The History of Ndlovu Care Group

Six days after the first free elections in 1994, Liesje and Hugo Tempelman took the big step to start the construction of the Ndlovu Medical Centre in the middle of Elandsdoorn, a township in Moutse.

Moutse is a region in the Sekhukhune District of the Limpopo Province, comprising approximately 27 villages with a total population of between 120 000 – 130 000. Residing under the Bantwana Tribal Authority, most inhabitants are Northern-Sotho speaking. Medical infrastructure was minimal: two poorly equipped public health care clinics managed by brave professional nurses, and not a single medical doctor working in the area.

It was the start of a long and exciting journey that would lead to the development and implementation of an integrated, holistic model of community development.

In 1990, as a newly graduated doctor, Hugo Tempelman travelled to South Africa with his wife Liesje, to start working at Philadelphia Hospital in the former homeland of KwaNdebele. Starting out as a medical doctor, Tempelman later became Assistant Superintendent and then Director of Para-Medical Services at the administrative offices of the homeland’s Department of Health. 

Their affection for this country – its beautiful nature, its warm people and its many challenges – grew day by day, and in 1993, they decided to stay on after their initial contract had ended. They were confronted with many hurdles before this decision was finalised,  but early one morning, after performing an emergency Caesarean Section, Dr Tempelman walked home, woke up his wife and asked her to step outside. Sleepy and surprised she followed him, and standing in the garden looking at a beautiful sunrise, he asked her: “Where in the Netherlands do you see such a beautiful sunrise? “Nowhere” was her response. “Then we stay…..”, and it was never discussed again. 

Many times during the thirty years that followed they would get up very early in the morning to see the sun rise and have their energy levels refuelled…

After a preparation period of approximately half a year, a business plan was developed, negotiations with the local community authorities were completed, a second bond on the Tempelman home was raised, and 60 000 bricks were ordered. Thus, on 4 May 1994, Dr Tempelman stood on an empty plot of land in the middle of the Elandsdoorn Township, with a bakkie and construction plans in his hands. He was waiting for the builder Fanny Mahlangu, to assist him in the construction of Ndlovu Medical Centre. Fanny did not show up.

Not surprised or fazed by this, Tempelman saw a young man walking by. He whistled and asked him:  “Do you have a job?” to which the man responded “No”. Tempelman asked: “Can you dig?” and the answer was “Yes”. “Then you have a job!” And that was the start of the long journey.

Half way through construction, a young lady stood in the doorway and asked: “Are you the doctor of this clinic?” Tempelman confirmed this and she informed him: “Do you know that I will work here?” And she did! Johanna Matenji would go on to work at Ndlovu for 28 years: first as a cleaner, later a translator and then as head of the pharmacy. She ended her working career in September 2023 as Maintenance Manager for the entire Ndlovu Care Group!

While constructing Tempelman was confronted with many cultural issues, very different from how had been raised in the Netherlands. Many things were also the same……….. Employees take chances and do not always adhere to the tea and lunch times. Tempelman was fed up with the constant late coming and told the construction people so. “Anyone not adhering to the tea-and-lunch times will not be employed anymore, you lose your job instantly” was his final answer. Three days later Amos did not show up after lunch. Tempelman was disappointed as he was a good worker, but decided to be nevertheless firm otherwise his authority would truly be undermined.

Half an hour later Amos showed up with a man tied with his arms at the back and on a leash. Everybody stopped working and wanted to hear the story. Amos told Tempelman that when he came home for lunch he found this burglar robbing his house. They fought and finally Amos tied him up, realising he would be late for work.

He decided to take the evidence with him to convince Tempelman not to fire him.

Everybody laughed, but a few of the other employees said that their houses had also been robbed while at work. They wanted to visit his house and go and check.

The man was loaded in the back of a bakkie and they drove off with him. An hour later they came back with twelve televisions, seven radio sets, chairs, cutlery and a variety of other stolen items. According to Tempelman much more than stolen from his workers but everything was taken out of his house. The workers were “very sure that it definitely was not his”.

Tempelman smiled and told the workers to drop him at the police station and make a case. They all looked very surprised and requested Tempelman to go and work at the other side of the construction site. African Justice took place and the man was given an enormous hiding. Thereafter he was released and everybody seemed satisfied.

Three or four days later the burglar walked past the clinic construction site. He yelled to Tempelman from the other side of the street, “He Doc, do you have work for me?”

Tempelman laughed and referred him to Fannie, the foreman, saying laughingly “He hires and fires………..”

Ten minutes later Tempelman, to his big surprise, saw the man walking behind a wheelbarrow pushing bricks around. He looked at Fannie with a questioning look…………Fannie answered him very relaxed.” He underwent his punishment, we retrieved all stolen goods from him and if he works here I can keep him under control……….”

Tempelman’s mouth fell open and stared at him in disbelief. 

Respect was the only thing he could think of…………..

Another anecdote to be told from the construction period is the payment of wages. 

Every two-weeks the construction employees got their wages on the Friday afternoon and often they disappeared directly into the shebeen. They came out pissed like a doornail, had many “friends” and at the time of coming home there was nothing anymore in their pockets.

The wives of one of the labourers came to complain and Tempelman understood the problem but did not know what to say. He was their employer not their father, but it did not leave him without thinking about it.

The next payday Friday he called everybody together and proposed to do it differently from then on.

“At 13.00 construction will stop, all of you will start cleaning and counting the tools (tools have feet, did you know that…?) and put them in the garage. Four of you, under the guidance of Fannie, will start a braai and we will evaluate the last two weeks and the plans for the next two weeks will be discussed”, he said.

They all agreed and then Tempelman went on: “and by the way, while we braai I will provide everybody with two beers and then the week is at its end. Those who do not go home and bring their wives part of the wages but go straight to the shebeen, are not welcome  on Monday anymore.” They looked at him in astonishment but all understood.

In the time thereafter Tempelman only fired one of the employees, the message had been clear. Needless to say that the wives of the workers were very pleased with this rule………….

The time of constructing Ndlovu Medical Centre was full of stories like this, funny, shocking, sad, tiring, confronting but especially learning. Learning and adapting before becoming ‘the doctor’……………..

