Life into Hillbrow
Hillbrow and you’re more likely to think of a deprived inner city area
characterised by poverty, crime and disadvantage. But the Hillbrow Health
Precinct (HHP) is changing the perception of Hillbrow…and the reality.
Breathing new life into the inner city, the HHP is an internationally
recognised focal point for innovation in research and training in the field of
health care and community development.
Firmly rooted in the community, the precinct is gradually reversing the decline
that has characterised Hillbrow in the last decade, with the restoration of
several important heritage buildings to renewed glory as centres of medical
excellence. A unique partnership between the City of Johannesburg, the Gauteng
Department of Health and the Wits Reproductive Health & HIV Institute, the
HHP is a visionary, world-first health precinct addressing HIV and related
diseases poverty and urban renewal in Johannesburg’s inner city.
Standing at the intersection of urban regeneration and community based health
care, and demonstrating the best use of modern technology in both spheres, the
Hillbrow Health Precinct is a beacon of inspiration in the urban development
landscape and a model of co-operation that is sure to see others follow in its
contains one of the finest collections of historic buildings in Johannesburg.
It includes buildings to the west of Hospital Street such as the South African
Institute for Medical Research building, designed by Herbert Baker and Frank
Fleming in 1913, said to be based on Christopher Wren’s designs in Greenwich,
London. Close by is the old Wits Medical School designed by A and W Reid and
Delbridge in 1920. These buildings represent the work of some of South Africa’s
most renowned architects, including Gordon Leith, Herbert Baker and Wilhelm
Pabst, attracting the attention of visitors from all over the world.
A Window on
Health Care Through the Years
The value of
the buildings lies not only in the historic style of their design but also in
what they can teach us about the development of health care and technology that
has made our present high-tech medicine possible. When the Johannesburg General
Hospital was at its peak, it represented cutting-edge medical care and was in
the same league as other well-known hospitals around the globe. The precinct
has an historical association with countless medical students, doctors and
nurses who learned their profession at this teaching hospital.
applies to the thousands of Johannesburg residents who received medical
treatment there over a period of nearly 100 years.
The site is a
dense conglomeration of buildings where the Hillbrow Community Health Centre
currently provides a fully functioning hospital service. WRHI has located its
head office in the renovated Hugh Solomon Building in Klein Street since 2006,
following renovations to the buildings which were done by the Johannesburg
Development Agency in 2004. Also within the precinct are several vital health
services that provide a focal point for community mobilisation.
The Community Care Centre provides
psychosocial care and support to individuals and families infected and affected
by HIV. Ward 21 is the world’s largest non-hospital antiretroviral treatment
site, serving over 4000 patients a month with life-saving antiretroviral
The most recent addition is the Shandukani Maternal and Child Health Centre.
Shandukani is a Venda word mean meaning ‘change’ or ‘asking for change’, and
the Shandukani project is a flagship public/private partnership that represents
support for community clinics, community health programmes and HIV awareness in
a truly integrated manner. The facility will become a centre of excellence for
maternal and child health, for the training of health care providers, community
workers and researchers, and will be a focal point for conducting world-class
research on a range of health-related topics of national and regional
relevance, including HIV; TB; maternal and child health; infectious diseases;
reproductive health; and social science.
The Shandukani project encapsulates the
objectives of the Hillbrow Health Precinct which aims to strengthen the
delivery of health and social services through the regeneration of disused and
deteriorated building stock, thereby increasing the asset value of Department
of Health properties.
The development of the precinct has been
designed to create an integrated, safe, secure and functional area that will:
- Be the preferred location for primary
- Consolidate the research base and
operational connections among stakeholders
- Enhance existing residential
- Create world-class education and training
An Urban Design Framework for the northern
portion of the precinct has been generated with the professional assistance of
the University of the Witwatersrand Campus Development and Planning Unit with a
plan for a fully integrated campus-like precinct. Future plans will see the
precinct developed and upgraded in order to facilitate improvements in health
service delivery and practice.
Wits University has identified five ‘urban
foyers’ where its academic and student offering can be delivered to the
community it serves. The Hillbrow Health Precinct has been selected to be one
of these foyers.
