WEBVTT

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[sil.]

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Previously on Life…
Poverty means bad health.

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Bad health means poverty. One
point three billion people

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live on one dollar a day! You could get
everybody vaccinated with all of these

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new vaccines-no problem! Most of the
diseases we have in here can be cured.

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It is scandalous that curable diseases
could batter the lives of so many people.

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[music]

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[music]

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Kwazulu Natal, one of the poorest
provinces of South Africa.

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The government’s promise to provide
health care for everyone in rural areas

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like this is going to take time.

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The province only has one
doctor for approximately

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every four thousand people.
Most rural people don’t have

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access to primary health care. They
never have a chance to see dentists,

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opticians, or even community nurses.

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What attracted me about this train was that

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it was giving healthcare,
affordable healthcare, to the rural

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people of South Africa. I am
passionate about rural people.

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I am passionate because I know
that those are the people

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who need most, yet they are the
ones who have very little.

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And because they don’t complain,
they tend to be forgotten.

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[music]

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In many ways I feel my whole
training was centered

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to be used fully on this train. I think,

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how could I have been so lucky -
every bit of my learning was made

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for the Phelophepa! From, from birth
- I feel - it just went

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round and round until I finally came to
help the rural people of South Africa.

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[music]

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Good morning Phelophepa…

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The time is ten minutes past six on this

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beautiful Thursday morning. This is not a
bad dream but this is your wake up call.

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Phelophepa means \"Good, Clean Health.\"

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This train spends nine months each year
traveling to the most remote areas.

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Its role: to bring health care services to
places that the government’s new policy

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still hasn’t reached. You
see, patients call this train

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\"The Train of Hope,\" a magic train, a
train that is going to solve everything.

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And I think also when you’ve been wanting something
for years, when something like this happens,

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you think it’s going to solve all
your problems. It doesn’t. It can’t.

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Lillian went to England to specialize at
a time when there were no opportunities

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for black women to take advanced
training in South Africa.

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She opened the Neurosurgical unit at London’s Royal
Free Hospital and went on to do her master’s degree

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in counseling psychology.

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[non-English narration]

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We know you’ve got no money, we
know you’ve got no transport,

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and this is why we’re here,
to support and help you.

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But unfortunately we cannot see all of you.
We quite appreciate

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that for a long time you haven’t had
these facilities. But we also know

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that we cannot see you after 8 o’clock.

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Even in our imagination we never
expect the numbers who come.

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If I tell you the dentist’s clinic or health
clinic is full and you haven’t got a sticker

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by that time, apologies, you’ll have to
go home. Now remember, I am saying this

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to people who got up in the morning at
3 o’clock, 2 o’clock in the morning;

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walked for an hour, got a
taxi which took them maybe to

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another 25 five kilometers, walked another 5
kilometers, ran to the train. I see people running

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and falling, coming to the train.
And I think my god, don’t even run

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because it is already full.
All the clinics are full.

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The eye clinic is full,

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[non-English narration]

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Apologies.

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[non-English narration]

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[sil.]

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The best thing about working on the train

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is the challenge, meeting the
different patients and each community

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has its own dynamics. And
the community people

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are human beings who are unpredictable.
He lost his ticket,

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now he is crying because he lost his ticket,
he does not know where his ticket is

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and he’s coming for eyes.

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Okay. Okay. Okay.

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There are 13 permanent staff living on the
train but it is the final year students

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from hospitals and universities who
do most of the work and gain valuable

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practical experience in return.

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The students are indispensable on the train.
Those are the people who do the real work.

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But they gain so much from
the experiences, well both

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in life terms as well as
professional terms. And to see

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the way they change over
two weeks is just amazing.

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The disks look a little bit Glucometers,
so maybe that’s the reason. You know,

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they maybe Glucometers and that’s the reason for
the bad… And I think the students see the value

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of their chosen profession because it’s
very satisfying when somebody walks in

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being lead, or with a stick, and can…

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can walk out, out of the train with a broad smile
on their face for seeing for the first time

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for many, many years.

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Here we go. Right, here’s your bag. Okay.
Put your glasses in there. Okay.

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[sil.]

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[non-English narration]

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I don’t like children sleeping on the train like this. But they
also have got eye problems. They couldn’t see well in the morning.

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[non-English narration]

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My problem is always having to balance it. If I force
issues that the children are seen in the eye clinic,

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it means also that the eye
clinic uh…people have to work

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even longer than perhaps 8 o’clock. And it
also means one compromises professionalism.

