Mseleni Hospital – KwaZulu Natal, Republic of S. Africa
This medical ministry began as a clinic service situated in a remote part of eastern South Africa. Today it serves 75,000 rural people through outpatient care, mobile clinics, inpatient pediatrics and adults, maternity, dentistry, physical therapy and surgery. The region suffers from some of the world’s highest concentration of HIV; 33 percent of individuals are infected.
Supervision is provided by Dr Victor Fredlund, recognized in 2003 as the Rural Doctor of the Year by the South African Medical Association. Students coming to Mseleni Hospital participate in the full range of hospital services, including surgery and obstetrics, as well as mobile clinics and community interventions against TB, malaria and HIV. Communication in English and an available guest house make this location convenient for international students.
Location & Community
Mseleni Hospital is situated in the town of KwaZuluNatal in far eastern part of South Africa. On a map of the country KwaZuluNatal can be found just south of Swaziland, near the Mozambique border. The rural area is home to 75,000 people. The weather is warm and rainy November to May, and cool and dry June to October.
Visitors usually fly into the city of Durban, South Africa, where a local tour guide will meet them and arrange transportation to Mseleni Hospital. Minibus taxis also make regular trips from the Durban airport to Mseleni Hospital.
For current information, please visit the South African Embassy website appropriate for your country. United States citizens can consult the South Africa Embassy in Washington, DC. American passport holders should obtain a visitor visa only, which is generally valid for 90 days.
Traveler’s Health & Safety
Malaria is common in South Africa, and travelers are usually recommended to begin taking malaria prophylaxis prior to arrival in South Africa. One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information.
Mseleni Hospital patients consist mostly of indigenous people groups, who suffer the physical consequences of poverty and lack of education. Malaria, HIV, schistosomiasis, intestinal parasites and childhood malnutrition are quite common. Mseleni Joint Disease, a local arthritis of unknown etiology, is also unique to the region. Bites from snakes are occasionally encountered, as are infrequent injuries by hippos and crocodiles living in nearby Lake Sibhaya.
South Africa has the largest number of people living with HIV/AIDS in the world. 1 in 4 South Africans are HIV positive. In KwaZulu Natal, the statistic has risen to a shocking 1 in 3, where half of HIV positive mothers’ babies are also infected.
English is the language of schools, government and the media, and is generally understood across the country. Translation is needed at times to communicate with non-English speaking patients, thought all staff at Mseleni Hospital speak English.
Medical Care Services
Mseleni Hospital is a 184-bed, full-service hospital that provides outpatient care, mobile clinics, inpatient pediatrics, inpatient adults, maternity, dentistry, physical therapy and surgery. These services are complemented by basic laboratory, microbiology, radiology, ultrasound and pharmacy services. In all, some 200,000 patient’s are cared for each year, including 6,000 hospital admissions, 1,700 baby deliveries, and 800 major surgeries. Common surgeries include inguinal hernia repair, hysterectomy, total hip replacement, skin graft, amputation, circumcision, Caesarean section and tubal ligation. Emergency surgical care is also provided, such as appendectomy, ectopic pregnancy and laparotomy for trauma.
Mseleni Hospital supports specific community interventions against TB, malaria and HIV. The hospital also promotes school health, community-based rehabilitation and more than 100 community health workers. Eight clinics in the surrounding area refer patients to Mseleni Hospital.
HIV Care Services
This government hospital serves the highest concentration of HIV in all of South Africa; 39 of every 100 people are infected, including 33 of every 100 pregnant women. Mseleni Hospital has 2,700 people in HIV treatment, and has witnessed the greatest decline in HIV deaths in the entire nation. They also provide special care to HIV orphans and to children with HIV.
Students are mentored in HIV care by Dr Victor Fredlund – recognized in 2003 as the Rural Doctor of the Year by the South African Medical Association. They participate in the full range of HIV intervention including community education, prevention of mother-to-child-transmission, drug therapy and orphan care.
Public Health Initiatives
Health leaders in this remote region of northeastern South Africa have established a number of public health programs in cooperation with clinical primary health care services. These involve tuberculosis control, school health, immunization, and child focus groups known as Phila Phaqa Phikinini. These groups promote survival and development of young children, and meet periodically to review childhood health data and community interventions.
INMED International Public Health students will participate in community education programs in cooperation with community health workers. They also will engage in caring for orphans and vulnerable children in connection with the outstanding Lulisandla Kumntwana Project. Mseleni community leaders complement public health training with opportunities in community development and job creation. The particular interests of students will be accommodated on an individual basis.
South African trained pharmacists play an essential role in the comprehensive clinical services provided by Mseleni Hospital, supporting inpatient care, outpatient services, and numerous rural clinics. HIV, tuberculosis and medication compliance are significant challenges in this community, and Mseleni Hospital pharmacists are frequently consulted and relied upon in this regard. Pharmaceutical standards of care for Mseleni Hospital are comparable with their European counterparts.
Pharmacy students participate in the full range of pharmaceutical services, including frequent consultation with professional colleagues in the fields of medicine and nursing. Students are invited to also participate in the very active clinical care provided at the hospital, as well as in the context of rural clinics, public health initiatives, and orphan care.
Healthcare Profession Staff
Mseleni Hospital has six physicians on staff. Dr Victor Fredlund is the medical superintendent, and has been with Mseleni Hospital since 1981. He was recognized in 2003 as the Rural Doctor of the Year by the South African Medical Association and the Rural Doctor Association of Southern Africa.
Students can anticipate being involved in all aspects of care, including inpatient rounds, outpatient clinic, and night call with an attending physician. Nights are generally quiet after about 7pm, but not always! Students who come for longer periods of time generally have the opportunity to take on greater responsibilities. In the operating theater, students scrub in and assist, or help with an anesthesia. Students are also encouraged to join the mobile clinic teams, and be involved with community health, school health, and special TB and AIDS care.
Student Lodging & Meals
Accommodation is provided at a nominal charge, and the guest room is fully equipped with cooker and fridge freezer. Food is available in the hospital cafeteria, or visitors may buy food to cook for themselves.
Students have their own postal box at Mseleni Hospital: P.O. Box 161, Sibhayi 3967, KwaZulu Natal, Republic of South Africa. Letters from the USA generally take 7-14 days. Email is available in the doctor’s office.
INMED invites all participants to consider raising extra funds to donate to support this facility. While such efforts are not required, they will provide opportunities INMED personnel to become involved in this important aspect of international healthcare.
The Mseleni Hospital complex has a tennis court and a squash court, and badminton and table tennis as well. A lovely beach along the Indian Ocean is just a 40-minute drive away. Game parks in the area are also a major international attraction.
Behavior & Dress
White coats are optional in hospital and at clinic work. Women are expected to wear skirts or dresses and men may wear business casual shorts. The same standard applies to attending church, though men should wear long trousers. At the beach, shorts are acceptable for women. It is not considered appropriate for women to wear trousers except around the house. Those coming in the summer, Nov to April, will not need warm clothing, but should bring an umbrella because heavy showers are frequent.
What to Pack
Visitors should bring copies of all healthcare profession licenses, diplomas, or certifications. It is also recommended to pack a carry-on bag that has essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather, and remember that in this environment clothes frequently become soiled.
Other items to bring include sunscreen, swim wear, stethoscope, camera with film, drivers license, flashlight, insect repellent, and mosquito net. Banks are not available in the rural area, therefore cash should be brought instead of traveler’s checks or debit cards.