TLC CLOSES DOORS, TURNS PATIENTS BACK

SIDVOKODVO – The Luke Commission (TLC), a vital healthcare provider in Eswatini, has made the unprecedented decision to close its doors due to a critical funding crisis and overwhelming patient demand.  This closure leaves hundreds without access to essential medical care. Echo Vanderwal, Executive Director of TLC, expressed her deep distress at the institution’s inability to meet the growing need.  “TLC has always operated 24/7, 365 days a year,” she emphasised, explaining that “sickness doesn’t take a break, and emergencies don’t wait.”  However, yesterday, for the first time in its history, the gates of TLC were closed.

Beacon

“This is a painful moment for everyone,” Ms Vanderwal stated, describing TLC as ‘a beacon of hope for the nation’. The closure was triggered by the depletion of crucial relief funds, including a short-term E30 million government injection in 2024, which proved insufficient to sustain services long-term. While the exact number of patients turned away is unknown, Vanderwal confirmed that ‘many were turned away both physically and via the TLC hotline’. She explained that they had proactively communicated the closure to minimise wasted journeys. TLC has been a cornerstone of Eswatini’s healthcare system. In 2023, it recorded over 300 000 outpatient visits and 22 000 inpatient nights. 

However, this success has been undermined by escalating demand and inadequate resources. From February 15, 2025, TLC will cease several outpatient services for patients aged 50 and over, and most inpatient services.  “This isn’t because we want to, not because the need has lessened. But because, for the last several years, demand has far outstripped available resources,” Vanderwal clarified. This funding crisis has been a growing concern for the past five years. “We knew foreign aid would shrink,” Vanderwal reflected. “While we didn’t expect it now, the writing was on the wall. We’ve been tirelessly advocating for local, sustainable solutions, but despite visible support from the highest office, corruption and mismanagement have stood in the way.”

Vanderwal expressed gratitude for TLC’s long-standing partnership with PEPFAR through USAID, which has been instrumental in expanding services. “For 15 years, their support has allowed us to do more with less,” she said.  “During the COVID-19 crisis, they were with us in the trenches, helping us care for 90 per cent of the nation’s ICU patients and build the largest PSA oxygen plant in Africa.” Despite these efforts, resources are no longer sufficient. “Today, we can’t stretch any further, and for the first time ever, we close the gate,” Vanderwal said.

Future

She remains committed to advocating for a future where quality healthcare is accessible to all, free from corruption and mismanagement. TLC continues to call for the equitable allocation of national health resources. “We’re grateful for the 2024 government funding, but this is a short-term bridge. We need long-term, sustainable solutions,” Vanderwal emphasised.  “We’re working towards a public-private partnership with the Government of Eswatini to create a diversified funding model.” Currently, TLC is ensuring admitted patients receive necessary care and working with the Ministry of Health to facilitate transfers to other facilities where possible.  “We will never stop advocating for a future where healthcare is a right, not a privilege,” Vanderwal pledged.
*Not real names to protect patients from victimisation.

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