Waiting for Phelophepa: A train with a soul so deep

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On that first day, there were just three refurbished railcars with a few dedicated souls on board. Their mission was to deliver primary eye care to the most remote rural villages. It was a dream of the optometry department of Rand Afrikaans University, brought to life with the help of $2.3 million from Transnet Ltd., South Africa?s biggest logistics company and manager of the national airline and railroad. The engineers, technical experts and health care professionals who had worked on its design and construction?all local South Africans?had named it ?Phelophepa,? (pronounced PAY-low-PEP-puh), meaning ?good, clean health? in the Sotho and Tswana languages.

The day was Jan. 10, 1994, and ?it? was the world?s first primary health care train, a lifesaving clinic on wheels in South Africa. Phelophepa?s project manager is Lillian Cingo, a neurosurgical nurse and counseling psychologist. ?Phelophepa is a lifeline to survival and to hope for a better future? for the people it reaches, she says.

Ten years old now, Phelophepa has 16 cars and weighs 600 tons. It has come a long way from its humble birth. There?s a modern communications network on board, an industrial kitchen, and a car that generates enough electricity to supply a small town for two weeks, not to mention the comfortable clinic offices and consulting rooms. For 36 weeks each year, the train covers more than 9,000 miles, dispensing an array of basic health-care services, counseling and training, free of charge and without government subsidy, to more than 180,000 men, women and children. Everyone awaits its arrival anxiously?villagers; social workers and doctors at shabby rural clinics and hospitals; even, sometimes, the proud village healers.

On board Phelophepa are 15 professional staff members and a support crew of graduate and post-graduate students from South African institutions. The students, specialists in optometry, nursing, dentistry, psychology, pharmaceutical and even tourism and hospitality studies, are a microcosm of South Africa?s religious and ethnic groups. Phelophepa offers them a rare and often life-changing experience of the stark reality of rural health. To date, more than 6,200 have returned as volunteers. Another 5,644 villagers have voluntarily completed the five-day ?Basic Health Education Program? in the Edu-Clinic on board.

There?s never enough money, but Phelophepa makes do. Transnet is providing about 65 percent of the funding for the current fiscal year, with the remaining 35 percent coming from corporate donations, individuals and fund-raising activities. South Africa?s national and provincial departments of health give support where they can, mostly in the form of human resources.

On Dec. 11, just shy of Phelophepa?s 10th birthday, 400 ?friends of the Phelophepa Healthcare Train? gathered at Capitale restaurant in New York City to celebrate Phelophepa and to raise funds for its operation. Among them were C. Payne Lucas, recently retired head of Africare, and Franz B. Humer, CEO of Switzerland?s Roche pharmaceutical company, Phelophepa?s principal and oldest foreign sponsor. James E. Copeland Jr., former CEO of Deloitte Touche Tohmatsu, and Deval L. Patrick, executive vice president, general counsel and secretary of the Coca-Cola Co., were honored for their dedication to Phelophepa. Phelophepa?s corporate friends came out en masse. Colgate-Palmolive Co., Ernst & Young, Time Warner, Citigroup, 3M Co.?they were all there. Colgate sponsors a dental clinic that occupies one and a half carriages. There are plans to add cars for oncology and diabetes care this year, diseases that sometimes get short shrift in South Africa with AIDS so prominent, Humer notes.

What attracts them all to Phelophepa, says Humer, is its innovative approach to health care and the fact that all support goes directly to Phelophepa, not to a third party who keeps a portion of it. ?Bringing together several groups such as business, government and local communities, enables us to more effectively address this particular health-care challenge, which might be too complex for any one group. The Health Care Train is a great example of how people with a pragmatic but creative mind can successfully address the challenge head-on,? he said at Capitale.

Savion Glover danced his heart out for Phelophepa that night?performing for nearly 40 minutes, backed by the Soweto Sound Machine. The Tony Award-winning tap dancer, who created Broadway hits like ?Bring in ?da Noise, Bring in ?da Funk,? performed an original piece, ?Keeping ?da Phelophepa Train on Track,? choreographed especially for the event.

More than one million lives have been touched by Phelophepa, the train with the soul so deep.