ONE of the sad aspects of life in South Africa today is that the term "public" has become synonymous with mediocrity.
Things markedly improve when they are private. We know about the wide gulf between public schools and private schools. A similar dichotomy exists between private and public hospitals. One system works while the other flounders. One system is world-class and the other third-world and pedestrian.
Which is sad if one considers that most South Africans are poor. For them, private healthcare will forever be out of reach. So it makes sense to make public hospitals places where people can get decent and efficient care, where they will be treated with dignity. Sadly, that is often not the case, as Gauteng premier Nomvula Mokonyane found out this week on a tour to healthcare centres around Soweto. She got a chance to hear how ordinary people battle to gain access to healthcare. One patient told of how she had been to Chris Hani Baragwanath Hospital twice in as many weeks, only to be told each time that there was no medicine for her rash. The biggest hospital in the southern hemisphere without medication for a rash!
Mokonyane was adamant that the province she rules as premier was in no crisis. She said capacity was a major challenge because Gauteng's healthcare system was being used by people from elsewhere as well, straining resources. Fair enough.
But there's no denying that, on the whole, healthcare is not merely feeling the burden but is cracking up. Recently the Sunday Times ran a story of a hospital in crisis in Limpopo where patients bring their own food and water. It is well known that patients from the Eastern Cape prefer to travel the long distance to the Western Cape for treatment they cannot get back home. Mpumalanga is also struggling.
One of the biggest problems is that the health sector has failed to retain skilled and competent doctors. As soon as they qualify, these medics invariably leave the country - unable to bear the strain of coping working long hours in an unfulfilling environment. Evidence suggests that nurses do not fare any better. Underpaid and overworked, they often stop being caring caregivers and become monsters who ill-treat patients - a breaking point reached. The poor working environment makes public hospitals a place you go to because you are poor and don't have medical aid.
What's to be done? We need to fix their management. We need to get administrators who are not necessarily politically connected but are efficient executors of healthcare policy. Once the environment improves, proper equipment and medicine will be obtained; doctors and nurses would not have to leave for greener pastures.
Most importantly, poor people will begin to get the healthcare they deserve, one of the things for which they vote every five years.