And so it was, on 24 September 1994, that a proud young Tempelman family opened the doors of the clinic to the public. Two patients were treated. The next day, an old, bent ‘gogo’ walked with difficulty into the clinic, looked around in awe, and asked: “Is this also for black people?” This confirmed the value of starting a clinic in this very disadvantaged area: a quality healthcare centre at community level. Not a ‘taxi-rank practice’, but a proper dignified medical centre in the middle of the township, providing comprehensive primary health care, and attended daily by a doctor. In the beginning Liesje ran the pharmacy, purchased all medical supplies, managed accounts and executed general administrative tasks. Hugo was the doctor, running the operational side of the clinic.

The clinic grew rapidly, exploded after a year with an average of 60-70 patients a day, and in some cases, attendance of over a 100. It was definitely time to look for a second doctor! Dr Harry Maarsingh, a Dutch doctor with whom Tempelman had worked at the Department of Health in KwaNdebele, joined to strengthen the team. During this period, Tempelman started to engage more and more with the employees and the community. The employees became his informers – educating him in community dynamics and the cultural differences between Tempelman, as a foreigner, and the local community. There was so much to learn!

Working in this environment, Tempelman realised that many of the medical problems were related to the poverty profile of the area and general lack of infrastructure. The number of mothers with young children attending the clinic with coughs, skin problems, ear, nose and throat issues, and diarrhoea was staggering. The symptoms they presented with were all signs of underlying malnutrition, poor hygiene and lack of appropriate knowledge on how to raise children. Hence, the idea of the first Ndlovu Nutritional Unit (NNU) was born: not a feeding centre, but a centre of education for young mothers and caregivers on ‘how to raise a child’. The first unit was built in 1996, on the same plot next to the clinic. Still standing, the building has subsequently been refurbished to serve as a school room for the youth of the Ndlovu Youth Choir. The idea of the Nutritional Unit came to the attention of the Nelson Mandela Children’s Fund in the Netherlands, and was viewed as an excellent model of integrated community development, addressing food security, education and malnourishment as central issues. The support from the Nelson Mandela Children’s Fund, Netherlands, now called Stichting Kinderfonds MAMAS, spans over 28 years. No longer has a donor-NGO relationship, this longstanding partnership developed to a point where the two organisations consult and assist each other in strengthening other NGOs providing childcare in South Africa. A good example is the food garden project, a component of the Nutritional Unit. MAMAS Kinderfonds has adopted this approach and now supports over 50 child care projects across South Africa. 

The NNU was the initiator of the Water Program. To ensure daily food security, the NNU promoted household or community gardening. The challenge – no gardening without access to water, and piped water was not available in the households. Time to do something about this! The first water program was established in the community of Leseshleng where one of the beneficiaries of the NNU lived. The grandmother of the child had to walk six kilometres each way to collect clean water for the household, so clearly, water for a garden was not an option. A Dutch volunteer donated the funds for the first water borehole, enabling the whole community to start household vegetable gardens.

This success story spread like wildfire and requests for water from every community ‘poured’ in. The leadership of Ndlovu Care Group established an application process, with rules and regulations. Formal proposals were required from the communities, with the signatures of the community members. A further requirement was the establishment of a Water Board, to discuss issues around the water program and to provide security for the borehole and its pump. Over the years, the Ndlovu Care Group has developed more than 80 water programs, completely changing the Moutse Valley. This did not only change the environment but also the image of the Ndlovu Care Group. The organisation became the community’s trusted development partner.

But not everything was easy or without danger. South Africa was only a few years into its Rainbow Nation Period and crime was high, especially in the rural areas. On 8 December 1996, five men entered the clinic at the end of the day and pretended to be patients. When it was their turn to enter the consultation room, one of them pulled out a gun and put it against Dr Tempelman’s forehead. Instructing everyone, employees and patients, to ‘lie down and shut up’, he demanded the cash revenue of the day. Using his cool head and quick brain, Tempelman told the man to kick in the last door as Dr Maarsingh was consulting there. When this happened, Tempelman realised that this was just a robbery, and if you give what they ask, they eventually will leave. 

Tempelman was thrown on the ground and told not to look up. The leader entered the pharmacy and told all employees that they would not be harmed as long as all the cash was given. The till was emptied but it was a disappointing amount, which angered the man. He stood on Tempelman’s back, pulled his head towards him, and pointing the gun at his eye, nose and ear, told him to hand over everything otherwise he would ‘get a new hole’ in his head. Tempelman responded that that was all there was and that the robber should come back to learn something about the human anatomy. “Wherever you have pointed the gun, there is already a hole,” Tempelman said. Pointing his finger at the top of his head, against his cheek and below his mouth, he added. “These are places where you can make a new hole.” The young man laughed and said, “You are a funny guy, I will let you live”.  He kicked Tempelman in his belly and demanded the keys to the Toyota Hilux and disappeared.

The next day the clinic opened and it was business as usual. This astounded the community and they flocked to the clinic to apologise, pray or offer assistance. This was indeed done and all the robbers were finally apprehended and charged. They were professional criminals with many robberies to their name. It was an experience that had a major impact on all the employees and not the least on Tempelman himself. It took him years to get back his basic trust in people. Until today he does not understand why he chose to use an anatomical lesson as his response to the criminal…………

From day one, Tempelman realised that he was unable to provide affordable comprehensive medical care. The number of patients with possible tuberculosis attending the medical centre was overwhelming. Lack of tools to properly diagnose and/or treat the patients created great frustration. Attempts to reach out to the Department of Health for help, other than referring possible cases to the public hospital, remained fruitless. There was no cooperation or joint venture at any level between the public and private health care sectors.

Fortunately Tempelman had established a trusting relationship with many of the managers and officials at the Department of Health. This allowed him to approach Dr Gulam Karim, Head of Department at the Mpumalanga Department of Health, the province under which Moutse was administered at the time. He was enthusiastic about outsourcing medical services to willing and cooperative private practitioners and a MOU was entered into between the two parties, resulting in the Ndlovu Tuberculosis Program being initiated in 1997. The challenge of diagnostics, especially the lack of an X-ray Department, was solved through a visit to Ndlovu by a wealthy member of Liesje’s family. She was emotionally touched by our dedication and immediately wrote a cheque. This provided for an expansion of the clinic, including an X-ray instrument. What joy!

