Frustrations

Up until now I've tried to resist writing anything too negative so I'll try to get it all out in one go. I think the worst frustration is that although there is often money available it often gets spent in ridiculous ways. There are so many expensive pieces of equipment lying around that either no-one knows how to use or are not working and no-one knows how to fix them but when you want something simple and cheap it is not available. For example, someone recently installed a very expensive state of the art piece of anaesthetic equipment in our operating theatre, it must have cost £10,000, yet we have no trained anaesthetist and no specialist surgeon with little hope of either arriving soon. Just recently the head of maternity services spent her budget on an enormous desk and comfy chair that are sitting in her office (I think the chair gets more use than the desk); this is in a department that often has inadequate resuscitation equipment for sick newborn babies. It feels like living in dictatorship when the despot spends the last of the foreign currency on fighter jets rather than grain.

I thought that because South Africa is a middle income country it might be spared some of the corruption found in other African states. However, even in the medical profession there are many stories of doctors who claim full salaries from the government but spend less than half of their time working in the public hosptials and the rest of it working in private practice.

I must balance these frustrations with some of the freedoms that working in this environment gives you compared to working in a First World setting. Paperwork for doctors is generally kept to the minimum required to deliver effective care rather than the excessive amounts required to stand up in court, and similarly it is not necessary to over investigate healthy people for reasons of avoiding litigation rather than because it is what they really need. The bottom line is that wherever you work there will be frustrations, when you move from the Developed to the Developing World you really just swap one set of frustrations for another.