For the past three decades, the Phelophepa train has been a lifeline for South Africa’s remote communities, offering free medical services to those with limited access to healthcare. What started as a modest three-carriage train has grown into two 16-carriage trains, providing vital medical assistance to underserved areas across the country. These trains, known as “clinics on wheels,” bring healthcare professionals to areas where hospitals and clinics are overcrowded or simply too far away for many to reach.
Today, the Phelophepa train made a stop in Tembisa, a large township east of Johannesburg. Over the next two weeks, the train will provide essential medical services to hundreds of residents, many of whom have been waiting eagerly for its arrival. The train is staffed not only by healthcare workers but also by managers, translators, and security personnel to ensure smooth operations. Patients line up in the early morning to receive care, with some staying overnight due to the long distances they have traveled.
The Phelophepa train is operated by the Transnet Foundation, the social responsibility arm of Transnet, South Africa’s state-owned railway company. It was first launched in 1994, at a time when many black South Africans still lived in rural areas with little to no access to healthcare facilities. Initially functioning as an eye clinic, the train quickly expanded its services to address a range of healthcare needs, including dental care, general medicine, and psychological counseling.
Despite the train’s valuable contributions, public health experts, such as Alex van den Heever, caution that it is not a complete solution to South Africa’s healthcare challenges. Since the country’s first democratic government in 1994, there have been significant increases in the healthcare budget and in the employment of doctors and nurses in the public sector. However, many regions, particularly rural and impoverished areas, still face severe shortages of medical staff and resources, making the Phelophepa train’s services all the more critical.
For many South Africans, healthcare remains inaccessible. About 84% of the population relies on the public healthcare system, which is often underfunded and overstretched. In contrast, only 16% of South Africans can afford private health insurance, a stark reflection of the country’s broader inequalities. High unemployment rates, currently over 32%, make private healthcare unaffordable for the majority, increasing the reliance on public services like the Phelophepa train.
The train’s impact in provinces like Gauteng, home to both Pretoria and Johannesburg, is significant. The healthcare budget in Gauteng has grown from 6 billion rand ($336 million) in 2000 to 65 billion rand ($3.6 billion) today, but demand continues to outpace supply. For patients like Thabang, who has been suffering from poor eyesight, the arrival of the train offers a rare opportunity to receive free, quality medical care. “I’ve been struggling a lot with my eyesight,” he shared. “I heard the train was coming to help people, so I came. They see around 150 people a day and help us by the next day.” The Phelophepa train remains a beacon of hope in a healthcare system struggling to meet the needs of millions.