Another medical challenge was the safe deliveries of newborns and maternity care. There was a total absence of proper ante-natal care and maternity services in the community of Moutse, and home deliveries were common practice. The complications, which were often brought to Ndlovu Medical Centre, included postnatal bleedings, retained septic placentas, as well as other specific problems experienced by the neonates. This led to a fundraising drive to start a maternity clinic. Herman van Veen, a Dutch artist, came to our rescue by making a significant financial contribution. With additional support from the Royal Dutch Embassy through their Development Aid budget, the Colombine Maternity Clinic was constructed in 1999. This served the community for many years, with approximately 500-600 mothers each year choosing to have a safe delivery here. The name Colombine originates from a cartoon figure of Herman van Veen, whom we honoured for his contribution to the work of the Ndlovu Care Group.

As the charitable work of Ndlovu became more prominent and the contributions by donors began to make a significant impact, it was time to formalise the administration and governance of all these efforts. Up until this time, the Tempelmans had initiated, managed and led all interventions. The community development programs became as important as the medical centre and the need to formalise operations in a structured entity was clear. And so the Ndlovu Medical Trust was established, serving the community of Moutse and surrounding areas.

Through the combined work of providing affordable, quality health care and the community development programs, especially the water program, the relationship of trust with the community grew organically. Ndlovu Medical Centre and all its workers were protected and cared for. But Tempelman became also culturally more involved. He spoke to Sangomas’ about child diarrhoea and how important the vaccination program is. He showed them respect and if they accompanied a patient to the clinic, he treated them with collegial dignity. If an X-Ray was taken he showed the sangoma the signs and symptoms of TB. The relationship grew to mutual respect and consultation.

At one stage the Local Chief, Chief Mashego in charge of the Initiation School, where “the boys grow into men” and circumcision takes place, consulted Tempelman and asked advice how to prevent infections.

Tempelman provided sterile material including suturing material, betadine, sterile gauzes and dressing material and invited the Chief to come and bring the kids for a medical check up to the clinic prior to going “into the woods” for six weeks. This relationship grew over the years and finally Mashego brought his pupils before circumcision to the clinic, covered in blankets under the darkness of the evening, for check-up. When Tempelman misadvised a few to participate because of underlying disease, Mashego always followed his advice. Tempelman also gave every boy a long-acting penicillin shot in the buttocks and a five-day- course of antibiotics. After many years Mashego taught him how to recite in Sepedi and Tempelman joined in the woods. To the great surprise of the boys and the elders…………..

Often Chief Mashego invited Tempelman to sit in, at the fires and they checked together every young men’s circumcision wound in the early mornings and Tempelman advised treatment accordingly.

This has prevented many septic penises and long healing processes. It was also the ultimate honour of acceptance of the chief into the customs and secrets of his tribe.

The Ndlovu Tuberculosis Program took a serious ‘sprint’ with many patients choosing to be treated at Ndlovu Medical Centre. The program was unfunded, with costs absorbed by the clinic. Additional costs for diagnosis and treatment were facilitated by the Department of Health.  Sustainable annual funding provided by Stichting Sonnevanck from the Netherlands made a huge difference to the Tuberculosis Program. The National Health Laboratories Services (NHLS) became our service provider, and with the annual support of Stichting Sonnevanck, we were able to cover the costs. As diagnosis was made not only for TB but also for HIV, the relationship between Tuberculosis and HIV/AIDS became more apparent. 

During this period the ugly face of HIV and AIDS became increasingly visible and the frustration, growing out of the South African Government’s denial, was huge. Ndlovu Medical Centre had developed a trusting relationship with the local community, and hence many desperate patients approached Ndlovu Medical Centre for help. Dr Maarsingh reached an age to say goodbye and proposed to invite his successor in Canzibe Hospital in the Transkei Dr Peter Schrooders, also a Dutchman. Peter joined Ndlovu in 1998 and three year later became a partner in the practice. Three years later Dr Robert Moraba joined when the clinic and its work continued growing. These three doctors created a name for the clinic which was known far beyond Moutse and Sekhukhune. Patients flocked from everywhere to be treated seriously and affordably. The clinic grew to over 120-140 patients a day. 

Following the new Millennium, Ndlovu Medical Centre witnessed many patients suffering with HIV, and there was little to offer. As clinicians, we developed the firm rule that ‘we treat you as well as possible, for as long as possible – but when the coin flips into full blown AIDS, we let you die as soon as possible and with as much dignity as possible, providing guidance to the family.’ We lived in a country where the President denied the relationship between HIV and AIDS, stating that AIDS was a poverty-related disease. The Minister of Health was not much wiser and, denying the positive effects of ARV treatment, informed the entire world that the solution was a potion made up of garlic, onions and olive oil. Lots of garlic as a means to prevent the transmission of HIV makes some sense, but no more than that!

In early 2002, Tempelman received the following email from the Netherlands:

Dear Dr Tempelman 

Through the media and political channels, your name has come to my attention and I would like to come and visit you.

Regards Rene Valks.

Tempelman’s response was short and sweet:

Dear Rene,

I like blind dates

More than welcome

Regards Hugo

Three weeks later, Rene Valks and a partner, both representing the Dutch Stichting Dioraphte, visited the Ndlovu Medical Centre. This was a life-changing experience, and became the start of the Ndlovu ARV Treatment Program, a holistic community approach based on four strong principles:

• HIV is not going to leave South Africa in the next few decades

• It is as important to treat those with HIV and AIDS as it is to manage those who are HIV negative

• If 100% of the population is affected then bring all services down to the community level

• Create a model program that can be presented to Government, as the time will come when government will start treating.

A full year was needed to prepare the Medical Centre, including constructing an HIV monitoring laboratory, educating the doctors and nurses, and growing an army of Community Health Workers to initiate the Ndlovu AIDS Awareness Program in the community. Tempelman was sent to the Netherlands for HIV treatment education at the Amsterdam Medical Centre (AMC) in Amsterdam where he met Dr Jan van der Meer, his tutor, mentor, coach and longstanding friend.  In 2003, the Ndlovu Medical Centre became the third public ARV treatment site in South Africa. Medicine sans Frontiers initiated an HIV Treatment program in Khayelitsha in 2001, and in 2002, CAPRISA managed a program at the King Edward Hospital in Durban. 

