Africa-Press – Eswatini. The Luke Commission (TLC), which has become the go to health facility in the country, may be forced to turn patients back as there is a mismatch between patient needs and available funding.
Last year, the facility attended to 217 363 outpatient visits and for this year, projections are 274 578 outpatients’ visits.
For next year, it is projected that the visits will shoot up to 337 420.
This comes as the country’s health sector is faced with a drugs shortage crisis, which has seen patients having to purchase their own medication.
With the high costs of medication at pharmacies and also private hospitals, patients end up at TLC where they are treated free of charge by trained doctors and also get free medication. Patients travel long distances to TLC at significant personal cost to the patient.
An emotional TLC Executive Director, Echo VanderWal narrated the challenges being faced by the health institution during a breakfast meeting with the Eswatini Editors Forum yesterday.
VanderWal told the media that their main goal was not to turn any patient back once they reached their facility. They have committed for the last 18 years to treating each VIP (Very Important Patient) as their own father, mother, brother, sister or child.
She said since they arrived in Eswatini their policy was to provide healthcare to ‘every last one’, adding that they would not leave any community until every patient was seen no matter what time of the night. TLC continues to welcome increasing numbers of outpatients at both the Miracle Campus fixed site hospital and at mobile hospital outreaches,” she said.
Adding, she said between 2019 and 2022, the total number of outpatients’ increased by more than 50 per cent each year, requiring additional personnel, medical supplies and financial resources.
“TLC has never charged patients. The generosity of private donors, gift in kind donors, foundations organisations and government partners supply resources for TLC’s mission,” VanderWal stated.
She said with the number of patients needing care versus the available funding they currently receive, they are concerned about being able to sustain the current level of operations.
The executive director said they received some additional funding during COVID for vaccinations and for the oxygen plant. Donations have returned to pre-COVID levels while the numbers of patients seeking care has continued to rise.
In the wake of the outbreak of COVID-19 pandemic, TLC served as part of a national response receiving 90 per cent of severe and critical patients (over 1 700 patents).
Oxygen
The director further said in June 2021, TLC opened a 2 500 litres per minute on site oxygen plant to serve the need of patients and to supplement supply for other healthcare facilities.
The plant was the first of its kind in the country and the largest in Africa.
As a referral hospital, the Miracle Campus accepts referrals for services such as; COVID-19 care, critical care, cancer screening and treatment, complex snake bite management, complex HIV and TB care, casualty/ emergency, drug resistant TB, palliative care, vision care, surgical care, rehabilitation and other services.
She further disclosed that given the population size of Eswatini, the number of medical specialists available in-country would likely remain limited.
She said TLC maintains a growing cohort of medical specialists to advise on diagnosis and treatment via digital technology.
“Some specialists visit Eswatini, embedding with the team for a week or more to provide high-volume specialized care,” she stated.
The Luke Commission was founded with the purpose of serving the most isolated and underserved people of Eswatini with free comprehensive, compassionate healthcare.
It provides outpatient, inpatient, surgical, emergency, and critical care at the Miracle Campus situated in Sidvokodvo.
TLC also delivers outpatient care through more than 1,500 mobile hospital outreaches each year across Eswatini.
Harry and Echo VanderWal are the founders and Executive Directors of The Luke Commission, registered as a non-government organization in the country.
“Extending this level of care at this scale will require new levels of collaboration, diversification of funding, and a commitment to solutions,” VanderWal said.
Luvelo Digital Ecosystems ensure accountability
TLC Director, Echo VanderWal, every cent was accounted for at the institution as they use top class technology, named Luvelo.
Luvelo, according to VanderWal, is the best-in-class digital ecosystem and communication platforms with transparency, accountability, controls.
She said they were able to monitor their supply chain from procurement up to the moment the drugs were issued to patients.
At TLC whenever medication is issued to a patient there is a picture of that medication, which is taken and fed into the system for verification purposes.
“Every commodity received is tracked from procurement up to patient receiving every medication dispensed, there is a picture of it,” VanderWal stated.
She said the system was built in Eswatini and scaled for the world adding that it was developed over the last seven years and recently re-platformed to handle millions of simultaneous users.
The system realises the promise of interoperable platforms and also promotes organisational efficiencies for serving every patient at the highest possible level.
With the latest technology being developed by TLC in the health sector and being a trend setter, the Commission has disclosed that it does help other institutions who come to them for help from time to time. The executive director disclosed that they have assisted government in coming up with the COVID-19 vaccination certificates which people were able to receive through their cellphones.
300 patients serviced daily by Matsapha mobile clinic
The Luke Commission has disclosed that through its mobile clinics it services 300 patients daily in Matsapha.
These mobile clinics according to the director targets young adults, working age and those who work
TLC Director, Echo VanderWal, said they also have a public private partnership with Matsapha Town Council providing security, site, utilities, and vehicles. PEPFAR/USAID are also partners for this site.
The speciality care and surgical care centre at TLC also offers treatment for snake bite patients.
According to TLC in 2023, they cared for over 250 snake bite patients. The surgical service it was disclosed has 3 operating theatres. It was disclosed that there had been zero stock out of antivenom in the past seven years.
TLC partners with companies for health care
TLC has also embarked on an initiative where it has partnered with companies to provide comprehensive platform of 45 health services during working hours.
The Business Wellness Programme (BWP) outreach sites include both small and large businesses across the country including factories, construction sites and business premise.
The aim is to optimise prevention and early detection of disease since Emaswati usually present to facilities late in the disease process when it is hard to intervene.
The executive director disclosed that they have engaged in a partnership with Business Eswatini and Eswatini Business Health and Wellness.
TLC has also partnered with communities to provide comprehensive, integrated platform of 45 health services hosted in primary schools, churches, and community centres
They have forged partnership with community leadership and serve 400-500 people per site.
PATIENT FEED BACK
TLC has a patient feedback which ensures that each concern from a patient is attended.
Following each visit, the patient receives an SMS: “Did you receive quality service today?” and yes / no options in English or SiSwati depending on what the patient choses as language of choice. All “no” responses generate a task in TLC’s task management system for the patient to be called. Senior manager calls those who answered ”no,” addresses the challenge, and closes gaps in compassion to regain the trust of the patient.
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