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So one has to balance that.

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[music]

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[music]

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We basically are a primary

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health care train and we do
a lot of health education,

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preventative measures. But you
know it’s so difficult really.

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If you talk to a rural person about a normal
diet, what is a normal diet when they live

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on pap and vegetables, when there is no money,
when there’s no money for food? So sometimes

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it’s so frustrating talking about
what is normal. What is normal

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to me is definitely not normal
to the people we deal with.

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Excuse me. Well, we just finished

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a ten-hour shift and were filling
in our quotas for tomorrow

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and when there were 10 other patients that came from twenty
kilometers away, crying for treatment. They said they’d been here

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for three days and they weren’t helped because they
came too late. And I just felt that we… we said

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we could do it and would only work an extra hour. So I asked
the students if they were willing to just work an extra hour

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and they were willing to sacrifice. Are
you…are you… are you coming to work?

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Jolly good, that’s the spirit.

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I find it so amazing that they’re willing to wait so
long, and so patiently, none of them really complain.

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Some of them have been living with this pain
for so long and I just thought that we can,

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if we can help them, they said we can do.

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Rural people are poor and I think, for me,

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the worry, the concern, is the about

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the fact that we are faced with
people who are not just faced with

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not having things but even
the weather ravages them.

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There seems to be so much that
piles against them. And I think,

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my goodness, why do you deserve this?

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[music]

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[sil.]

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Morning, Phelophepa, wakey-wakey!

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I don’t know if you heard the birds at 5
o’clock, the birds were singing for you.

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And if you look outside the skies
are absolutely beautiful and blue.

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Is it because we are here to serve
the people of the rural areas.

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And even as I speak, it seems to me

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the wind has been silenced.

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As well as the train’s clinics,
there are visits to local schools.

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Here Sister Maggie

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and her students screen children
and teach basic healthcare.

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When I was first allocated to work in the rural
areas, I thought that it was a punishment.

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Because I felt that I had the expertise

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to work in the clinical situation.
So it was by chance, and then

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I loved it. So here is red, here there
is wax. So when you look at a child,

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you look to the general appearance of the
child, yeah? Because you may have to refer

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the child now for other things. Look, for
instance this one has got scalp sores,

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has got ringworm, yeah?
So you have to refer

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even for that, yeah? Because this child
was fortunate that he came to the clinic.

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[sil.]

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In rural areas it is difficult to explain
to patients, so really you must…

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you must get a feel for your patients.
Basically when the patients come in it’s like,

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greeting the patients, letting the patients know that you
are on their level. You know, you’re standing here behind

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this counter, yeah, and you’ve got this bar in
front of you and you need to bridge that gap.

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So basically when you greet your patient, get
the patient to smile, so the patient can

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umm… you know, also be in feeling with you.

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[non-English narration]

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We dispense medication

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and with a product like this you need to get
medicine also uh… at a very cheap price,

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but you need to have quality as well. And quality is really where
the pharmacist comes in. That’s our role basically on the train.

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[non-English narration]

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The reality is that, this train cannot
run if the patients don’t contribute.

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We ask them to think, do they want a train
like this to run at affordable prices,

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or do they then want it to stop?

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The train spends five days at each stop.

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On Saturdays it travels to the next.

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It’s a challenge because you become
involved with them, you bond with them

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and now when the train leaves
you feel that at the same time

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you haven’t done enough for them. The
sad look in their eyes, their gestures

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when the train moves showing you
that, \"I wanted to come for glasses

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but I didn’t have money.\" It’s
a challenge and then we always

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feel that we haven’t done enough for them.

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[sil.]

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I was visiting South Africa and then I heard about
this train from one of the executives at Transnet.

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I thought, my god what is going to
happen, I must work on that train.

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So I still then applied.

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[sil.]

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There has never been a woman who
is manager on a train for a start,

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whether black or white. So I had to be
taught as to how to do the hand signals,

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how to shunt the train, how to check the
diesel, how to check pressure on the train.

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[non-English narration]

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The train started in 1994, January. It really
was a nightmare, but a very nice nightmare.

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I didn’t really have to ask any
permission because the then government

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was busy preparing to leave and the new government
really wasn’t in place. That was the nice part.

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The not so nice part was
Lillian not being there.

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And then I met Lynette, and somehow

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this woman was not what I had thought an

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Afrikaner woman would be.
And we just hit it.

