Discussing healthcare in South Africa usually ends up in a heated conversation. It is generally divided into two area’s: private and public sector. Those exposed to private sector complain about exorbitant fees, and those in the public sector complain about the lack of staff, equipment and patient volume overload which then results in ridiculously long waiting periods. So as you can see, whether the opinion is coming from health professionals working in healthcare, or whether it is coming from patients who are using the service; the general opinion is not a positive one.
The government is trying to change the dire situation by implementing the NHI (National Health Insurance) with the hope to redistribute funds so that the minority of the population doesn’t receive the majority of the funds (which is what is currently happening in the private sector.)
With NHI focus being on areas such as maternal health, reducing child mortality and improving HIV treatment, the government is addressing important issues but their approach to it is incorrect. I have worked in public sector. I have seen firsthand what the lack of equipment, long working hours (doctors being on call for over 24 hours and often up to 32 hours), and poor working environments do to clinicians and other healthcare professionals (HCP). At the end of the day, it is the doctors and HCP’s that decrease mortality and improve treatment. It is the one on one interaction they have with patients that globally affect the statistics and improve South African healthcare. Therefore first and foremost the government should be improving the working environment in the hospitals which will subsequently improve all of these other aspects.
I worked briefly in a few clinics in Alexandra Township in Johannesburg. One of the clinics which had an Emergency Room had recently been given a brand new incubator. There had been an extravagant unveiling with red ribbons being cut. The incubator immediately started gathering dust. No one ever used it. Hundreds of thousands of Rand’s wasted. I first saw the incubator when we were resuscitating a child who was having continual seizures. Of the 6 or 7 drugs that we were taught to use to stop seizures, this clinic only had one of them, and it was the entry-level drug. The clinic was run down, the air conditioning was broken, and it was situated in a dangerous area with poor roads leading to it. The clinic was understaffed because doctors and HCP’s didn’t want to work there due to the bad working conditions. Yes, an incubator will decrease the chance of a new born baby from dying. However, if the doctors and HCP’s aren’t at their peak performance, it will make no difference. Instead of buying an incubator, the money could have been used to directly improve the clinic, which in turn would increase staff morale by bettering the working environment, and ultimately lead to better treatment and a decrease in mortality.