The ordinary should not be the extraordinary: a look at Nomangesi Jayiya Clinic

The ordinary should not be the extraordinary; it’s what Garth Hennings believes and why he laughs a little that there should be any “special interest” in Nomangesi Jayiya Clinic in the Nelson Bay municipality where he is operational manager.

But the clinic does tick many of the right boxes and it’s largely down to putting in place some of the basic recommendations for improved clinic services and practices. It’s also because Henning takes a hands-on approach and leads by listening, communicating and even some humour, those who have watched him work say.

Henning says the clinic in Kwa Nobuhle in the Uitenhage area of the Eastern Cape services between 3400 and 3800 patients a month. Many of those patients he knows come from outside of his catchment area.

“The other day I spoke to one of our patients, a teacher. I know the school where she works and I know there is a clinic right next to her school. But she told me that people told her she must come here to get better service,” Hennings says.

He’s open to public feedback, good or bad, and says “we just try to do our best for the public with our limited resources”.

Henning exited the Lilitha College of Nursing in 2006 as a professional nurse. Since 2010 he’s been based at Nomangesi Jayiya and in 2016 was promoted to Operational Manager.

“I like to get stuck in wherever I’m needed, especially when we are short-staffed – maybe other managers like to sit in the office and concentrate on admin but I don’t like to sit on my hands,” says the married father of two, who admits that sleep and catching up on soapies is how he recharges for every new work day ahead.

But at work, he’s all in – it means sometimes he’s helping the dispensary staff, sometimes he’s at reception or helping the nursing sisters. Patients will also find him calling out their names because they don’t have a PA system.

“Sometimes when the patient doesn’t hear me calling them maybe I’ll sing their name out loud, then everyone laughs and maybe that helps,” he says, adding that he is an upbeat person and tries to engage with patients and is staff meetings focus not just on what needs to be done or fixed but takes some time to check in on the emotions and feelings of what staff are experiencing.

For Ritshidze community monitor Andiswa Rhode, Hennings and his team stand out among the six clinics that she monitors in this part of the Eastern Cape.

Rhode says: “When you go there you won’t find Hennings sitting in his office. In the beginning he didn’t want to make an appointment with me because he was always busy and I thought he was going to be unhelpful. But then I could see that he was working with patients, sometimes out delivering medicine himself. Then we did have an appointment and he was open and gave me all the information that I needed – he is an all-rounder.”

Rhode says a key intervention adopted at the clinic is pre-packing chronic medication for patients one day before their appointments and increasing home deliveries of medicines.

“You can come there by 8am some days and it’s quiet because there aren’t many people standing in the queue waiting for their medicines; they pick up and go,” Rhode says of a small but effective intervention that means the clinic doesn’t stay clogged up with patients.

Also noteworthy, she says, is that the medicines are packed in brown bags and stapled. It means patients’ privacy and confidentiality is protected.

“They also ask the patients first if they are comfortable with home deliveries. This is important because sometimes people haven’t disclosed to their families or they don’t want the neighbours to talk,” she says.

Rhode says Hennings and his team have a good attitude in taking the time to explain dosages carefully or when brands of medicines or regimes are changed. It’s crucial she says because patients who don’t understand the treatment are more likely to default.

She says the clinic is also kept clean. It’s the kind of pride and care in the workplace that she says makes a difference for patients who have to be in the facility.

“We must focus on our successes and Nomangesi Jayiya Clinic is one of our successes. When other clinics can see what is being achieved then we will have more improvement at all our clinics because I can see the promise.

“With the Ritshidze monitoring we ask how are we going to solve these problems, and I don’t exclude myself for that because I am part of this community,” she says.

For Hennings, he still says that interventions like the home medication deliveries and pre-packed medicines are simply about keeping up with recommendations to keep stable patients out of clinic queues during a time of Covid.  But it gets done that’s the point, and he admits that sometimes he just gets into his car to do a few deliveries himself when they don’t have transport.

“What we do need is to be able to have our contract staff that came to us after the field hospitals closed to become permanent staff. I have a very good team now who all do their best, but in a year their contracts will finish, so we need them to be permanently employed,” he says.

Other things he said would help is to be able to have a shipping container onsite where they can do better on-site storage of medicines, which will help to manage stock levels. Better waste management at the clinic will also improve the running of the clinic, he says.

Hennings acknowledges that the relationship and trust between patients and the public healthcare system has worsened and become more tense over the years. He believes a step in the right direction will come with better communication.

“We have to ask why, not just to assume things. We have to be good at explaining to patients and we need to work to maintain a good relationship all the time,” says Hennings.

From patients he’d like them to set some of their frustration aside to understand that clinic staff are mostly working under very stressful circumstances and don’t always have the resources to help everyone as they want to.

“Sometimes patients don’t understand what the nurses are going through many things that they are not expressing. Especially in this time of COVID it has been very stressful coming to work with this big fear of the unknown. Many of my colleagues have good ethics and are really trying their best for every patient with what we’ve got,” he says.

His words are a reminder that they are a broader community – each dependent on the other. Going to work should be going to war and patients shouldn’t be the enemy and nor should clinic staff. The goal is the same: the more better functioning clinics there are, the better it is for everyone.

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“Ritshidze” — meaning “Saving Our Lives” in TshiVenda — has been developed by people living with HIV and activists to hold the South African government and aid agencies accountable to improve overall HIV and TB service delivery.

Partner organisations include the Treatment Action Campaign (TAC), the National Association of People Living with HIV (NAPWA), Positive Action Campaign, Positive Women’s Network (PWN) and the South African Network of Religious Leaders Living with and affected by HIV/AIDS (SANERELA+)—in alliance with Health Global Access Project (Health GAP), the Foundation for AIDS Research (amfAR), and Georgetown University’s O’Neill Institute for National and Global Health Law.

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