Health Precinct in Action – The Present
The Research & Training (R&T)
Centre is a specialist research site providing a purpose-built environment for
the conduct of clinical and other research trials. The site has the capacity to
recruit and retain hundreds of study participants on a monthly basis and
includes a research pharmacy and laboratory on the premises. The laboratory
boasts state-of-the-art equipment, backup generators to protect against power
outages, and also serves as a training facility for WRHI staff studying towards
The City of Johannesburg’s Esselen Street
Clinic handles tuberculosis, sexually transmitted infections, family planning
and HIV counselling and testing. The clinic, a partnership between the City and
Wits Reproductive Health & HIV
Institute, sees up to 350 people daily and plans to increase this to up to
1,000. WRHI also runs a number of special clinics for vulnerable and
marginalised groups such as sex workers and youth within the Esselen Street
3. Ward 21
Part of the Hillbrow Community Health
Centre, Ward 21, as it is known locally, is the largest non-hospital
antiretroviral therapy initiation site in the world, seeing over 4000 patients
every month. For many people, a visit to Ward 21 is the first step on the way
to a stronger and healthier life after being diagnosed with HIV. Once stable on
ART, patients are down-referred to a local clinic for ongoing treatment, care
4. WRHI Head
The Wits Reproductive Health & HIV
Institute has its headquarters in the Hillbrow Health Precinct. WRHI is one of
the largest programme implementation, research and training units of its kind
in sub-Saharan Africa, leading the way in the field of HIV, sexual &
reproductive health and related conditions. The work of the WRHI is driven by a
number of technical and research programmes:
Health Programmes support the South African public sector to
improve care and access to health services, in the context of the HIV epidemic,
with work conducted at national, provincial, district and sub-district levels.
Research Programmes aim to create an understanding of the social
and biological contexts and determinants of risk for sexual and reproductive health,
HIV and related conditions in order to identify interventions to prevent and
ameliorate morbidity, with the aim of positively influencing health policy and
Community Programmes work towards increased community engagement
in health and social care, research, advocacy, health promotion and health
literacy to ensure an enabling and supportive environment in which communities
Research Teaching Programmes have been developed within the
University of the Witwatersrand in support of Masters and PhD students, and in
partnership with international academic institutions from Africa and the
Training Department supports the Department of Health and other
key partners through training initiatives.
5. Lefelo la
Tlhokomelo Community Care Centre
The Lefelo la Tlhokomelo Community Care
Centre is a free walk-in service centre that caters for HIV-positive people and
their families and the broader community giving general support, counselling,
wellness support, information, advice and referral. The Centre is a partnership
involving a large number of NGOs and CBOs who work together to provide a wide
range of services to a deprived inner city community.
Centre for Maternal & Child Health
A public/private partnership between the
Gauteng Department of Health, Vodacom Foundation, Altech, Altron and WRHI, the
Shandukani Centre provides expert medical care to pregnant women and children
infected with HIV/AIDS and tuberculosis.
An investment of 28 million rand by the
private sector has resulted in the creation of a turnkey facility jointly
managed by the Gauteng Department of Health and WRHI.
Shandukani is a Venda word meaning ‘change’ and is an appropriate name for a
facility that represents multiple aspects of positive change: the value of
public/private partnerships; the transformation of a derelict building with
heritage status into a thoroughly modern facility that nonetheless preserves
its historical stature; and the positive impact on change we can all have.
Shandukani is a flagship public/private
partnership project that represents support for community clinics, community
health programmes and HIV/AIDS awareness in a truly integrated manner.
Community Health Centre
The Hillbrow Community Health Centre is a
provincial secondary-level health care facility providing 24-hour casualty
services and minor theatre, a polyclinic and outpatient services, psychology
and dental care.
Located within the HCHC, this provides
important services to support SAPS and victims of domestic and sexual abuse.
Potential – the Future
Together with the University of the
Witwatersrand’s Campus Development and Planning Department, an Urban Design
Precinct Plan dealing with the northern area has been generated. This will
ensure that coherent and integrated development takes place within the precinct
relating to movement, signage, safety, street furniture, landscaping and
way-finding. This work will be extended across the entire precinct to provide
development parameters for any new, refurbished and/or existing facilities.
- WRHI is seeking User Agreements with the
property owners to expand our footprint within the precinct and thus provide
further health and medical support to all beneficiaries. The activation of
currently derelict and mothballed heritage status buildings will help to
protect the asset value of the properties as well as enhance urban management
initiatives by populating the wider area.
- Residential buildings both within and
surrounding the precinct will be made available for regeneration once certain
legal obstacles are removed and will offer a much needed complementary activity
within the precinct.
- Once the correct mix of building use has
been established, there will be scope for a retail outlet in the form of a
coffee shop, much anticipated by staff working in the precinct.
- WRHI has joined the Ekhaya Neighbourhood
City Improvement District initiative, established by property owners to
organise and champion a well-managed neighbourhood environment adjacent to the
Hillbrow Health Precinct that encourages and sustains the economic and social
wellbeing of its residents, workers and visitors. Its aims are twofold: to
establish an investment node that will attract and protect the financial
investment of home-owners, larger property owners, small and large businesses
and financial institutions; and an investment node that will attract and
protect the social investment of private and public investors in the form of
schools, clinics, neighbourhood leisure facilities, parks, libraries and
religious organisations. Continued involvement with this innovative initiative
will lead to better urban management and service delivery outcomes, further
public environment upgrades and better recreation facilities; and it will
create a facilitative environment for further community outreach programmes.