The work and expertise in the field of HIV/AIDS became renowned and was recognised at all levels. Schrooders, Moraba and Tempelman developed a centre of excellence. The Department of Health even recognised their expertise as a tertiary referral centre for the government clinics and hospitals in the area. This trio served a tremendous need and put over 30.000 patients in Ndlovu Medical Centre over the next decade on ARV treatment. It was the combination of proper field work (on the level of HIV Awareness and adherence to treatment, performed by the NAAP Team) and their HIV treatment expertise which put Ndlovu so highly appreciated on the map. 

Ndlovu Care Group has always regretted that both Dr Schrooders and Dr Moraba decided at a certain stage to move on for personal reasons. Tempelman lost in them two good friends and two super colleagues with their hearts in the right place.

In the following years, many community development programs took shape. The Elandsdoorn Bakery, the Ndlovu Information Technology Program, the Waste Program and the Postal Agency with 2000 post boxes, were all realised. In the Netherlands, a group of friends under the guidance of Arthur Batenburg, initiated our first donor organisation abroad, and in 1999, the Elandsdoorn Foundation was created. After many years the Foundation was renamed ‘Tjommie’. The Tjommie Foundation is still one of our main support structures in the Netherlands, providing funding for our Child Care & Youth Development Programs.

The severe inequality that Tempelman observed in his environment, between the ‘haves’ and ‘have-nots’, aroused the anger which fuelled his drive to make a contribution. The problems identified and solutions provided led to the later successful principle of ‘nothing for me without me’ – that not one project should be developed if the need is not defined by the community. 

But what does this ‘nothing for me without me’ mean?

Tempelman saw an elderly patient, who at the end of the consultation for his high blood-pressure, asked: “Doctor, you live in Groblersdal, isn’t it?” After confirming this, the man then asked: “Can you maybe bring me ten stamps tomorrow?” Tempelman’s answer was: “I am not the postman, but why do you ask this?” The man explained to him that there were no postal services in Moutse. This was another example of the inequality in South Africa. Eight thousand White South Africans living in Groblersdal enjoyed a house-to-house postal delivery service, while 120 000 Black South Africans that live in Moutse cannot even buy a stamp, receive a letter, make a photocopy or receive any other similar service. Once again, fuelled by his anger, Tempelman bought the man his stamps, divided the Pharmacy into two divisions, and initiated a Postal Agency with 2 000 post boxes. But Elandsdoorn had no postal code! This took over a year to solve and finally 2 000 keys to post boxes were handed out to the community. Elandsdoorn 0485 existed. The same old man came proudly to Tempelman and said: “Now we exist. Everybody in the world can reach me: Samuel Ndlovu, PO Box 146, Elandsdoorn 0485”. The lesson Tempelman took home was that this relatively small project had a significant impact on the community.

The Ndlovu Model began to emerge, a holistic model based on three pillars:

1. Health Care Programs

2. Child Care & Youth Development Programs

3. Community Development Programs

Only much later, a fourth component, ‘Research’, would be added.

All programs begun to mature and, through falling and getting up again, the organisation grew steadily in this community. Ndlovu Care Group was born and managed under the umbrella of the Ndlovu Medical Trust. Tempelman still served as a doctor during the day and a program manager at night, writing proposals, developing budgets, having meetings with his steadily expanding team – and having occasional nightmares about whether he could maintain what he had started.

During one of the evening meetings, a program manager showed Tempelman his stethoscope telling him: “We do not want to have all our meetings in the evenings, only because you do not want to meet while patients are waiting. We want to know if this stethoscope is hanging around your neck or on the wall”. This was a difficult and emotional choice but Tempelman knew he had to choose the wall for his stethoscope. He started to manage the NGO Ndlovu Care Group on a full-time basis. He could not enter the clinic for the next coming year, afraid he had made the wrong choice.

Professor Adri Vermeer came into Ndlovu’s life in 2002 and changed the organisation’s and Tempelman’s perception about research and data. Adri Vermeer was sent to us by Rita Kok, the wife of the former Premier of the Netherlands, Wim Kok. On their State visit to South Africa in 2001, Mrs Kok visited Ndlovu as one of the Royal Netherlands Embassy-supported projects. In return for hosting the visit, Ndlovu was invited to identify a donation. Tempelman’s request to Mrs Kok was for her to profile the work of Ndlovu Care Group amongst her network. Ndlovu was in need of academic knowledge and did not have any relations in the Netherlands with academia. 

Vermeer, a professor emeritus in Special Education at the Utrecht University’s Faculty of Social Sciences, was a good friend of Rita Kok and offered to assist. Unannounced on a Tuesday afternoon, the professor, in white takkies, walked into the clinic, introduced himself and told Tempelman that Rita Kok had sent him.

Vermeer’s opinion was that “something is only done when it is properly described” – a good lesson for life. An NGO survives and thrives by the grace of its reliable data and evidence of impact. The data collection underpins the development process, with program activities and actions leading to outcomes, which in turn lead to impact and provide proof of sustainable development. In short, program evaluation needs to be done as if it were research. Proper documentation, description and data analysis provides the evidence to our donors that the finances invested in our work are spent responsibly. At the end of the day, we need to be able to prove to the donor that the financial support provided is efficiently and effectively spent for what it was originally intended.

Prof. Vermeer’s contribution to Ndlovu also led to the formation of the Ndlovu Research Consortium, a partnership between the Utrecht University in the Netherlands and the Witswatersrand University and Ndlovu Care Group in South Africa. Many Masters and PhD students assisted Ndlovu to set up the Ndlovu Research Department. Trial and academic research have been performed under difficult circumstances in a deep rural environment, but top-notch academic representation resulted in many peer reviewed publications and quality trial research. Dr Anne Wensing, Monique Nijhuis, Prof Roel Coetinhoe and Prof Rick Grobbee have played a major role in the academic performance of and capacity developed in the Ndlovu Research Centre. Wensing and Nijhuis still play a major role in the academic research initiatives of the Ndlovu Research Department. Friends forever…….

