Agincourt Health and Demographic Surveillance & Malaria Control Programme

By Charlyn Goliath

All excitedly the group departed to Agincourt and after traveling for a few kilometres we were stopped by the traffic cops. We received a “R3 000.00” ticket, payable at any traffic officer along the road. What an eventful start to the day!

Our arrival at the Agincourt
Health and Demographic Surveillance Unit

Agincourt Health and Demographic Surveillance System (HDSS) is a project of the MRC and Wits Rural Public Health and Transitions Unit within Agincourt. The need for the project was identified in 1992 when there was very little information available on the health status of rural populations. The HDSS is a longitudinal population registration system that monitors demographic dynamics in a geographically defined population. It is an integrated field and computing operation, designed to manage the longitudinal follow up of individuals, households and residential units and related demographic and health outcomes within the site.  

Ryan Wagner the project manager gave us an overview of the HDSS project. 

Ryan Wagner

Activities structure

Bush Buck Ridge study area map 

Demographics

Field trippers listening attentively

A Learning, Information dissemination and Networking with Communities (LINC) unit was started in 2004 to assist with maintaining community networks. Audrey, the manager of the LINC unit, gave an overview of the LINC programme.

We visited a site office of the HDSS to get a better understanding of what happens with the census forms once completed.

Afterwards the “public health cencus workers” took out their hats and hit the road with the data collectors to do a household cencus. This provided the group insight into the information that is being collected and processes that is followed.

Census awareness

En route to the census 2012 field office

The team learning about the census in the field office

Thembi from the Wits Rural Facility was like our
mother during the field trip

Community visit with the census field workers

Sorted out census forms

On the left are 4 census data capturers

Ryan showing us the filing room

We had a wonderful lunch prepared by locals from the community.

Agincourt AHPU:
http://www.agincourt.co.za/

After lunch we departed to learn more about the Malaria Control Programme of the Bushbuckridge Sub-district. Mr Alpheus Zita gave us an overview of the programme. There has been an increase in imported cases of malaria due to migration patterns in this sub-district. Tintswalo hospital, a district hospital in this region, was the highest reporting facility for 2011/12.

Spray operators from the local community are used for the vector control programme. Spraying is done once a year in dwellings and twice a year in lodges and game reserves. The environmental impact of DDT was highlighted during the presentation. Surveillance work is being done by case investigators and these case investigators visit health facilities to collect malaria notifications for reporting purposes and follow-up on patients in the communities.

The presentation was followed by a demonstration of the spraying. Muthei has decided to give up her day job and become a spray operator.

Malaria control programme office.
Please note the water container in the background

Contrary to what it looks like (a bomb) this is the life saving pressurized container
that is used for residual spraying 

Sikhumbuzo operating the residual spraying container
Muthei supervising

Spray demonstration

Malaria fairy Dombo...

Kruger National Park

Up with the birds and left the camp just before 6.  Our guest, Steve from Rhodes university, was ready with a backpack and water bottle.  At Kruger National Park Orpen gate we paid and within 5 minutes from the gate we saw three lazy lions sleeping unaware of the tourist commotion while digesting their last meal.  We were speculating wether this was in fact 'natural' and about chances that they were tranquilized and placed there to satisfy the camera burdened Chinese tourists.  

Before 11:00 we saw and array of wildlife ranging from impala, wildebeest and kudu to rhino and elepant.  In between many fascinating birds were identified ranging from malachite, pied and giant kingfisher to different types of vultures harassing eachother to get the tastiest parts of a rotting carcass.   

For lunch we had to fend off a semi tame and vervet monkey trying to steal our food before we enjoyed our sandwiches.  On the way out we enjoyed tea and coffee at Skukuza rest camp.  At the gate of the Wits Rural Facility we met up with Charlyn Goliath who joined us from Stellenbosch University, Robin Dyers who went back to Cape Town for the weekend and Alicia Aziz a student from the US planning to do some health systems and history research in the area.  Our braai plans failed because of rain…

South African National Parks - Kruger:
http://www.sanparks.org/parks/kruger/

2012 Public Health Field Trip Background

Yesterday happened at a tremendous pace!  5 different flights, missed flights, airport transfers but eventually 6 Capetonians, a Mpumalangan a Congolese, a Cameroonian, a Brit, a Ghanaian made it to from their origins in Cape Town to Sunnyside Park Hotel in Johannesburg in a tired but excited state.

Senior lecturers, occupational health registrars and public health registrars are all looking forward to the long awaited public health field trip that was organized by Dr. Neil Cameron.  In the next two weeks we will visit and learn at the:
NIOH (http://www.nioh.ac.za/),
SASOL in Secunda where we will visit their facilities as well as a coal mine (http://www.sasol.com/sasol_internet/frontend/navigation.jsp?navid=1&rootid=1)
NICD (http://www.nicd.ac.za/)
WITS School of Public Health (http://www.wits.ac.za/publichealth/10374/publichealth.html)
WITS Rural Health Facility (http://www.wits.ac.za/wrf)

More information on the party:

Dr Neil Cameron:  Officially retired public health specialist but still very much involved in organizing field trips utilizing his experience, wealth of knowledge and a career of contacts.

Dr Fidele Mukinda:  Senior Lecturer in Health Systems and Services Research - Stellenbosch University

Dr Julius Ayuk:  Registrar in Occupational Medicine - Stellenbosch University
Dr Mutheiwana Dombo:  Registrar in Public Health - University of Cape Town
Dr Gina Bernhardt:  Registrar in Public Health - University of Cape Town
Dr Ziyaad Essop:  Registrar in Occupational Medicine - Stellenbosch University
Dr Rosamund Southgate: Registrar in Public Health - NHS, UK
Dr Sikhumbuzo Mabunda:  Registrar in Public Health - University of Cape Town
Dr Vivian Apiah-Baden:  Registrar in Public Health - University of Cape Town
Dr Robin Dyers:  Registrar in Public Health - Stellenbosch University
Dr Bart Willems: Registrar in Public Health - Stellenbosch University
Me Charlyn Goliath:  Occupational Therapist, Health Systems Research - Stellenbosch University
Me Alysha Aziz:  Public Health USA - Bay Area, San Francisco

Thank you to Medical Education Partnership Initiative (MEPI) and Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI) for funding us to go on the fieldtrip.

http://www.mepinetwork.org/

http://surmepi.sun.ac.za/ (website under construction)