The HELP Guide For Community Based Rehabilitation Workers: A Training Manual grew out of Marian Loveday’s work as the only physiotherapist working in a community of about 300,000 people. Given the overwhelming needs in this community, she determined her task to be passing on basic rehabilitation skills to people of the community. She defined the community she was working with as the community of disabled people, which included disabled adults and the mothers of disabled children. In each area in which she planned to work, a meeting was held with this community of disabled people. They chose from amongst themselves a person who would receive training and then work as a rehabilitation worker in that area. During her last years of work with the project, she completed a Masters degree in Maternal and Child Health, and for her thesis she completed a quantitative and qualitative evaluation of the rehabilitation project. She left the project in 1994 after ten years, and the work continued for a further ten years until the whole organization was forced to close due to a lack of donor funding.
In 1994, following political freedom in South Africa, she — along with her husband and two small children — moved to the Kalahari Desert near Botswana, where they lived in a rural area for six years. She lived at the Moffat Mission in Kuruman where her husband was the Director. Moffat Mission was David Livingstone’s first home in Africa. There, she was employed by the newly established Northern Cape Department of Health as the District Health Manager of the Kalahari District. In this position, she was responsible for all the public health services within a defined geographical area which had three hospitals, fifteen primary healthcare clinics, and seven mobile clinics.
Although she loved the Kalahari, her eldest daughter was diagnosed as having juvenile diabetes, and so for health and educational reasons, her family left and moved to KwaZulu-Natal, another province in South Africa. During this time, she has been employed by Health Systems Trust, a non-governmental organisation, which strives to improve health services for all South Africans. Initially, she worked in a remote rural area supporting the local district health managers to implement an effective Primary Healthcare system. More recently, she has moved into health systems and operational research focusing on TB and the interface between TB and HIV.
In the years since 1994, Marian has continued to draw on the wonderful memories of that time working with disabled children and their mothers, as well as the lessons that were learnt in providing good health for all the people of South Africa.