning and engaging with one another.  The Limpopo province also offers wonderful tourism opportunties including the Kruger National Park, the Venda Art Route, and fossil rich locations.

The Tintswalo Hospital, where the majority of the volunteers can and will work, is a Department of Health district hospital in Acornhoek which serves around 300 000 people, the majority of whom live in poverty. Many of the 10 000 patients visiting the hospital each month present with life threatening diseases such as malnutrition, malaria, diarrhoea, HIV/AIDS, tuberculosis, and diabetes and hypertension in epidemic proportions. The hospital is also a Regional Centre for Psychiatric care and is additionally responsible for placing doctors at 14 local clinics. The Tshemba Volunteer programme has already placed volunteer medical professionals at this hospital, with real success. 

Medical volunteers are also being placed at the Tshemba Women’s Clinic at Hlokomela – a pioneering healthcare infrastructure project of the Tshemba Foundation. Opened on July 7th this year, the clinic is dedicated to promoting women’s health, and is the only one of its kind in the region. Alongside funding the building of the clinic and placing medical volunteers at the institution, Tshemba Foundation was instrumental in bringing two projects to the clinic – a Breast Cancer Prevention Project, out of Johns Hopkins Hospital (Baltimore), and a Cervical Cancer Prevention Project, out of Mt Sinai Hospital (New York)

Sitting in the boma, watching the flames flicker, and seeing the sun set over an amazing landscape, the doctor and some student doctors are engrossed in a fascinating conversation.  One young physiotherapist, who is doing her Community Year, post graduation, speaks of learning real resilience from her work at the hospital, and of being forced to find new and creative ways to support her patients – ways that she had not learnt during her academic training.  Whilst she, and her young colleagues, are not staying at the Tshemba Centre, it’s an opportunity for long-term volunteer Dr Fatti, his wife, and the young doctors to get together over a drink to exchange ideas.  Volunteers are able to bring family members to stay at the Centre, whilst they work at the hospital.  Anne, Carl Fatti’s wife, highlights how nurturing the space is, both to her husband and herself, and describing how she had spent the day baking and reading by the pool.  Dr Fatti, himself, seemed inspired by his day, focussing on the opportunities to continue to learn and make a difference.

Professor John Gear, the Chief Medical Officer at Tshemba Foundation, and also the co-founder of Wits Rural many years ago, took us on a whistlestop tour of the hospital, introducing us to the staff – nurses and administrators in the Women’s and Maternity Wards.  As we entered the administration building, we were struck by singing from one of the rooms, even as dozens of people waited patiently to be treated. Prof Gear is empathetic and enthusiastic. In discussion he notes how a programme of this sort not only has the possibility of being scaled, but how it provides equitable opportunties, supporting public, private and social partnerships whilst engaging with both local and provincial government departments. (Tshemba works closely in partnership with the Department of Health and healthcare institutions in the rural communities of Limpopo and Mpumalanga.)  The hospital gets sorely needed skills, supporting stretched medical staff,  whilst volunteer doctors and medical practitioners are offered a powerfully enriching experience.  Gear highlights the challenges of working in the hospital (as does retired Doctor Fatti with the specific case of the bone drill) but both the professor and doctor highlight the reward and the learning to be found in the experience.