Are We Secretly Our Own Worst Enemies?

If you’ve been reading South African news, you’ll know that at least 300 interns and community service doctors stand to be unemployed next year, due to a lack of funded posts at accredited institutions.

Perhaps you read about our inhumane working hours last year.

Perhaps you have read about the overflowing hospitals where patients pile up in the corridors.

These are not new problems, we just hear about them more because doctors and patients have phones with cameras, and social media accounts.

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When I was ill recently (appendicitis) there was a shift of mine that nobody could cover. The hospital should have paid a locum to do it. Instead, people cancelled their plans and shifted around and, with great cost to themselves, made it work.

South African doctors are really good at “making it work”. Maybe that’s why we’re so well-loved in other countries. In a natural disaster, South African doctors will be the ones who work day and night among the injured and ill. They’ll find sleeping space for the destitute, but not for themselves. They’ll jerry rig drip stands. They’ll crack open chests with minimal tools. They’ve seen horror in their own practice, and they won’t be overwhelmed by this horror. Or at the very least, they won’t show it.

We “make it work” every day in state hospitals. And our employers know that we will make it work, and maybe that is why nothing changes.

Our nurses – bless them – have indomitable unions. When they speak, the administration listens, lest they suffer the wrath of a union inciting its members to protest. And they get results.

At my hospital, nursing staff have two 30-minute tea breaks as well as an hour lunch break during their twelve-hour shift. The doctors have no guaranteed break(s). I have eaten my lunch at 01h00 in the morning. I have arrived home after a 26 hour shift and realised that I did not pee my entire shift (and then I wonder why I have a post-call headache).

I have worn surgical gloves two sizes too big because my size had not been in stock at a certain hospital for over two years. I learned how to adjust my technique to avoid slipping. I still ended up with a needle stick injury that year.

I know of people who have worked shifts while hooked up to an IV line, because they knew that their patients would not be seen otherwise.

When we are short-staffed, we make it work. We cut team sizes to the minimum so that everything is covered. We come to work earlier, and finish later. We skip teaching meetings and training and courses because patients are dying, and further education is really a just a privilege, right?

But…

We

Never

Drop

The

Ball.

And maybe that’s the problem.

We stretch our muscles to breaking point to catch all those balls. We become weary and strained, but we hold on.

Maybe if we dropped some of those balls – dropped them so they clattered across the floors, and people stepped on them and tripped over them and they became a real nuisance – maybe then something would change.

Because we say that we are overworked, but all our employers see is patients who are saved at the witching hour.

We say that we are short-staffed, but all they see is that the shifts are covered and the work is done.

We say that we are under-resourced, but then we find private funders for our new ICUs, and to paint our hospitals, and to provide the medication our government will not provide.

Where is the impetus for change? It is not there, because we make it work.

Perhaps we are too proud to let the ball drop. We’re too proud to say, we can’t: we need help. Because isn’t that how we got ourselves through medical school in the first place – by convincing ourselves that we were invincible?

dbf8e6f859df16669b4d3d302c86a486There is a story about an oncology department at a KwaZulu-Natal hospital that had its medical officer program shut down. The remaining doctors left, because they could not run a service without medical officers. Very quickly, the Department of Health funded the MO posts, and the service was up and running again.

Sometimes I think that may be the only way we ever achieve anything.

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South African Books To Read This Heritage Day

Because it’s Heritage Weekend, and I’m working tomorrow (the actual Heritage Day), and I haven’t posted anything bookish in a long time.

I continue to have a love affair with South African (and African continental) books. Below are some of my previous lists on the same topic. (This is not a ranked list. This is a list of more books I’ve discovered since my last list.) (Mh. I thought I had more than two of these…)

Continue reading “South African Books To Read This Heritage Day”

DOC-U-MENTALLY: The Film [Review]

Breaking this unintentional hiatus to tell you (read: shout from the rooftops) that I have watched Doc-u-mentally and

IT.

IS.

AMAZING!

Continue reading “DOC-U-MENTALLY: The Film [Review]”

The Safe Working Hours Wristband Campaign is Missing the Point – Here’s Why

If you’ve been paying attention, working hours of doctors (especially junior doctors) have been getting some good airtime over the past few months. The Province of the Western Cape has committed to actively reducing maximum continuous working hours for doctors to twenty-four, the HPCSA has promised to “look into it” (not that we have too much confidence there), and our biggest representative, SAMA (South African Medical Association) has come out in our support.

One of the things to come from all this is the launching of an armband campaign. This has its origins, I believe, from a similar campaign in the UK – although I have not been able to find any source to this link.

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If You Plan To Spend Mandela Day At A Hospital…

Although I believe that community service should be a habit rather than an annual event, I am a big fan of Mandela Day. I’m a child of the 90s, after all, and my first hero was Nelson Mandela. There’s nothing quite like a day where the whole nation reaches out to one another to build morale. (And it’s not just for South Africans!)

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Public hospitals are a popular venue for community service, which is not entirely a bad thing because many of our patients truly fit the description of being disenfranchised.

But every year, my colleagues and I find ourselves a little annoyed by many of the people who arrive to do their bit. Here are some pointers if you intend to visit a hospital this Mandela Day – or any other day. Continue reading “If You Plan To Spend Mandela Day At A Hospital…”

FAQ: Will I Get Into Med School?

Ever since I first posted tips for applying to medicine (in South Africa) in 2014, I have received multiple questions from aspirant medical students.

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The hardest to answer (and thus one of the most popular) is DO I STILL STAND A CHANCE? – usually prefaced with the person’s failure to achieve the desired grades for medical admission, or some other stumbling block. Continue reading “FAQ: Will I Get Into Med School?”