“There’s really no such thing as the ‘voiceless’. There are only the deliberately silenced, or the preferably unheard.” Arundhati Roy, Author and human rights activist
The Voice Project is a project developed by RHAP in partnership with RuDASA, RuReSA, PACASA, MSF, the HIV Clinicians Society and SECTION27.
Despite reforms to the health care system post-1994, marked inequalities in health outcomes continue to exist between urban and rural areas of South Africa. Rural health services remain fraught with health system failures, from medicine and equipment shortages to understaffing, corruption and violations of patient rights. Health care workers (HCWs) are ideally placed to serve as agents of change within this system, however many lack the motivation, knowledge, confidence and/or skills to navigate and problem solve specific challenges within the health system.
To increase the capacity of HCPs to report and act on health system failures, RHAP has launched The Voice Project. The Project has five strategic objectives:
Objective 1: To advocate for the transformation of health professionals education including advocacy for the development of HCP change agents
Objective 2: To advocate for implementation of the National Department of Health Human Resources for Rural Health (HR4RH) strategy
Objective 3: To build advocacy competencies among in-service rural HCPs in collaboration with communities and civil society structures
Objective 4: Provide support to HCPs at risk of or who experience victimisation
Objective 5: To support the rural HCP associations in increasing their membership, networks & advocacy
The Voice Project provides education and support to existing and future HCPs (enrolled in Medical Schools and other schools within the Faculties of Health Sciences in South African Universities) to begin the process of growing a critical mass of confident, health rights-based thinking “HCP advocates” that are informed of their rights and those of their patients and that have the confidence and tools to defend these rights by using internal and external reporting tools and strategies.
Building an active citizenry role among rural HCPs, that extends their functional role of disease prevention, treatment and rehabilitation, is a critical piece of the puzzle in civil society’s efforts to promote, protect and realise the right to health. The Voice Project builds on various initiatives and partnerships with a wide range of organisations and networks – promoting long-term sustainability of the Project as well as many platforms for replication through train the trainer approaches and integration into the health science education curriculum.
A Voice Manual for in-service health care workers, who are based at the coalface, has been developed which informs several activities such as workshops, presentations, public debates and curriculum reform.
After a small pilot phase in 2014, where the initial concepts and training material were presented at a number of workshops and presentations and well received by the participants, phase one of the project is now being implemented on a small scale to document effectiveness. This includes the development of another manual, supporting the integration of advocacy competencies into the health sciences curriculum, which is informed by action research at UKZN and which will be piloted early 2016. Lessons learnt during this phase will be used to inform the second phase of the project – which is its full roll-out – that will start in October/November 2016 and continue until December 2018.