Part two of our field trip focused on the health care system here in South Africa, something I have really enjoyed learning about. South Africa is based on pluralistic health care which allows one the choice between public health care or if one can afford the luxury, private health care. Private health care would be similar in comparison to the health care one receives in America and it comprises about 82% of the medical professionals while serving only 16% of the population here in South Africa. Our fieldtrip focused on the public side of health care, one that serves the majority of the population and although it is affordable and accessible to all, it is overcrowded and under resourced. We got the opportunity to talk to a few patients about the health care system and they were very blunt and they weren’t very satisfied with the system as there are often long, long waits involved in just seeing a doctor. Health care in South Africa is founded on a tiered system comprising of three different levels of care. The bottom, referred to as primary health care, is the largest section that focuses on minor and preventative care. All patients, no matter the situation, are first seen at primary care clinics. This serves all of your basic medical needs as they have specialists in countless different areas of medicine and are able to treat most diseases, illnesses, and injuries along with other physical and mental difficulties. They have specialists on site, such as psychiatrists and optometrists, to fulfill the essential needs of patients. I was shocked by the conditions of the clinic as it was far from a normal clinic that I am use to back home. Everything was pretty worn down and dated—even the EKC machine looked like very primitive technology that would have been used in the states in probably the 1970s or 1980s. We were able to walk right through the clinic and even into the trauma unit without question, something that certainly would not be allowed in a clinic back home. I even saw a sign that a sign that informed patients that all eye appointments were booked through the end of the year… wow. Although the largest sum of money is allocated to the primary health care clinics and they have the services to provide treatment to patients, the issue arises that is are not a large enough supply of specialists to meet the demands of the patients. If primary health clinics are unable to assist and fulfill the medical needs of patients or if they require long-term care then they are referred to secondary hospitals. Often these patient’s situations are more serious and require specialized care that is unavailable in primary clinics. We visited Victoria Hospital in Wyneberg and walked right into the hospital through the emergency area to the wards. On the way, I saw metal carts that are used to transport patients throughout the hospitals. From what I was able to see, the carts didn’t seem to have any sort of liners for sanitation however which made me question the sanitation practices of the hospital in general. It didn’t seem as if they took any extra precautions to make sure that everything was in perfect, clean condition like they do back home. I was shocked by the living condition for the patients. We were able to visit a ward and personally it reminded me of a prison rather than a hospital. There were very few private rooms, which were reserved for patients with infectious diseases, while the rest were crammed into small, dorm-like rooms. The place seemed unwelcoming and the dorm-style rooms offered little to no privacy as some didn’t even have curtains separating the patients. I was most taken back by the psych ward which housed four patients in a very small space. The room that we saw, which arguably looked more like a prison cell, sufficiently locked up the patients as the room was equipped with a metal gate and lock along with a security guard that was housed right outside—to me it seemed pretty barbaric and even inhumane. I guess there is a stigma that exists with being classified as a psych patient but the reality of the condition was over and beyond anything I would have expected or even imagined still in existence today. After seeing firsthand the shocking reality of patient conditions within the hospital, I had no idea what to expect as we moved on to the top of the tiered system and visited the tertiary hospital. However, the tertiary hospital was unlike the two we had toured before in that it was well-kept, quiet, and it even offered modern facilities. The rules were a bit more strict as there was a security checkpoint upon entry to the hospital but still very lenient compared to what I’m use to. It seemed much more like an American hospital in terms of upkeep and I presume that sanitation is more of a pressing issue here as everything was relatively clean. I found it interesting that most people here are against the donation of organs for culture and traditional reasons as they place value on certain body parts and there are superstitions involved that have been passed down from previous generations. Anyways, for being so interested in medicine, I found the field trip to be very interesting but I was definitely shocked with what I saw! I couldn’t believe that the psych wards still had locked metal gates with a security guard and the lack of security (even after they have had issues lately with stolen infants), but I guess it’s Africa?!?
Makes you appreciate the health care at home I suppose!