In 2004, an important development in the community took place in the form of the Elandsdoorn Sportsgrounds, funded by the Johan Cruyff Foundation. Not only a 6m x 6m soccer field, but also facilities for basketball, tennis, netball and volleyball were constructed, complemented by a fully-fledged fitness hall. Johan and Danny Cruyff, as well as the Dutch artist, Herman van Veen, attended the grand opening. A festival that spanned the entire weekend was attended by many of our national and international funders and friends. Organising an event with such celebrities provided Ndlovu Care Group with massive media attention. 

The opening soccer game was a demonstration that people living with HIV can lead a normal life. The one team, consisting of young male and female HIV-positive players on ARV treatment courageously wore shirts with the text ‘Because of three pills a day we will still be there in 2010’. Still six years away, 2010 was the year that South Africa would host the World Cup Soccer Tournament. 

Johan Cruyff received such a shirt as a present; he immediately put the shirt on and started playing with the team of HIV positive players. This was broadcast on almost every sports channel in Europe. South Africa, still in HIV denial, did not pay any attention to this wonderful event, a missed opportunity where people living with HIV disclosed their status in public, showing that a normal life with HIV is possible. They won the game, by the way, 3 goals to 1 (the HIV status of the opponent was not known).

Educating your employees about their rights and responsibilities and introducing, at a rapid rate, major development programs to the community does not come without problems. The employees see how much is invested in an impoverished rural area, resulting in gossip, jealousy and backstabbing. In 2008, while Dr Tempelman was fundraising in Germany, the clinic staff and all its program staff went on a strike. Total panic!

Ndlovu Care Group was one of the only NGOs paying market-related salaries, contributing medical insurance and provident fund for all its employees. What more did they want? All AIDS patients on treatment were refused access and deprived of treatment, as were all the children in the Child Care Programs. How could this happen? The clinic was locked and no-one was allowed to enter. The organisers demanded that Tempelman come back and negotiate better terms, improved working conditions and salaries. They would only speak with Tempelman, no-one else!

Liesje informed the strike organisers that she was a Tempelman as well and that they could discuss with her their demands and problems. Four tense days of backwards and forwards negotiations followed, until Liesje and the HR manager reached consensus with the strikers. This lady has guts and an iron mentality!!

The HIV treatment program was a major success and within four years, Ndlovu Care Group had approximately 3 700 HIV positive patients successfully on treatment. The Waterberg Welfare Society, an NGO working in another area of Limpopo, requested Ndlovu Care Group’s assistance in setting up an ARV treatment program. Expansion of the Ndlovu Care Group meant that reinforcement of management was necessary. The Royal Netherlands Embassy assisted with a five-year funding grant for Head Office operational costs. The finance office was professionalised and a COO, Mariette Slabbert, was appointed, an IT office was established, and the Social and Child Care Program became an important development focus, requiring its own manager. 

In 2007, the Dutch Government surprised Tempelman and his wife Liesje, with a tremendous honour: they were, in the name of Queen Beatrix, ordained as ‘Ridder in the Orde van Oranje Nassau’, a royal distinction they are both very proud of. In the same year, many important developments made it possible for Ndlovu Care Group to grow. 

Tempelman received a telephone call from Sir Richard Branson requesting assistance for his workers at his Bushbuckridge game farm in Mpumalanga. Tempelman told him directly that an exclusive program for his workers was not an option and that a treatment program for the very disadvantaged community of Bushbuckridge was a much better idea. This was a whole other story as there was no infrastructure at all in that area. Ndlovu Care Group, in cooperation with Virgin Unite, Anglo American and USAID, developed a concept of an ‘Integrated Primary Health Care, Tuberculosis, HIV/AIDS Treatment Centre’ and Bhubezi Community Healthcare Centre (CHC) in Lillydale was born. This same concept was repeated a few years later when the Nyarhi CHC was established in Utah Village, near Acornhoek.

Herman van Veen, the Dutch artist, revisited our projects together with all the employees of his theatre production company. Vivi Eickelberg, his German Marketing Manager, was emotionally touched and impressed with what she experienced.  She returned three months later with a film crew to make a beautiful documentary titled ‘Ithemba Africa’. The premiere in Berlin created a chain reaction and mobilised influential people across many parts of German society. Under the guidance of Vivi, the Hugo Tempelman Stiftung was founded, another platform that has been supporting the work of Ndlovu Care Group for more than 15 years.

The HIV and AIDS epidemic created many more problems other than the disease itself. A whole generation was dying at a very young age. South Africa had, at the height of the epidemic, over 1 100 HIV-related deaths and more than 2 000 new infections a day. Over 25% of all pregnant women were HIV positive, with up to 50% in some provinces. A massive number of HIV orphans resulted in many child-headed households. The Ndlovu Care Group was very concerned about the long-term effects this would have on the communities in which it worked. In response, an Orphaned and Vulnerable Children Program (OVC), was designed and implemented.

The Ndlovu Child Care Program was expanded to include an AIDS awareness and Life Skills facilitation program. Sports, Arts and Drama were utilised as program pillars to get the attention of the target groups. With the assistance of Dutch Development Aid, the Miracle Theatre was constructed in 2008, providing a home for all the Child Care and Youth Development Programs. The opening of the Miracle Theatre was celebrated with a choir from the community, under the guidance of Ralf Schmitt. This led to the inception of the Ndlovu Youth Choir. The Miracle Theatre was built under the guidance of Dutch banking entrepreneur, Rene Frijters, who continues to be involved with Ndlovu Care Group, and serves as the Chairperson of the Tjommie Foundation.

The work of Ndlovu Care Group had not gone unnoticed, with many publications, newspaper and magazine articles, television documentaries and awards recognising the long term contribution to the rural community of Moutse and the high quality of programs implemented. In 2008, NCG received the Platinum Impumelelo Award for innovation as well as the Gold and Silver CPSI awards for innovation and public-private-partnership. These were followed by the Martin Buber Plaquette, a Dutch-German Award received by Hugo and Liesje Tempelman for long term involvement in charity and philantrophy work. The previous recipient of this award was Michael Gorbachov and two years later, Queen Silvia of Sweden was presented with the award. In 2010, NCG received the Impumelelo Innovation Award for Social Entrepreneur of the year. In the same year, the Salomon Neumann Medaille (German Society for Social Medicine and Prevention, Charite University, Berlin) was granted to Tempelman for the integration of Clinical and Public Health in societal improvements and innovations. In addition, the staff of our satellite clinics received awards of high standard. In 2011, the Bhubezi CHC Clinic Manager and Doctor were nominated for the Frontline Hero Award by the Global Business Coalition, and travelled to New York to receive this prestigious award. In 2021 Dr Tempelman was honoured with an Honorary Doctor of Philosophy, PhD by the Utrecht University for his contributions to science and the development of the rural Ndlovu Research Department. A PhD is considered the highest postgraduate achievement you can earn.

