So, during COVID, our clinic, which is a primary health care facility in Mariannridge run by the eThekwini municipality, and would be under the Department of Health, stayed open throughout the COVID period.
At some point, we did have COVID testing, but due to continuous infections amongst the staff COVID testing was limited, and we were referring people outside of Mariannridge for COVID testing, or to the helpline, which comes to your house to do the COVID testing.
Because of COVID-19, access to the clinic was limited, meaning that they would open the clinic for an X amount of people per hour or so. The regular sanitizing, temperature-taking and filling of the register is done by a designated person at the entrance of the clinic.
The clinic uses SMSes before and during COVID to communicate with clients about reminders of doctor’s appointments or any other information. If they’ve defaulted, then the clinic would send them a reminder to come to the clinic using SMS – that didn’t change during COVID.
The clinic has always only offered a face-to-face service, and during COVID only face-to-face services were offered. We did use our social media forums to try to inform the community not to use the clinic service if they were presenting with COVID symptoms, which we also described, and used social media, and printed media around the SPAZA (small convenience stores like mini bodegas – explanation added by the researcher) shops etc., to inform people of what the COVID symptoms were.
So, we did encourage people not to use the clinic if they were showing symptoms, but rather phone the hotline. We did however have a lot of people reporting to the clinic with COVID symptoms during level two we had … during the second phase, we had a very high COVID incidence in our community and a very high rate of death, losing three people per family to COVID-19.
So, during the second wave, we also saw the closure of some of the institutions like the local police station. Although the local clinic did not close, they did work under a lot of pressure with staff going off, either to coordinate quarantine or isolate or being sick, or symptomatic. So, when that happened in there was a few staff, a skeleton staff and this did create a huge challenge. We did lose one nursing sister to COVID-19.
But otherwise, there are … there is a general functioning of our local clinic. COVID-19 information is available. There is enough information about all chronic illnesses, and everybody who was on chronic medication was advised at the beginning of the pandemic to fetch their medication for a long term, so they were provided with three months at a time of their chronic medication so that they didn’t have to come to the clinic.
We also have a dispensary, which comes to the community library where people on chronic medication can pick up their medication without going into the clinic, so this also helped a lot during COVID because it limited the number of people needing to access the clinic, and it also meant that those with chronic conditions didn’t have to expose themselves to the clinic where they are generally lots of sick people. So, the mobile dispensary was also providing services for people in the community.
When I talk about the clinic service it’s important to also say our clinic serves not only the community of Mariannridge, but also serves the surrounding communities because our Primary Healthcare Centre is so well managed, there is a perception that we offer a better-quality service than in comparison to other clinics.
So, we have a high incidence of non-residents using the clinic service. We also have an informal settlement, which is outside of our ward but uses the clinic for services. The informal settlement has about 1000 families, or more and they also access our clinic. So, all of these services during COVID were continuously provided, I think that our clinic did very well.
We also, in collaboration with the clinic, through the clinic committee did a lot of education, information, we did mobile drive-about with loudhailers informing people of COVID, informing people of symptoms, informing people of where they could go to, if they were symptomatic or how to care for a person with COVID in the home, where to go for isolation if you couldn’t isolate a quarantine at home.
We also informed people on what the lockdown rules were, what they meant, what you could or couldn’t do, and we generally used the loud-hailing and the community social forums to reinforce all the non-pharmaceutical messages of mask-wearing, washing of the hands regularly for everybody, using soap.
We also informed people about social distancing or physical distancing. We also informed people of basic house remedies that could be used during a COVID infection, but also pre a COVID infection so for everybody could just build their immune system, so we did all of that work as the clinic committee.
And I think that we fared quite well in managing the COVID pandemic, we still continue to do so, even though there’s are kind of a lull now between the second wave, and the expected third wave.
In our analysis, we think that nobody was left unable to access chronic medication. No one was left unable to access any health service, and no one was left unattended because of the COVID-19 infection.