Siyakhana Health Trust has deployed seven retired nurses to provide dedicated HIV testing and assistance with general primary care, in seven public sector clinics in Buffalo City.  An additional seven Siyakhana counsellors conduct pre and post HIV test counselling at the clinics.  Siyakhana project manager Dr Simeon Odugwu explains the rationale for this move.
Siyakhana was designed as a project to assist small and medium businesses to manage the impacts of HIV/AIDS on their employees and businesses.   However, it soon became clear that company-level initiatives HIV/AIDS would only be of limited success if they were not coupled with assisting government with much needed improvement of health care systems and services.
Research indicates that if people are able to access testing and treatment seamlessly, they are more likely to comply with treatment regimens which are critical for treatment success. This knowledge influenced Siyakhana to find funding to support the public sector to “scale up” HIV testing and improve the process of referral for treatment, care and support. An agreement was reached with provincial government for Siyakhana to support local clinics and to provide clinical mentorship and in-service training for nurses in HIV/AIDS care, support and treatment.
Siyakhana nurses and counsellors are located at the following clinics:  John Dube Clinic in Scenery Park, Berlin Clinic, Newlands Clinic, Needs Camp Clinic, Zwelitsha Zone 5 Clinic, Philani Clinic in Zone 1, Mdantsane and Zone 16 Clinic, Mdantsane.
Treating HIV and AIDS places a considerable burden on the already overstretched public health services, where seas of faces gather daily in a quest for treatment for a range of minor ailments through to chronic illness.
While theoretically most people know that taking an HIV test makes sense and many are becoming more aware of the favourable prognosis with timeous treatment, in the face of residual discrimination, stigma and denial, the psychological barriers to testing remain high.
Nurses are often so busy that they are compelled to request people seeking HIV tests to return on quieter days, but in many instances quieter days never arrive and so a slew of people are routinely sent away and may take weeks, sometimes months to return for testing. 
Siyakhana staff’s presence enables the clinics to routinely offer HIV testing to people accessing clinic services whether they do so for antenatal care or treatment for sexually transmitted diseases, tuberculosis or any other illnesses. All people taking HIV tests are offered beneficial pre and post test counselling. 
And on the days that there are fewer cautious knocks on the Siyakhana nurses’ doors the counsellor trawls the waiting room, and sometimes the streets outside the clinic gates, stating the range of good reasons for HIV testing. For the public there is no distinction between clinic and Siyakhana staff and so indirectly each clinic has acquired two more staff.
Testing rates at the clinics have steadily increased and clinic staff have more time at their disposal to treat their patients more thoroughly which has positive health outcomes and a positive impact on the patient’s experience at the clinic.
The ripples of this simple act of support are ever widening and give all of us at Siyakhana a sense of satisfaction.