As mentioned earlier the opening of the Miracle Theatre in 2008 led to the inception of the Ndlovu Youth Choir. The preparations for this event opened the eyes of the young conductor, Ralf Schmitt, to the potential of a choir in this rural area. The Ndlovu Child Care and Youth Development Program requested him to stay on and continue the work with the choir. 

Africa always sings: at births, birthdays, weddings, funerals, and every other opportunity in-between. The idea to establish a choir within the Orphan and Vulnerable Children Program and integrate it into the Life Skills Development Program was identified. Ralf liked the idea and travelled 200 kilometres back and forth each week to train these vulnerable children in choir music. The children responded to his efforts in a very special way. They did not stop rehearsing when he left for home, but as the Miracle Theatre was a place of safety, they stayed on and rehearsed the whole day. The choir grew rapidly and it was time to start performing for other audiences. The problem was who would want to book them for an event?

Transforming the choir from an OVC program within the Child Care Program to a possible professional choir and youth employment program was discussed with donors, especially the Hugo Tempelman Stiftung and Tjommie Foundation. It was a dream but the funders were used to Tempelman dreaming! The Hugo Tempelman Stiftung provided the choir with inner earphones, headsets and a professional studio which would be set up in the Miracle Theatre. Uniforms were made and ethnic beadwork completed the dresses.

It is amazing to see what happens when a child is given the opportunity to shine. Children who never received attention from anyone, who had lost their parents through HIV and AIDS, who were victims of domestic violence, substance abuse, crime, and other social ills, got together and showed what they could do: they could sing, dance and perform.

If you want to sing, you have to straighten your back, take a deep breath and use your vocal cords. If you dress the individuals in uniforms and let them sing together with their peers, in front of an audience, something wonderful happens in their lives. And at the end of the song they get applauded, something they have never experienced before. They grow in self-esteem and achieve excellence at a level they never dreamt they could reach.

Although very proud, Ralf was looking for even better opportunities. He created, together with the choir members, a Zulu version of Ed Sheeran’s song, ‘Shape of You’. This went viral and a scout from ‘America’s Got Talent (AGT)’ reached out to Ralf. At first Ralf thought it was a prank and did not take it seriously. Until he got contacted again! The Ndlovu Youth Choir was invited to participate in the greatest music competition in the world. When asked by the judges what an African choir is doing on America’s biggest show, a chorister answered: “The fact that we are born in poverty does not mean we are poverty”, and they went on to become AGT 2019 finalists. South Africa had new idols and the whole country was as proud of the Ndlovu Youth Choir as they were of the Bokkie, our national rugby team, who won the World Cup in the same month.

And the rest is history: the Ndlovu Youth Choir has grown from strength to strength and now travels the world, records CDs and are successful young people. Ask yourself: If all this talent comes from one township, what would happen if we were able to unlock the potential of the youth of this country in each and every township?

With the expanding programs and increasing numbers of donors, the responsibility of leading Ndlovu Care Group as a soloist became too much for Tempelman.  He developed the idea of an Ndlovu Advisory Board, later maturing into the Board of Trustees of the Ndlovu Medical Trust. The first meeting of the Ndlovu Advisory Group was held in May 2010, under the leadership of Emeritus Prof Geert Blijham, ex- chairman of the University Medical Centre Utrecht of Utrecht University, in the Netherlands. The Board has served the trust diligently in its capacity as advisor, guardian of governance, risk management and financial control. Prof Blijham became a personal friend and advisor to Tempelman and still leads the Board as Chairman today.

Over the years, the relationship with the Hugo Tempelman Stiftung and Tjommie intensified. Each year they visited Ndlovu Care Group, often with friends from the donor group. The two organisations have been and continue to be important pillars for Ndlovu. Tempelman has travelled often to the Netherlands and Germany to motivate and explain why the work of Ndlovu Care Group is such ground-breaking work. The friendship with Vivi Eickelberg and her team became solidified through these visits and lasts still today. The same can be said for Tjommie, now under the reigns of Rene Frijters. Both organisations are not only donors but also serve as advisors, critics, councillors and assist in formulating the way forward.

Other important donor relationships developed. A visit by Annemieke Hogeboom brought Ndlovu into contact with the People’s Postcode Lottery in the UK. This has been a staunch supporter and major financial pillar for Ndlovu Care Group since 2014, often providing a lifeline in difficult times. In 2015 the Ndlovu Youth Choir performed at the Lottery’s annual gala in Edinburgh, Scotland. It was the first international performance of the Choir for such an esteemed audience.

All clinic satellites flourished in their respective communities: Bhubezi CHC in Bushbuckridge and Nyarhi CHC in Agincourt. They were well managed by Ndlovu Care Group and over the years handed over to the provincial Department of Health. Bhubezi CHC was built on an empty piece of land near Lillydale and has since grown into a new township. In 2017, ten years after the opening of Bhubezi CHC, the community health centre was handed over to the Mpumalanga Department of Health and continues to serve the respective communities. 

Over its fifteen years of existence, the Ndlovu Care Group has initiated over 50 000 patients on Anti-Retro Viral treatment. All babies born from HIV-positive mothers at Ndlovu’s maternity clinic are HIV negative – a spectacular result over the years. Despite these positive results, in 2016, Ndlovu was forced by the Department of Health to close the maternity clinic, as the hospital licence was not renewed. Two years later, in 2018, the ARV program was closed down when the Department of Health stopped the funding support. They did not want NGOs to provide HIV services. It was their view that this was the responsibility of the Department of Health and not of NGOs. An important chapter was closed and Ndlovu Care Group handed over all its patients to the government health care clinics.

