SHAWCO, established in 1943, recently embarked on this first-time journey to give back to less fortunate communities around the Western Cape through skills development, health service provision and education programmes.    
 
“It was a trip filled with long hours, high patient numbers, long bus rides and nights spent in tents culminating in a life-changing, empowering journey.”  This describes the experience of one student who participated in SHAWCO Health’s 750 kilometres for the Students Health and Welfare Centres Organisation (SHAWCO), in celebration of its 75th birthday in 2018.
 
Based on the Faculty’s campus, SHAWCO is a student-led service working in resource-poor communities of Cape Town and the Eastern Cape. It was initially established in 1943 by UCT’s Andrew Kinnear and Dr Golda Selzer out of concern for the Windermere community’s lack of access to healthcare.
 
Fast-forward to 2018, and SHAWCO has grown beyond expectation, with  well over 2000 students from multiple sectors involved in providing community services across the two provinces. According to its website, there are a range of programmes such as SHAWCO Education, which provides academic support and homework assistance to 1 300 learners weekly. The SHAWCO Health programme delivers primary healthcare to 5 000 adults and children (annually) close to their homes, with fully equipped mobile clinics.
 
“One aspect that has not changed over the past 75 years,” says Peace Francis, responsible for the marketing portfolio in SHAWCO Health, “is SHAWCO’s passion for the community.”
 
It is no surprise then that community engagement emerged at the forefront of their plans to celebrate and commemorate SHAWCO’s 75th birthday.  
 
The idea for the 750 kilometres for SHAWCO campaign came from Liam Devenish, SHAWCO Health’s Head of Clinics for 2018. The plan was to travel 750 km to Western Cape rural towns that SHAWCO Health had not been to before, over a period of 4 days that spanned a weekend.
 
“We wanted to broaden SHAWCO Health’s horizons, engage with and - most importantly - make a sustainable change in communities within the Western Cape through developing students and investigating health issues,” says Devenish.  
 
The students visited Clanwilliam, Swellendam, Zoar and Slanghoek, areas with an extreme need for health services.
 
Months of careful planning was done with a new partner; the Trust for Community Outreach and Education (TCOE), which organises and facilitates multiple programmes focused on community empowerment, outreach and entrepreneurship in communities of the Western Cape.  
 
A fundraising campaign mobilised awareness and support from the UCT community. It’s “1km = 1 patient” was aimed at sponsoring 1km for R150 – the equivalent cost of one patient’s complete healthcare package (screening, health promotion, consultation with a doctor, any medical or rehabilitation procedures or assessments, medication and referral should it be required).

 Prior to setting off on the 3rd of May, the group of students were given messages of support from SHAWCO’s Director, Gavin Joachims, Chairperson of the Board of SHAWCO, Prof. Crain Soudien, Director of TCOE, Lungisa Huna, and Mr James Irlam, of the Primary Health Care Directorate at UCT. Amid cheering from fellow students and staff, 60 Health Sciences students (MBChB and Occupational Therapy), volunteer doctors, a dispensing nurse, and a dentist set off from campus on their four-day trip.  
 
The group hosted three focused clinics a day – family health, women’s health and paediatric, with a big emphasis on health promotion, health education and screening. As part of the preparation for the trip, student volunteers had attended training sessions by senior staff members and clinicians on various skills including implanon insertion, pap smears, intramuscular injections, paediatric approaches, and health education methods.  
 
“This was to ensure that all the students were prepared and equipped with a full understanding of what the work would entail and the reasons for this,” says Francis. The students were divided into 4 groups to ensure that they would all get an opportunity to run each of the clinics, including facilitating the health promotion and screening stations under the mentorship of senior students.  
 
The students report that the following four days were filled with hard work, lots of travelling, learning platforms and community engagement opportunities. Each day presented opportunities for development and growth. Each town had its own feel and its own challenges - ranging from site challenges, patient-flow problems to the extent of the communities’ lack of access to appropriate health care.  
 
“It was incredible to watch students problem-solve and adapt in various situations while retaining the SHAWCO spirit of community engagement and patient-centredness,” recalls Francis. Nearly overwhelmed by patient attendance at their first sites, students had to learn the valuable skill of clinical administration.  
 
The experience also brought many firsts for SHAWCO Health - the range of services offered; the number of patients seen; the emphasis on universal screening and health promotion; and the focus on long-term student mentorship.
 
A highlight for Francis was seeing how every group had an opportunity to take on administrative roles to ensure smooth running of the clinics; watching students from various programme years collaborate efficiently and even across programme lines to truly create a multi-disciplinary environment and having the space to encounter, engage with and assist patients with stories and lived experiences very different to the students’ own and those they’ve encountered before.
 
And in keeping with their aim of sustainability of healthcare, the students hosted Community Health Liaison training with almost 20 selected individuals from two communities.  
 
“We provided a comprehensive, SHAWCO-designed resource to allow them to stand in the breach and help their communities to have access to the care they require in the absence of other health structures,” says Devenish.