In Afrikaans* there is a saying, “It’s the small foxes that ruin the vineyard,” referring to the tendency of many tiny problems to cause the biggest drama.
Never before have I understood it so clearly as now that I am in the thick of South African public healthcare. We work daily in a hospital that is overcrowded and understaffed, with too many things on the CEO’s plate and too little theatre time for our patients.
We have learned to adjust to these circumstances, because being angry every day makes the working environment unpleasant. But sometimes it is the small things, the absence of tiny luxuries, that plunges one into despair.
- Patient labels – I don’t think anybody realises how much time it takes having to write every detail of your patient on every form and every blood(y) tube. Having access to self-adhesive patient labels really streamlines a ward round. (Our hospital “has” these, but the printers are perpetually broken or otherwise indisposed.)
- Staff parking, or ENOUGH parking – there is nothing that ruins your day before it has even begun quite like jostling for a parking space among visitors, and hoping that nobody will have parked me in when I want to head home that evening. Some days there are no open parking spots available, which necessitates me standing on a random patch of grass and then being glared at by the unsympathetic security guard.
- Not having to stand in a line for half an hour before going home in order to have your car searched in case you’re “stealing things like CT scanners” – if you have no idea what I’m talking about, consider yourself lucky and then read this.
- Elevators that work – I always take the stairs because I have nightmares about elevators and also I think they are a repository for Tuberculosis. But it really is a massive problem when you need to get your patient up to theater and the closest working elevator is on the other side of the hospital.
- Theatre scrubs that fit – I’m certain our hospitals purchase theatre scrubs in size XL, XXL and XXXL only. At 1,56m tall, that may as well be a tent. My theatre repertoire includes altering the scrubs with a variety of safety pins and adhesives in an effort to avoid indecency while operating.
- A decent hospital cafeteria – you know, something that offers meals other than greasy sausages, overcooked chicken or lardy pastry pies.
- WiFi – not to browse the internet, but to access patient results! Although our hospital has wifi, it is so slow that I may as well use the ward desktop computers.
- Nevermind nr. 7 above – just give me sufficient cellular reception! At both hospitals the cellular network is dismal, so I cannot even check results on my own account.
You could say that these small luxuries are just that: luxuries, and selfishly so. But a pleasant working environment is important, and I don’t see why doctors should be excluded from that. In fact, if our country’s public sector truly wishes to retain its doctors, it is rapidly going to need to demonstrate concern for their doctors’ professional circumstances.
*Apparently this is not an Afrikaans saying but a verse from the Bible! Whoops.