The Ndlovu Research Department, initiated by Prof Adri Vermeer, got the attention of the International Partnership of Microbicides.  The Research Department was requested to participate in the Ring Study, an important research trial to prove efficacy of the HIV Dapivirine Vaginal Prevention Ring, a latex ring impregnated with the ARV Dapivirine. To accommodate this, the Ndlovu Research Centre was constructed in 2024, and many more research trials in the field of public health followed. The vaginal ring research proved the prevention of HIV in over 65% of the users, and in 2024, the ring is on the market as a successful tool for women to control HIV transmission independent of men.

In 2018, the Ndlovu Research Laboratory, a state of the art centre of excellence contributing to HIV research and COVID-19 research and management, was established. Central to this success story is the participation of the local community. Research doctors, laboratory scientists and professional research nurses were brought in from other parts of South Africa, but all other research employees were recruited and educated locally.

The growth of the Trial Research Department was rapid, with HIV Prevention trials followed by COVID-19 Vaccination trials. The massive expansion as a result of the increased number of trials all at the same time became a problem, and in 2022, poor management of a research Principal Investigator led to data fraud, one of the most difficult challenges for a research site to overcome. 

The Department of Health temporarily closed down the Ndlovu Research Department (it can operate again in 2025). Meanwhile, the academic research continues to contribute towards further insight into infectious diseases, especially respiratory viruses and HIV diagnostic and cure research. Ndlovu Research continues to work successfully with the Utrecht University in the Netherlands, the University of Pretoria (Immunology Department) and Witwatersrand (WITS Ezintsha). Ndlovu Research is currently preparing for new trials in 2025, in cooperation with Merclinco in Middelburg. As a learning organisation, Ndlovu Care Group has learned much from the negative experience and as always, will emerge stronger over time.

In 2016 another important gap in service delivery came to the surface: care for those with disabilities, especially disabled children and youth. In Limpopo there were no special schools or quality institutes catering for those who do not have a medical aid. Our Child Care team was often approached for assistance for the disabled and unfortunately the answer was a negative. This was a situation we could no longer tolerate, especially since we claimed to be an NGO with a holistic and integrated approach towards child care and youth development. There was little expertise on this topic in our team, but fortunately it was a speciality of Prof Adri Vermeer, who had set up a very successful care program at Sizanani in Gauteng. Ndlovu Care Group developed, with his assistance, the Community Rehabilitation Centre for the Disabled, a day care centre for children with disabilities. This plan was appreciated by the Rens Joosen Foundation, which provided the funds to start this important extension of services.

The essence of the disability program was to provide an integrated, personalised care program for the individual, designed by an occupational therapist and taught to Community Health Care Workers (CHWs), who are the implementers. The CHWs practice while the children are on site and make home visits to teach family members how to assist as well. While on house visits, an assessment of the local circumstances is made and changes implemented like ramps, railings, a bathroom, special beds or trolleys etc. This facilitates a sustainable change in the quality of life of the disabled child in his/her own household.

In many communities, living with a disabled child also has a negative connotation, resulting in families hiding the disabled child. It is seen as a punishment from God or the ancestors, bad quality of semen of the father or a ‘wronged’ womb of the mother. This stigma makes it even more difficult to care for a disabled child in these impoverished communities. The program provides engagement events and gatherings, educating the community members about the stigma attached to being disabled. This component of the program has strengthened its impact. There is more acceptance by and assistance from the surrounding community members. As the program grew over the years, so did the number of beneficiaries as well as the waiting list. Many disabled children are unable to live without the support of the program and clearly cannot be discharged. This presents the challenge of sustainability as we will never reach a stage of non-dependency.

A special group of the beneficiaries of this program are the children who are physically strong but intellectually impaired. No matter how good our program is, these children will never be independent. They will always be vulnerable to abuse, inside and/or outside the family, victims of bullying, sexual violence and other abuses. Something completely innovative was needed for this group of beneficiaries. Ndlovu Care Group developed an ‘Integration Program at the Workplace for the Disabled’ and with the help of all our stable, long-term donors (Rens Joosen Foundation, HTS, and Tjommie) we established two new companies: a brick factory and a chicken-farm, run by intellectually impaired youth, under the supervision of a dedicated manager. There are currently more than 30 youngsters employed. Their status in their families has changed dramatically. From being the person to be bullied and abused, they have become the person who brings an income into the household, often the only one in the family with a job. This is an example of a truly impactful development program catering for the future of the disabled individual – ‘From Cradle to Career’, a program to be very proud of.

COVID-19 provided a set back to the whole world and also to the world of the Ndlovu Care Group. We had to close down! This was an impossible task to do in this community because how do you stop providing health care and child care to malnourished and vulnerable children. What would become of them?

A Tempelman one-liner, ‘Impossible is an attitude’, made this situation unacceptable to the Ndlovu Care Group. All donors were approached and informed that we would like to reformulate our services from centre-based care to home-based care, with an intensified feeding scheme for the whole household. This concept was approved by all and our versatile team sprang into action. In no time, a distribution system for feeding over 1 200 families was set up. The initiative had to be implemented in a manner that was fair and considered the community as a whole. The program was GPS-controlled and a poverty index of all families was taken.  The Ndlovu Care Group recognised that every family in our community has a level of poverty but not all were beneficiaries of our programs. The children of the Child Care and Youth programs were our first responsibility. Emergency funds were raised and Ndlovu continued its tasks under the most difficult circumstances. A feeding scheme was implemented, but as the close down period extended, our funds started to run out. Ndlovu needed to think of a more sustainable solution. This was found in an extension of our vegetable garden system set up in the NNUs. It became a rule that only families who started to work their plot and establish a vegetable garden would continue to receive food-parcels under our feeding scheme. In no time 1 200 family gardens were initiated, with the assistance and knowledge of our CHWs from the NNUs. The feedback provided to our donors was very positive, leading to greater generosity. This contributed to the survival of the Ndlovu Care Group and the continuation of essential services to our beneficiaries during COVID-19.

