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Ukwanda Centre for Rural Health
The Ukwanda Centre for Rural Health is one of the 24 Centres housed in Stellenbosch University’s Faculty of Medicine and Health Sciences. The Centre been has been highly active in the Overberg and Cape Winelands districts of the Western Cape for over a decade, where they have been providing a rural platform for research and the training of undergraduate medicine and health science students1.

Name
Ukwanda, is an isiXhosa word meaning ‘to grow’ and ‘develop’ within the community and to make a positive difference2. In keeping with its name, the Ukwanda Centre for Rural Health coordinates and supports training and research initiatives in rural and underserved communities.

History
The Ukwanda Centre for Rural Health was developed in 20013 and formally established in 2002 to train health care professions with applicable knowledge and hands on experience of health issues facing rural and underserved communities4. In 2011, Ukwanda expanded through the establishment of the Rural Clinical School 5.

Rural Clinical School
The Rural Clinical School offers undergraduate health science students a yearlong comprehensive rural placement opportunity at a regional hospital and other non-governmental organisations based in Worcester, a town in the Western Cape that is part of the Breede Valley Municipality and which is the regional hub of an important agricultural area. Students have access to an established community of people living with disability through organisations that includes Kaleidoscope: Innovation for the Blind and the National Institute for the Deaf both based in Worcester. In Worcester the academic activities are coordinated from the Stellenbosch University Worcester Campus located approximately 100 km away from the Tygerberg Campus, the base for most training in of the Faculty of Medicine and Health Sciences, linked to the tertiary-level Tygerberg hospital and urban community-based training in Tygerberg5. In the RCS offers yearlong placement at the district hospitals in Ceres, Hermanus, Swellendam and Caledon.

Academic Programs and Training Sites
The Rural Clinical School7program based in Worcester, offers a yearlong rural placement and short clinical rotations (2-8 weeks) in all 5 Stellenbosch University health professional undergraduate programmes, viz:


 * Medicine,
 * Human Nutrition
 * Physiotherapy,
 * Speech-Language and Hearing Therapy
 * Occupational Therapy.

In addition to training at the Worcester Regional Hospital, the Rural Clinical School provides training in other sites. The sites are:


 * Ceres
 * Robertson
 * Caledon
 * Hermanus
 * Swellendam
 * Upington

For a more detailed map of the 2018 the training sites click on the link below:

https://www.google.com/maps/d/u/0/viewer?mid=1V6xxjqfMJzsKdTj-Jgw6T-FUb7Q&ll=-32.21082444147582%2C23.51074219687507&z=7

Medical students who are selected for final yearlong rural placement have the opportunity to pick from one of two clinical training models. The first, is the traditional rotational model whereby students undertake clinical rotations through various speciality departments (internal medicine, psychiatry, obstetrics and gynaecology, paediatrics, surgery and orthopaedics) at the Worcester Regional Hospital, with some integration through weekly clinic or collaborative care sessions. The alternative option, is training through the longitudinal integrated model. Students who select this option spend the year in a district (generalist) hospital site and are placed under the mentorship of a family physician. This physician is, supported by specialists from the regional hospital who make regular visits; the ‘curriculum is what walks through the door, in other words it is determined by the patients seen in the district hospital.

Both Occupational Therapy and Human Nutrition divisions offer yearlong clinical training to final year undergraduate students in Worcester. These students are work in a multitude of settings such as the Worcester Provincial Hospital, Community Day Clinics, local NGO’s and NPO’s as well as privately run organisations and farming communities.

Health Science students (Occupational Therapy, Physiotherapy, Human Nutrition, Speech language and Hearing Therapy) either have  longitudinal placement at the Rural Clinical School or short clinical rotations at the Rural Clinical School/ one of the LIM sites. The short clinical rotations/ extended programmes under selected health science programme are as follow:


 * Occupational Therapy rotations
 * Therapy, Management, Psychosocial and School


 * Human Nutrition/ Dietetics rotation
 * Ukwanda-comprehensive rotation, Therapeutic Nutrition, Community Nutrition and Research


 * Speech Language and Hearing Therapy rotations


 * Community


 * Physiotherapy rotations
 * Community, Adult Neurology, Paediatrics

The uniqueness of the intimate training environment at the RCS has led to clinical interprofessional education, collaboration and practice. The Collaborative Care project, which consists of Academic Lunch sessions and Collaborative Home Visits allows for student engagement around practice, social determinants of health and patient management.

Teaching, learning and research at the Rural Clinical School is fostered through clinical training, interprofessional education and community engagement.

The Avian Park Service Learning Centre (APSLC) is the culmination of the aspirations of a number of stakeholders who wanted to respond to the community needs for access to basic healthcare while providing learning opportunities for students. Through a number of service-learning initiatives in Avian Park, a variety of health services have been developed in the community. Community Care Workers have become teachers, community developers and an integral part of the health service team. They enhance access to the residents, community projects and networking within the community. The APSLC improves the opportunities to integrate theoretical academic work with practical application, providing students with a unique opportunity to be involved in healthcare service design and development (as active participants, not observers) based on community-identified needs. University and community collaboration has been purposeful and aims to strengthen community engagement, while up-skilling residents and affording community-based education opportunities for future health professions.

Research
Ukwanda focuses on relevant rural research that will improve access and equity in healthcare while addressing the needs of the country’s rural and underserved communities. The research agenda for Ukwanda includes four priority areas which are 11,12:


 * Rural Health Professions Education
 * Collaborative Care
 * The First 1000 days of life
 * Clinical Research relevant to regional and district settings

Student housing
Ukwanda offers accommodation at the various locations, which is managed by the Stellenbosch University Logistics for the Clinical Training Platform (SUNLOC)13,14. SUNLOC provides a logistical support system to students, this includes accommodation and transport facilitation and information technology infrastructures such as electronic access to the Stellenbosch University Library, internet and intranet facilities and support for cooperation between the public health sector and academia at various levels, amongst other things14,15.

Each student residence of the Rural Clinical School incorporates a laundry room/services, kitchen and in some instances a common living room, braai facilities as well as on site information and communication technology.

Facilities and Services
The Rural Clinical School makes use of an academic building on the Worcester Campus, which houses five seminar rooms, a 120- seat auditorium, a function area, a modern telematics learning area, office space for academic and administrative staff as well as a library.

The library houses programme specific collections however, students in the various rural platforms have access to all the Stellenbosch University Library collections including those from other satellite libraries such as in the Faculty of Medicine and Health Sciences all of which are catalogued on a computerised database. Selected material is obtainable through service such as interlibrary loans.

Smaller learning centres are available at a number of the district hospital sites providing students and staff with the needed information and communications technology to access the e-resources and areas to work and study.