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The disadvantage I had growing up

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during the famous old South African system

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of Apartheid: I never had the opportunity
to know black people, never and Lillian

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is my first black friend. But she’s not
black; she’s Lillian. She’s my friend.

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I have got three children of
my own and two adopted ones.

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When this challenge came, I
discussed this with them

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and then they said to me, \"Mummy,
do you want to take the job?\"

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And then I said, \"Yeah, but I can’t take it, I’m
afraid of leaving you.\" And then they said,

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\"If you want the job, take it.\" I manage
to talk to them over the phone sometimes.

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Sometimes I have to scold them for doing

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nonsensical things at home when the eldest reports them.
I have to act on the phone and pretend as if I’m there.

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The interpreters are late,

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perhaps in another 10 minutes
I’ll bring them down.

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If we are lucky. I think I
get my strength from knowing

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why it’s so vital that
this train continues.

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This train must not stop and I also
know that I have got to be strong

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for the staff to be strong, for the students to
be strong, for the patients to also be strong.

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So somehow I have to
continuously keep this up.

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[non-English narration]

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I know that the communities
we visit, call this a train

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that gives them vision in various ways.
And so it does,

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but I also know that we’ve got our
limitations. The reality is that,

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the need in South Africa is enormous.

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It’s been a need for so many,
many years that whatever we put

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is only a drop in the ocean. But again my
belief is that an ocean is made out of drops.

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We are like a big family

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and you know in families you do get to
fight. And in a small space like this,

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you get to see the person that you fought with five seconds ago.
The whole day, you sit with them at breakfast, lunch and supper!

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So it gets to you. But you know we…
we are all professionals and I think

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the respect we have for each other is very nice because
we can work out things, we can talk about things.

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[music]

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It’s fun.

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It’s something I could do
when I’ve finished my course.

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One learns that actually we
are a multi-professional team

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and that we are not functioning as
individuals or as one profession

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on its own. So it’s nice seeing
that we actually need each other to

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interact and function in proper nursing
or proper health care for all patients.

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Well, our living conditions are
not exactly what one would want.

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I’ve always liked space, but if I can’t
have space, it doesn’t really matter.

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\"The three things I missed,\" I said, \"A
big bed, a bath and going the theatre.\"

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Lynette said, \"I can’t do anything about
your theatre, not much about the bed,

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but I can try something about the bath.\"
And I got my bath. And it’s written

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\"Only\" as you can see. And there are
no compromises here, this is my bath,

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and this is mine only. You are
free to photograph this one.

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After a hard day’s work, I come here,

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I soak, I think, I reflect, I feel better.

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[music]

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Good morning. I’m coming just now.
I expect you also

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to treat each patient
with dignity and respect.

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I don’t want you to shout at them because most of
the patients have been shouted all their lives

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and the last thing I want is for
you to be shouting at them.

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People from local communities receive
basic health training at each stop.

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Before the train leaves,
they get a certificate

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and a healthcare manual.

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This year Phelophepa staff
have seen over 100,000 people.

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[non-English narration]

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It was just that like your one lens is

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a bit thicker than the other. You’re a star! So I had a
bit of a problem. But as long as you can see with them.

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Now, what I’ll do, I’ll just… As long
as you can tell me if you’re married,

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I’ve got three sons who are looking
for a girl. You’re embarrassing me.

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Okay! Okay, thanks! When people are sick,

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the hospital is miles away from this place.

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The clinic, we have got no clinic here.
I think it came at the right time,

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when the people need it.

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Until South Africa’s dream of health
care for everyone comes true,

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Phelophepa will go on providing
services and hope for rural people.

00:23:25.000 --> 00:23:29.999
This train is about working together,

00:23:30.000 --> 00:23:34.999
but for me it is actually like a mini
South Africa, a new South Africa,

00:23:35.000 --> 00:23:39.999
where men and women come together to
give their best to build South Africa.

00:23:40.000 --> 00:23:44.999
Because I find to my disappointment

00:23:45.000 --> 00:23:49.999
and sometimes absolute anger, people say, \"Well,
why don’t they do this, why don’t they do this?\"

00:23:50.000 --> 00:23:54.999
Who is they? The majority of people in
South Africa must themselves do something,

00:23:55.000 --> 00:23:59.999
because they is me and
whoever is in South Africa.

00:24:00.000 --> 00:24:08.000
[music]