'Fatigue killed doctor'
Junior doctors are blaming shifts of 30 hours or more for the death in a car accident of young doctor Ilne Markwat. She crashed on her way home from Paarl Hospital on Friday after working a shift of at least 24 hours.The young doctor, who qualified in 2008, was described as someone who went out of her way to help others.Markwat veered into oncoming traffic on the N1 in Paarl in an accident that killed three others.The police have not said what caused the accident but doctors believe working long hours was almost certainly to blame.Markwat worked in the obstetric unit of Paarl Hospital, where interns last year complained to the Junior Doctors' Association of SA about overly long shifts.Legally, a doctor's shift can be 30 hours but many doctors said they worked an average of 300 hours a month.Safe Working Hours is a group of local doctors campaigning to reduce the hours doctors have to work.They said South Africa had "lost a wonderful doctor" in Markwat.The organisation delivered a petition asking for a legal limit of 24 hours a shift to the Health Professions' Council of SA earlier this year. It had 3,000 signatures.The council allegedly did not respond to the petition and failed to answer queries from The Times.Safe Working Hours spokesman Koot Kotze said: "Safe Working Hours directly approached the Department of Health with the same issue. We have not received any feedback."In her blog, intern doctor "Barefoot Megz" said of the accident: "The number of consecutive hours - such as our 24-hour-plus shifts - gives rise to exhaustion so bad you might as well be drunk."I hate how I second-guess my medical judgment when I've been working more than 18 hours. I hate driving home tired and I am afraid that I'll fall asleep."Johannesburg doctor Jonathan Witt said after the accident: "The constant abuse of doctors is disgusting and unacceptable."Cape Town's Red Cross Children's Hospital limited shifts to 27 hours this year after paediatric registrar Alastair McAlpine demonstrated to staff that there was a link between exhaustion and a greater likelihood of making mistakes to the detriment of patients .He warned of car accidents caused by tired doctors and said a shift longer than 16 hours would lead to fatigue that could contribute to an accident.Junior Doctors' Association of SA spokesman Zahid Badroodien said that even though doctors must leave their hospital at 2pm after a 30-hour shift, many are told to keep working by senior doctors."We need to start standing up for our legal rights," he said.Western Cape health department spokesman Mark van der Heever said: "The department manages the overtime duties of all medical interns in accordance with the HPCSA guidelines and the department's own policy."