Portfolio entry for the LOTS block...
Hospital day provides an opportunity for medical students to be exposed to the challenges posed by the healthcare system in South Africa. It creates a sense of social responsibility to the millions of people that rely on the public health care system in this country. To be honest, it can be a bit of an emotional rollercoaster at times. There are times when it is difficult to see the challenges that everyone keeps telling us about. However, in the renal ward at Charlotte Maxeke Johannesburg Academic Hospital it is often difficult to come to terms with the reality that many doctors face.
There are just 120 places for haemodialysis and 80 places for peritoneal dialysis for the whole of Johannesburg. Many patients are excluded based on a long list of qualifying factors. It’s something that is very difficult to accept, because renal failure is not a disease that can be treated with medication. Those that are not part of the lucky few are sent home to die, while private hospitals house dialysis machines that are not always used. To me it seems an unethical practice to let machines go unused. There needs to be a point where human life is valued above money.
When visiting Chris Hani Baragwanath hospital the same issues seemed to be staring me in the face. Orthapaedic patients were being forced to wait more than a year and a half to receive life-altering surgeries. Often people coming to the orthapaedic out patients department have restricted abilities that prevent them from going to work. Not being able to help them timeously adversely affects both them and their families. It creates this cycle of poverty where the poor are unable to work and the rich continuously complain that the country cannot function adequately when only around 10% of the population is paying tax. [1] It creates the perception that the NHI would not work in this country; that it will augment the exodus of the educated few to “greener pastures”.
Medicine is not a profession that should be undertaken in the pursuit of money. By nature, helping people should be done with the intent of helping them, with a complete disregard for cost. In fact, helping people often incurs a personal cost. And there are people that show their true faces in public healthcare, unscarred by the make-up of private healthcare. There are organisations, such as the smile foundation, which help correct cleft lips and palates, free of charge. Perhaps it seems a little unrealistic to wish for a state where health care is free and of a high standard, but is it not something that we should be striving toward?
Recently, while a lecturer was explaining the intricacies of the South African healthcare system, a few students brought up the topic of the NHI. It seemed that their main concern was about how it would affect their income, a clear sign that most were already planning to go into private practice. I have no problem in making them feel guilty. I don’t think that they should be able to live with the fact that they are essentially deserting the millions of people in this country that rely on public healthcare. Perhaps I am different to most of my current GEMP I class, but to be honest, I shouldn’t be.
The issue of private and public is one that is very close to my heart. The discrepancies in resource allocation mean that many people are left without any healthcare, while doctors and hospital administrators of private institutions live lavish lives. I think that it is time that the university began to push the social responsibility aspect of medicine in general. Hopefully those in my class will begin to see that there is more to medicine than money because, if they don’t, the future of healthcare in this country is in the wrong hands.
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