health

For the past 30 years, the Phelophepa train has been a lifeline across South Africa, offering free medical care to those in remote communities. What started as a single three-carriage train has expanded to two 16-carriage trains, serving patients who often struggle with overcrowded or distant local clinics. The train recently arrived in Tembisa, a township east of Johannesburg. Thabang, a local resident, shared his experience: “I’ve been suffering from my eyesight. I heard the train was coming to help people. They see around 150 people a day, and some of us stay overnight because we live far away.” The Phelophepa train provides a crucial service in a country where about 84% of people rely on an overstretched public health system. With only 16% of South Africans covered by health insurance, many face significant barriers to accessing care in a country with over 32% unemployment. In addition to healthcare professionals, the train is staffed by managers, translators, and security personnel. Operated by the Transnet Foundation, the social responsibility branch of Transnet, South Africa’s state-owned railway company, the train began in 1994. Originally focused on eye care, it quickly expanded its services to meet broader health needs. Now serving areas around Pretoria and Johannesburg, the train will spend two weeks in Tembisa. Despite its impact, the train is not a panacea for South Africa’s healthcare challenges. Public health expert Alex van den Heever notes that while there have been increases in the healthcare budget and staffing since 1994, the public health system still faces significant pressures. In Gauteng province, which includes Pretoria and Johannesburg, the health department’s budget has surged from 6 billion rand ($336 million) in 2000 to 65 billion rand ($3.6 billion) today. However, public health expert Alex van den Heever attributes the challenges facing the public sector to the African National Congress, the ruling party since the end of apartheid. For many South Africans who have witnessed the decline in healthcare services firsthand, the arrival of the Phelophepa health train offers a welcome reprieve. Thethiwe Mahlangu, who visited the clinic for an eye exam and pap smear, expressed her gratitude: “This train is truly helpful. I hope it doesn’t end here today. They should come back, even if it’s next year. There are so many of us who are really sick and in need.” Hundreds of residents walked away satisfied with the care they received, underscoring the train’s vital role in addressing health disparities.