COVID-19 also created opportunities. The whole world needed COVID-PCR tests and we had a research laboratory that could produce these tests. Tempelman, together with the CFO, Lourens Duvenhage, approached mines. They needed to get their employees underground and without a negative COVID-PCR, this was impossible. We introduced ourselves and the laboratory to them and informed them that with additional PCR machines and other lab equipment, Ndlovu Laboratories could deliver as many tests as they required. Two mining industries agreed to provide the equipment and they set their quota of tests as a return. The additional capacity allowed us to approach other mines and create a client-base for daily PCR needs. Ndlovu set up a laboratory courier service and implemented an IT system at the mines so that they could follow their own results after the tests were performed. Ndlovu Laboratories also provided the service to the NHLS for the Limpopo Department of Health, which had marginal PCR capacity. The Laboratory appointed extra employees, performed 24/7 PCR tests, more that 2000-2500 per day. This income was essential for the survival during the COVID-19 period and was a lifesaver for Ndlovu. It also provided the Research Laboratory with the opportunity to play another role because we were able to perform sequencing testing as well. Through the surveillance program for the variants of the COVID virus, Ndlovu played an essential role in support of government in the three northern provinces of South Africa (Limpopo, Mpumalanga, North West). 

This role positioned our laboratory on a national level and another one of the Tempelman one-liners, ‘Never Waste a Good Crisis’, came into play. It should be noted that this was not an original quote from Tempelman. The earliest attribution was to the Italian Renaissance philosopher, Niccolo Machiavelli, who reportedly said, “Never waste an opportunity offered by a good crisis.” During WW11, Winston Churchill stated: “Never let a good crisis go to waste”. Tempelman just adapted it.

During these times of both growth and challenges, the relationship between Tempelman and Lourens Duvenhage strengthened, each gaining trust and confidence in the other. United in leadership, the entire executive team navigated these storms very well. However, Tempelman had recognised for a while that his life as leader was not eternal and that he needed to think about succession. Over the years he had applied his mind on how best to do this. Handing over to an outsider did not appeal to him as the risk was too high if the wrong person were to be appointed. Mentoring someone from within also had its risks, but Tempelman had confidence in the skills of Lourens Duvenhage. To support the hand-over he needed to form an extended core management team, covering Child Care and Youth Development, Social Work, Research (academic and trials), and Community Development as well as all back office functions, including financial management, HR, M&E, Marketing, Fundraising, IT &IT Development. After COVID-19, which had personally impacted him, Tempelman started actively working on the transition process, a period in his life when the support of the Board of Trustees became increasingly important.

Under the leadership of Morongwa Mogongoa, the Child Care and Youth Development Programs have made quality improvements. The initiation of the Bloempoort Child Care Campus, with the vision ‘From Cradle to Adulthood’, has created a better focus on the integrated service delivery. This was made possible by many donors, but especially the HTS and Tjommie. Over the years the content of the NNUs, ECDs, Social Work, After Schools Programs etc., has greatly improved, thanks to loyal support from Tjommie. 

It also brought to the surface that in the current situation, providing services ‘to Adulthood’ is insufficient. In 2021, close to 3% of the 15-year-olds and nearly 9% of the 17-year-olds had dropped out of school. According to researchers, it is estimated that out of the 100 learners who begin school in Grade 1, only 40 will sit for the Grade 12 National Senior Certificate (NSC) examination. This is an overall drop out of the educational system of 60% of children, a frightening statistic for a country like South Africa. It gets even worse when we see that from those who passed the NSC, only 7% will enter any form of tertiary education. South Africa is developing a new generation without a perspective on skills, which is disastrous. Time to change ‘From Cradle to Adulthood’ to ‘From Cradle to Career’.  

Ruud and Annette Boekhoorn joined one of the Tjommie sponsor trips. They were overwhelmed by what was happening in Elandsdoorn and Bloempoort. They were impressed with the way Ndlovu Care Group implemented programs and how Tjommie supports the work. It changed their lives and they wanted to contribute. Drawing on Ruud’s background in the construction world, and with the start of his career as a carpenter, the idea of a vocational educational centre was quickly born. The idea took root when Ruud and Annette initiated the Boekhoorn Foundation and started their own fundraising efforts. At the same time Ndlovu Care Group started to investigate what establishing a formal Vocational Training Centre would entail.

A vocational school is an enormous undertaking, especially from the administration and qualifications point of view. If this is not done successfully, the school will never function properly and will not receive funds from the governmental agencies that support Vocational Training Institutes. A proposal was developed, the market was explored and the Boekhoorn’s convinced. The ‘Drie Ambachten School’ project was formulated, including carpentry/painting, plumbing and masonry, the three basic vocational skills needed to construct housing. Three years later, electricity was added as the fourth skill. The Electricity School is complex and expensive to set up. With the help of the HTS and RTL Germany, we managed to get this financed. From inception to when the first learners entered the buildings took three years, and a quality centre was set up in Bloempoort. The first learners came via a contract with a mine for skills development of unemployed youths. 

The process of obtaining qualifications and fulfilling all audit requirements is long and cumbersome. It is only this year, six years after initiating the school, that the school has qualified for subsidies from the National Student Fund. Since reaching this status, however, it is steaming ahead. In the meantime, two more subjects identified as priority needs, have been added – Mixed Farming (animals and agricultural) and IT & IT Development. The Mixed Farming has been financed by AFAS through the efforts of Tjommie. It is great to be supported in this way. The Vocational School has an annual capacity of 700-900 learners and will make a significant difference over time to the lives of youth and their future in South Africa.

Today we celebrate thirty years of Ndlovu Care Group in the community of Moutse and Bloempoort. Thirty years, which have delivered amazing results (and yes, sometimes disappointments) through passion, hard work, team work, community engagement and respect. It is evidence that if a community is empowered they can reach the stars, like our Ndlovu Youth Choir, and they can achieve a working future, like the youngsters graduating from the Vocational School.  

Ndlovu Care Group is a beautiful example of how a community can grow by providing knowledge, skills, infrastructure and opportunities. 

Ndlovu Care Group has assisted the community well through two pandemics – the HIV and AIDS/TB epidemic and COVID-19. 

Ndlovu Care Group has contributed to change, from deadly diseases to chronic manageable diseases. 

Ndlovu Care Group has succeeded in unravelling the secrets of community development, not by telling what to do, but by observing the suffering, listening to the needs, and understanding the historic disadvantages. 

Ndlovu Care Group, in collaboration with the community, has turned all the negative energy into positive results, proving that ‘Impossible is an Attitude’.

Now we look forward to the next thirty years of Ndlovu Care Group!

Dr Hugo and Liesje Tempelman