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Ubuntu clinic for moms and babies soon to be micro-franchised

A passion for caring for people led Freda Makanete to open a clinic that started in a Wendy house.

TUMISANG NDLOVU: In this week’s SME Corner on Moneyweb we speak to Freda Makanete, the founder of Ubuntu Health Care Clinic. Talk to us about Ubuntu Health Care Clinic, what do you do?

FREDA MAKANETE: Ubuntu Health Care Clinic is a mother and baby clinic. We provide a service to women who mostly don’t want to go to the public sector clinics owing to the time they spend there. So the service we offer is antenatal care for pregnant women. We take good care of them throughout their pregnancy. Should there be any complications, because it’s a midwife practice, we refer them to obstetricians in government hospitals. And for those with medical aid, we refer to the private sector. As a midwife my duty is to just go through the primary healthcare of the mother and, should there be any complications, it is my duty to refer them to the obstetrician – that’s why we then refer them to the hospital.

So that’s what a public clinic would be like. The midwife in the public space would then refer to the obstetrician; that’s how we work. After the mother gives birth she will be coming back. So birth will be for those who want to go to public sector. Mostly we don’t have mothers who give birth in the private sector, since we don’t have obstetricians we work with directly to take care of the mom through the antenatal period, and then the mothers only go there to give birth.

Usually we will see them early in their pregnancy and then later on they will go to the obstetrician. Most of our moms deliver in Rahima Moosa Mother and Child Hospital, and then others at Johannesburg General and Hillbrow. Most of our clients are from Cosmo City, so those from that area will deliver in Rahima Moosa. Depending on where the woman lives, we refer them to hospitals according to their address, because that’s how the referral system works with public hospitals.

After they give birth they will come to us for their three-day check-up. We don’t do the HIV programme as yet, so we still refer them for that. Should a mother be found to be HIV-positive antenatally, we refer her to be initiated on ARVs, although the moms still prefer to come back to us for antenatal check-ups, and continue their ARV check-ups with the public sector. So even after birth we do advise them. They will come back for their six-week check-up and, if they can pay, we do the PCR test. But if they can’t pay we refer them back to the government institutions.

Immunisation and wellness check-ups for moms and babies

Then we also offer immunisation services for the babies, and the moms come back for their six-week check-ups as well, for a Pap smear. We will continue with them if they want to do contraception as well. There are other little things that we also do, like wellness check-ups. So if the mom is on blood pressure tablets or wants to check her blood pressure with us, we do blood pressure and sugar tests because at times there are complications with moms who are pregnant, and we find they have diabetes or hypertension. So if that needs to be monitored we do monitor that as well.

Then with the babies we provide services for them until they are 12 years old with their vaccinations. For our vaccines we partly get our stock from the government side and we don’t charge much for it; we charge just for the consultation fee and not for the vaccines. But there are other vaccines like the chicken pox vaccine, the MMR vaccine, that you find in the private sector. So we buy those vaccines and then we charge. So we do see cash clients and medical aid clients.

TUMISANG NDLOVU: Talk to us then about why start a business of this nature; you seem extremely passionate about what you do.

FREDA MAKANETE: I hear that a lot [laughing]. Caring is something that I have. I care a lot and I happened to follow the profession that I wanted. I just knew I had to care somewhere, because I remember when I got to my first year of going into nursing and I did my interview, there’s a letter that you write so that, if anything happens to you while you are in college, they read that letter. I wish I could go and open mine, because I said I wanted to have my own hospice and it had to do with care –  but at the same time I wanted my own thing. I think there’s some business ability that I also have, but yet I knew where my passion was. So when I got to my second year and I did midwifery and we got to help moms deliver. That was the most exciting thing for me and I knew I loved this career. I used to always say, “One day I’m going to have my clinic”. As I went on, I learnt.

After my training I worked at Rahima Moosa Mother and Child Hospital, and after that I went to SANBS but still came back for my practice sessions. After I left SANBS I said I want to open my practice. So I went to Dis-Chem and I knew Dis-Chem would give me that private touch that I didn’t have, and I went in and I got it. I had a partner at that time and we just said, “Let’s jump ship”.

So then we started and just knew where to get funding; you [think you] know all these things. Only to find that after you have jumped ship it is not that easy, because then you realise I am on my own and the only thing I can do is be a nurse and sit with a patient and offer your service, show them your passion. But there’s also the business side of things.

There’s a business plan, there is you having to know about money. I discovered I didn’t know money and didn’t know numbers. There are a lot of things that have to do with the business side of things other than operations. I was equipped with operations and I really thought I had it. I even had to split with my partner because the moment I realised that this is not about knowing how to get money, where or what, it’s actually about you having to be there. You need to be present and say, I want to run a business and be present for that. You have to have passion, number one. I had the passion. I knew that was what I wanted to do but I also knew that I needed to work hard for the money. If I’m going to get a loan it’s not going to buy me a car. It has to allow me to work and then be able to pay my bills.

