In rural Limpopo, patients with diabetes and HIV often travel long distances to see specialists, and late diagnoses frequently lead to preventable complications. A shortage of endocrinologists and limited clinical support for general practitioners leaves many communities underserved.
Dr Ntsako Sambo, a general practitioner from Waterval near Elim, recently completed a postgraduate diploma in diabetes at the University of South Wales in the UK. With more than 17 years of clinical experience and a prior postgraduate diploma in HIV management from the Colleges of Medicine of South Africa, Dr Sambo said the training equips him to provide specialist-level care at the primary healthcare level.
“This diploma brings renewed hope to families who rely on primary care doctors as their first and often only point of contact,” he said. “It enhances my ability to provide evidence-based, patient-centred care and improves clinical decision-making for better outcomes.”
His training allows him to integrate diabetes and HIV care for patients with complex needs. He shared an example of a patient living with HIV whose type 2 diabetes was uncontrolled despite multiple medications.
“Using my training, I transitioned the patient to an insulin regimen and monitored long-term control through HbA1c testing. Over several months, the patient’s blood sugar stabilised, symptoms improved, and adherence increased,” he said.
According to provincial health data, thousands in rural Limpopo rely solely on general practitioners for chronic disease management, often without specialist support. Dr Sambo highlighted ongoing challenges, including limited clinical guidance, financial barriers to training, and an increasing burden of chronic disease.
“Many rural GPs are expected to manage increasingly complex conditions without specialist support,” he said. “Tools like HbA1c allow us to make evidence-based decisions, but advanced training is essential to improve healthcare outcomes in rural communities.”