Before coming to Afica I was troubled by this point. If I was prepared to donate 6 months of my time to the cause then how should it best be spent when looked at from the point of view of the patients. In short, should I go to Africa and do the work there or alternatively should I stay in the UK, live in a tent in field whilst working extra hours in a UK hospital but sending all the money to someone I trusted in Africa. The thinking was that although the former would be something I would prefer to do for myself perhaps the potential receipients of my 6 months labour would prefer the latter and maybe that was what I should actually do.
While it hasn't taken me all year to work this out I now realise that without a shaddow of doubt the right thing to do is to come and do the work here. As I have eluded to before in these posts it is the shortage of human rather than financial resources that is the biggest problem most of the time.
I'm therefore left wondering if there shouldn't be a shift in thinking regarding the financial needs of hospitals like ours. I will stick to the doctor situation for now although the same could be applied to most other groups. There are 8 doctors working here of whom 5 are foreign, 1 is here as a part of compulsary service and only 2 are South Africans who are here by clear choice. There are 140,000 patients under our care and we are in the middle of an HIV/TB pandemic so the ratios are in no-ones favour. The bottom line is that rural African hospitals can't rely on do-gooder foreign doctors like me in the long-term . I'm personnally very happy with the terms and conditions here (except the lack of hot water!) but I'm not talking about me. For sure a limited amount could be done by tightening compulsary service rules for South African doctors but the reality is that large numbers of staff will only want to come here if the living conditions are excellent and to put it bluntly the salaries are very high.
Significant funds have indeed been chanelled towards improving staff living standards but I can imagine that it would be extremely controversial to direct extra resources towards higher salaries. What I would say is 'look at it from the patients' perpective'- would they rather have a bunch of extra doctors and nurses and rehab. staff etc. or more expensive pieces of equipment that no-one knows how to use or get fixed when they are broken? I think the answer is clear but I suspect the change is very unlikely to happen. Perhaps I should go back to the UK and live in my tent and use the money to fund extra salaries after all!
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3 comments:
Hi,
South africa is a gud place for working .
Staffing
Hi Tom,
I agree the human resource situation is dire here. At Canzibe hospital (also rural Eastern Cape) we have 5 doctors, no pharmacist, no physio, no occupational therapist, social worker.... The list goes on!
In terms of what brings people here, I don't know whether it's salaries that attract health professionals, more than the desire to make a difference in an area where change is really needed. But people need to be exposed to this reality first, and that takes some bravery.
It is so important to document these experiences I think. I must also update my blog. I see less of the medical and more of the human rights / social issues. If you're interested it's aliceclarfelt.iblog.co.za
Alice- The point I was really making was that although some people are attracted by the chance to make a difference there simply aren't enough of those people in the world to fill all the jobs needed. That's why both our hospitals have a number of posts filled by such people but a large number of unfilled posts because there aren't enough like minded people to go around. Maybe I'm wrong and it is possible to find all these people- I certainly hope so. Tom
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