So it was very difficult for me to go ahead with a business plan and know that my business model would actually pay back the loan. You want a million, it sounds very good but will your model be able to pay back that R1 million? What is it that you are going to do to produce that money because that’s what business is. That’s you and your business plan. Knowing that this is my model, I’m putting it down on the floor. Here it is, with me knowing that I’m going to be buying all the resources I need with this R1 million — and will it bring it back?

At the time I had to be realistic, I didn’t know much. I said at one time to my partner let’s wait a bit. As much as it sounds like we are going to earn R40 000 because we are directors, no. How are we going to be able to work so that we can earn R40 000, so we need to get to that point. On the numbers side for me it didn’t make sense, so I said let’s work, let’s get a place in Soweto because the business idea was for Cosmo City, because Cosmo City at that time was new and it seemed like the right location.

Starting out in Soweto

We couldn’t get a location at the time, so I said to her we can’t just sit. Let’s go to Soweto. I know of a place in Soweto. But then we didn’t have money for marketing. We didn’t have money for a lot of things but we had money to set up. So you set up and you don’t even have a sign for your business. But it was part of growing, I’m glad I had to go through that. She left after we set up, so I was left alone and I had to decide why had i done this in the first place. Then I thought no, I always wanted to do this. This was not about me and a partner, this was about me. So I thought let me go back to Rahima Moosa, do overtime and work night shift in the labour ward. I just realised this morning that my son was six months’ old when I left my job at Dis-Chem in June 2013, and my mom helped to support and care for my son at that time. At that time it was just work, work, work.

So I went to work three nights a week of night shift and during the day [I was] at the practice. During the day if I get a break, I sleep. At that time we didn’t have a lot of relevant clients and I thought I needed to do something. As I was getting money from my night shift I was supporting my mother while I stayed with her, I bought my mom a house. So there was a house to pay for. Fortunately I was driving a car that was paid for and I didn’t have a lot of bills. There was a lady who was doing my admin and I had to pay her with the salary I was getting from the hospital. That was the plan and it worked. I did my night shift up until I had to move from that space to a better space in Pimville. I worked from there but still it was a struggle because a business needs capital and you need somebody to help you and you need to pay that person. It’s not that easy to get to that point. You might be able to make R500 but that R500 you need to divide at the end of the day. So that’s what running a business is about, and that’s entrepreneurship.

There was a guy who said you don’t start by having a farm, you start with the eggs. And you need that foundation. I didn’t know anything other than operations. I had to go into my own clinic and work from zero, and then one patient. We see our patients every four weeks so, if I’m at the point of seeing 12 or 20 a day I think I have done well. It started from zero. I even said no matter how much you have at the beginning you’ll actually waste it, because you don’t know what you are doing. You need to lay that foundation.

When I look back I started off in that really small space. I had challenges. I had to go back to Cosmo City and at the back of my yard I had to build a Wendy house and set up my clinic there. After that I had an opportunity to go to the shopping centre in Cosmo City, but I had challenges there because I was sub-letting. I thought this sub-letting is not working, only to find I had been evicted. I went back home to the Wendy house in the back of my yard. I sent out SMSes and I was starting to do well.

I built my clientele. Then I found some more space, three times the rent that I was paying, but it was a chance I was willing to take. So I have just set up there. I started off three weeks ago. I’ve been working the whole month of June and I haven’t had a day off. But I’m not complaining, this is my dream. I feel that if this doesn’t work I will be admitted because that’s how much of myself I have given to it. Not that I’m saying I’m giving up. but I’m saying I must always come out with a plan.

TUMISANG NDLOVU: Lastly, where to for your business and yourself, what can we expect?

FREDA MAKANETE: The exciting thing that is happening right now is my business has been selected as one of the businesses that will be micro-franchised. SA Franchise is working with the Department of Small Business Development, so my business has been selected as one of those to be micro-franchised.

TUMISANG NDLOVU: That’s wonderful news.

FREDA MAKANETE: Having to look back it’s not easy. It isn’t easy for me to be in the programme; it actually makes things worse because now my business is being paged through, one by one, to check have you done this and that. I’m struggling with my operational manual, so those are the challenges. I’m a nurse, I’m not a business person. But, because this is my project I have to put myself in there. I have to learn as much as possible and that’s the space I have put myself into.

TUMISANG NDLOVU: We wish you all the best and thank you so much for your time.

FREDA MAKANETE: Thank you very much.

TUMISANG NDLOVU: That was Freda Makanete, the founder of Ubuntu Health Care Clinic in this week’s SME Corner on Moneyweb.

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