The rural challenge

Social and Health Challenges in Rural Areas

The original FOM Scholarship Scheme was founded in conjunction with the Mosvold Hospital in Ingwavuma, KwaZulu-Natal.
Mosvold Hospital is one of five district hospitals providing healthcare to over 550 000 indigent people in the Umkhanyakude district, situated in the northern KwaZulu-Natal province. The district is relatively remote, sharing borders with Mozambique and Swaziland, and battles with various social and health concerns. These include:


  • Minimal access to electricity or piped water
  • Scattered homesteads
  • High unemployment rate
  • Scarce job opportunities
  • Low income (subsistence farming supplemented by income from old age pensions, disability grants and wages from migrant labour)
  • Poor infrastructure (transport and communication)
  • Overcrowded schools and poor education standards
  • Illiteracy
  • High occurrence of malaria, TB, HIV/Aids and gastroenteritis
  • Malnutrition and poor hygiene
  • High birth-rate and high teenage pregnancy rate
  • Parasitic infections in children
  • Epidemic levels of sexually transmitted infections (38% of pregnant women present with seropositive HIV)


Over the years, qualified healthcare professionals from foreign countries have been recruited to work at the hospital, however, these individuals were only contracted for a short period of time. Innovative training programmes have also been established in an attempt to encourage South African health science graduates to work in the district, but city-dwelling students were not easily enticed to move to a rural location.

Hospitals in the district, therefore, struggled to attract and retain healthcare professionals, which compromised the quality of service provided.

In fact, after a situational analysis of the district completed by the Centre for Rural Health in 2006, it was seen that there was a 46% vacancy rate for professional nurses (1171 vacancies of 2546 establishment posts), a 41% vacancy rate for Medical Officers including community service officers (CSOs), and a 55% vacancy rate for Senior Medical Officers and higher.

Once we began looking at recruiting healthcare professionals from the region itself, we noticed that an alarmingly high rate of learners from the district didn’t even receive tertiary education training. This was attributed to the poor standard of education, a lack of suitable role models, and the high cost of tertiary education in South Africa (>R80 000/year).

These are the types of challenges faced by rural areas such as those in KwaZulu-Natal, and this is why the work we do at the Umthombo Youth Development Foundation is incredibly important.