The Big Read: SA a cruel home for kind hearts

06 June 2014 - 02:21 By Jonathan Jansen

Emily (not her real name) graduated with her social work degree this year, but after a short internship with the provincial department of social development, she decided to abandon the profession.

An idealist since she can remember, Emily wanted to help broken families and work with abandoned children - the kind of stuff energetic, ambitious, committed youth everywhere want to do. But the internship was a disaster. Her application forms to the department were lost three times. The supervision of her internship at a local school simply did not happen. The glum, slow-moving, half-asleep officials in the department rolled their eyes when she complained about problems on site, such as neglected clients and the shortage of expert counsellors.

"If this is how my profession looks," reasoned Emily, "I do not want to be part of it."

Sanelisiwe (not her real name) finished her medical degree at a Cape Town university and started work at the Red Cross Hospital with the same vigour and dedication as Emily. Here was her chance to make a difference and live the dream of offering paediatric care to poor children. But the hours were so long that she had no time to take care of herself. She was led to believe this was how it was: You work yourself to the bone, often throughout the night, even at the risk of harming patients, because of this ridiculous tradition that young doctors must work until they drop.

Decisions around patients appeared haphazard as doctors seemed to play God with the health of patients. When a young child was sent home too early, and came back worse, Sanelisiwe packed her bags; her enthusiasm and energy drained from her body. Years of preparing to become a doctor came to an abrupt end.

Not a week goes by in which I do not hear different versions of the same story.

It is a troubling story about young people in professions such as nursing, medicine, teaching and social work dropping out when the realities of work in South Africa hit them.

The problems are remarkably similar across sectors - disorganisation in the provincial government departments, burdensome bureaucracy, the lack of responsiveness to complaints, administrative inefficiencies (such as losing forms), tired working cultures, depressing work environments and the absence of leadership. Worst of all, there is the disciplining of enthusiasm - your biggest mistake is to show too much energy, and to come up with all kinds of bright ideas that your new degree instilled in you.

You are left with a very clear message that this kind of vitality shows up the rest of the staff; so back off and fit in.

It would be easy to blame these young people. Working with troubled teenagers or chronically ill patients or families in divorce is a tough business. The young people I talk to get that.

What breaks them, though, is not the patients, it is their leaders and mentors. What destroys the spirit is the dead weight of bureaucracy and the viciousness of politics. It is the culture of laziness, insolence and official inertia that drains their energy.

Then there are the rival stories from their friends who work in highly professional environments with bright lights and modern buildings in the financial sector.

They hear about friends who are actuaries or computer science specialists or financial consultants who travel the world for their companies, and whose six-figure salaries make them comfortable without breaking a sweat.

Of course, they chose a different path but other options look attractive when you work in public hospitals, where budgets for basic medicines run out, or in rural schools where teachers' salaries have not been paid for months.

I could not find hard data on the extent of this problem of young people trained in the helping professions and leaving soon afterwards, burnt and disillusioned. But the accumulation of stories in newspapers, and even a recent book or two, suggests the problem might be more serious than we think.

So what can be done about this? I think government needs to make the revitalisation of the public sector - hospitals, schools, social work departments, among others - a major priority for the next five years. The appointment of strong public-sector leadership selected on the basis of administrative and management competence, not political ties, would be a strong starting point.

Either that, or we lose our most talented and enthusiastic young graduates to the private sector and to other countries while we remain stuck with moribund hospitals, schools and government departments.