The rural challenge

Social and Health Challenges in Rural Areas

The Friends of Mosvold Scholarship Scheme was founded in conjunction with the Mosvold Hospital in Ingwavuma, KwaZulu-Natal in 1999.
Mosvold Hospital is one of five district hospitals providing healthcare to over 550 000 indigent people in the Umkhanyakude district, situated in the north of KwaZulu-Natal. The district is relatively remote, sharing borders with Mozambique and Swaziland, and battles with various social and health issues. These include:


  • Minimal access to electricity or piped water
  • Scattered homesteads making service delivery difficult
  • High unemployment rate due to scarce job opportunities
  • Low income (subsistence farming supplemented by income from old age pensions, disability grants and wages from migrant labour are the main forms of income)
  • Poor infrastructure (transport and communication)
  • Overcrowded and under resourced  schools and poor education standards
  • High levels of illiteracy
  • High occurrence of malaria, TB, HIV/Aids and gastroenteritis in babies 
  • Malnutrition and poor hygiene due to poverty and poor infrastructure 
  • High birth-rate and high teenage pregnancy rate
  • Parasitic infections in children due to poor sanitation


Over the years, qualified healthcare professionals from foreign countries were recruited to work at the hospital, however, these were short term contracts and therefore unsustainable. Incentives exist to encourage South African health science graduates to work in rural areas, but city-dwelling graduates are not easily enticed to move to a rural location.

Hospitals in the district, and other rural areas for that matter, struggle to attract and retain healthcare professionals which compromises the quality of service provided. Based on the need for sufficient staff and international evidence of training local youth to be the healthcare workers needed in their community, resulted in the establishment of the FOM Scholarship Scheme. As more hospitals became involved in the initiative the name was changed in 2010 to the Umthombo Youth Development Foundation - Umthombo is an isiZulu word for a spring or well. 

Although the statistics are dated, a situational analysis of the district completed by the Centre for Rural Health in 2006, measured a 46% vacancy rate for professional nurses, a 41% vacancy rate for Medical Officers including Community Service Officers (CSOs), and a 55% vacancy rate for Senior Medical Officers and higher.

These are the types of challenges faced by rural areas and this is why the work we do at the Umthombo Youth Development Foundation is so incredibly important. Of our 592 graduates, over 90% of them have honoured their work-back obligations by working at their local hospital, and 65% have continued to work in rural areas over the long term - see a publication in this regard.