I used to be a doctor

Two months ago the most senior doctor in the hospital (the clinical manager) left and I was asked to fill his role. This didn’t seem like such a problem as I had watched the job being done for a while and was keen on the extra autonomy so I could make changes to the hospital that I’d had in my mind. What I hadn’t quite factored in however was that in the last year the hospital manager and the manager in administration have also both left and are yet to be replaced. That’s 3 of the top 4 management jobs in the hospital currently vacant.

Filling those gaps are a senior nursing manager who is acting as hospital manager and me who acting as clinical manager. Both of us have been trying to fill in for our old posts, our new posts and somehow the other unfilled ones.

Whilst I previously spent 80% of my time seeing patients and 20% on administrative matters but the numbers are now reversed and this has been a rude awakening to the world of management and administration.

It means that when the water supply to the hospital has not been running for a few days (not an uncommon experience) we are the people the hospital staff turns to. No running water in a hospital is an emergency situation in my opinion and therefore requires pretty much undivided attention until the problem is solve. As a result I can spend a whole day driving around different sites in the antiquated water system, turning on pumps, turning off valves, hitting things with hammers and the like to try to get things going again. A trickle of water might be the result and then 2 days later we have to go through the whole process again.

Learning to be a plumber has been a breeze however compared to being a human resources manager. Something as seemingly simple as getting a staff member added to the national government payment computer can seem like trying to solve the Middle East conflict at times. There are endless phone calls, documents to be signed, faxed, and delivered by hand and when all that is done people are commonly paid at the wrong rate or 2 months late. I’ve already had 2 staff members threaten to leave as a result.

I thought after about 18 months at the hospital that I had learnt almost everything I was going to learn but once again I was wrong; the last 2 months have probably taught me as much about running a hospital as the first 2 months taught me about TB and HIV. In another 2 months time I will be leaving Madwaleni and these problems will be handed on. From a personal perspective I must say I’m relieved, I’m looking forward to being a doctor again.