Hugo Tempelman: An extraordinary legacy

Hugo Tempelman arrived in South Africa as a 30-year-old doctor in 1990, in search of opportunities to work in community healthcare.

He was studying towards a specialisation in what was referred to as tropical health at the time, requiring him to do work and research in a country with major gaps in healthcare access, among other factors for which South Africa clearly fit the bill at the time.

Unbeknownst to the general population, South Africa was about to be hit with a fourth and most deadly epidemic to face the country yet, following the bubonic plague, Spanish flu and polio.

The HIV outbreak, which was first reported in the late ’90s, killed hundreds of thousands of people before the government began the world’s largest antiretroviral (ARV) treatment drive, closely overlapped with the uncontrollable spread of tuberculosis.

Authors Coovadia, Jewkes and others write in a series of reports (August 2009, Lancet), the roots of a dysfunctional health
system and the collision of the epidemics of communicable and noncommunicable diseases in South Africa can be found in policies from periods of the country’s history, from colonial subjugation, apartheid dispossession, to the post-apartheid
period.

Though many of the negative effects of this have lingered long past the dawn of democracy, Tempelman has been part of the machinery that enabled positive change to slowly manifest through community-focused projects in rural Limpopo.

His work has impacted South Africa’s entire healthcare system, from policy to patient.

“My proudest moment was when we got funds from an individual Dutch donor to start an antiretroviral roll-out programme while the country was still debating if HIV and Aids were still related,” he says.

Frustrated by the inequality in the early 2000s, he began to hunt for donors to bring the lifesaving drugs to SA during a time those in power were debating whether HIV patients should be given access to ARVs.

This gave birth to the still active and relevant Treatment Action Campaign (TAC).

“ In the late ’90s we started to experience the devastating effects and we were standing with our backs to the wall as doctors,” Tempelman said.

“Back then you couldn’t diagnose HIV; there were no references.

“We presumed that you were HIV-positive and treated you as well as possible for as long as possible and made sure that you died as comfortably and as quickly as possible.”

During the worst of times, Tempelman would witness as many as four patients dying a day while waiting to be treated.

Today, his most prized accolade is the legacy of the Ndlovu Care Group – that birthed the Ndlovu Youth Choir – through which he has conducted community-based projects for nutrition, water access, early childhood development and healthcare.

The group was built on his philosophy on holistic community-oriented healthcare.

Over the past 10 years, he has increasingly devoted himself to research into HIV infection and rural healthcare.

He was visiting professor in education and healthcare in resource poor settings at the Utrecht University, in the Netherlands from 2007 to 2012.

He initiated the Ndlovu Research Consortium, a scientific collaboration between Utrecht University, University Medical Centre Utrecht and the University of Witwatersrand Reproductive Health Institute.

He is also involved in several international clinical trials in the field of HIV prevention and treatment.

“I don’t think I was made to spend the rest of my life in consultation rooms – it’s too small, although I do still love it,” he says.

“Real health is not provided in the healthcare sector. I have saved more children’s lives by providing 60 boreholes in the community than I ever could … as a doctor [handing out] anti-diarrhoea medication.

“Ndlovu has saved more lives by providing the knowledge of how to set up vegetable gardens on a plot than I could ever have provided, trying to avoid under-nourishment medically.”

If a country could not provide quality water, food security, education and healthcare to all of its citizens, there was no hope for a future generation and the battle for development in that country continues, he says.

The multi-winning community doctor feels he has little left to achieve, except to leave his legacy in capable hands.

“I have recently been attacked by Covid-19… That had something of an impact in the wiring of my brain. I want to speed up the security of my succession. I have seen how vulnerable and not how invincible I am.”

He wants the authenticity, the passion and the innovation of Ndlovu to remain, likewise sustainability when it comes to employment and opportunities provided by the group.

“Local is lekker and local makes it sustainable.”