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South Africa: Rural Health Workers Honoured

Published on allAfrica by Wilma Stassen

Creativity and an understanding of where your patients come from are key to being a successful rural doctor, says Dr Jenny Nash, who this week was named Rural Doctor of the Year.

Nash, who oversees primary healthcare clinics in Greater Kei in the Eastern Cape, was chosen by her peers in the Rural Doctors Association of Southern Africa (RuDASA) at their annual conference in Worcester this week.

"You have to be able to network with the doctors in the bigger centres and explain about a patient - so you can use WhatsApp, e-mail, send pictures, and sometimes you can save the patients having to travel themselves," says Nash.

Nash adds that it is essential to understand where patients come from "so that you can understand what is influencing patients, why they might not be not taking treatment and some of their beliefs that influence their health".

"I get my inspiration from my faith, and my belief in wanting to help people and more than just giving out pills for every ill. In the rural areas you have amazing people, and in working with the different clinics it is important to draw in the people and all share a common vision. Sometimes it means doing many things that are not in your job description, but in serving the team to work together to achieve a goal," Nash tells Health-e News.

For Jabulile Ndlovu, named Rural Occupational Therapist of the Year, " you have to be multi-skilled", adding that she has to sometimes be a physiotherapist and social worker.

"You have to be sensitive to the needs of the patient and the effort that they've made to present themselves in a health facility, and try not to turn them away," says Ndlovu, from Manguzi Hospital in northern KwaZulu-Natal.

"You have to wreck you brain to come up with a solution. So the achievement of this award is like a handkerchief, wiping all the sweat of the years of frustration."

Meanwhile, Western Cape's rural doctor of the year, Dr Hans Hendriks from the Ceres District Hospital, says "often you are the final frontier for most patients".

"When you're on call, it's only you. You have to sort out the problem, so you need a wide range of skills. What we see in the rural setting is very diverse and you cover the full range of medicine and you have to be able to handle any situation that come your way," says Hendiks.

"When you are a rural doctor you live in the community and you start thinking community. You see where the problems are come up with ideas of how to solve it."

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Press Statement: Rural Awards acknowledge Perseverance in Rural Health

The Pierre Jacques Rural Doctor of the Year award was presented to Dr. Jenny Nash at the 18th Rural Health conference that was held in Worcester, 21-24 September 2014. The Provincial Rural Doctor of the Year award went to Dr. Hans Hendriks from Ceres hospital. The first ever award for the rural therapist of the year was presented to Jabu Ndlovu. What the award recipients have in common, is perseverance to make a difference in rural health, despite multiple challenges. The theme of the rural health conference was resilience, and this is demonstrated in the stories of each recipient.

Click Here for Full Press Statement 

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RURAL DOCTOR OF THE YEAR

We celebrate unsung heroes who makes a difference in a rural context. The Rural Doctors Association of Southern Africa (RuDASA) inaugurated an annual award for the Rural Doctor of the Year in 2002.

The award is presented to a rural doctor, working at the coal face, who is judged by the RuDASA Committee to have made a significant contribution towards rural health in the previous year. It is intended to be awarded to a practicing rural doctor rather than to someone who has made achievements in the academic arena. It is also awarded for a specific contribution within the previous year rather than for long service. The nature of the contribution is not defined given the great variety of work and activities of rural doctors.

The award was named after Dr Pierre Jaques, a founder member of RuDASA and a doyen of rural practice in South Africa. He spent most of his working life at Elim Hospital in rural Limpopo province and has been a tireless advocate for rural health and the role of the rural doctor in South Africa.

The first recipient of the award, in 2002, was Dr Thys von Mollendorf, previously medical superintendent of Rob Ferreira Hospital in Nelspruit, Mpumalanga. Subsequent recipients of the award have been as follows:

2003: Dr Victor Fredlund, from Mseleni Hospital in northern KwaZulu-Natal

2004: Dr Hermann Reuter, from MSF in Lusikisiki in the Eastern Cape

2005: Dr Nigel Hoffman from Rietvlei Hospital in the Eastern Cape

2006: Dr Vanga Siwisa from Taung, North West Province

2007: Dr Gert Marincowitz from Tzaneen, Limpopo Province

2008: Dr Munyadziwa Kwinda, from Donald Fraser Hospital, Limpopo Province

2009: Dr JJ Ogole from Piet Retief Hospital, Mpumalanga

2010: Dr M Kekana from Hlabisa Hospital, KwaZulu-Natal

2011: Dr KR Adigun from Bethal Hospital, Mpumalanga

2012: Dr Kelly Gate from Bethesda Hospital, KwaZulu-Natal

2013: Dr Ben and Taryn Gaunt from Zithulele Hospital, Eastern Cape

2014: Dr Jenny Nash from Amahlathi District, Eastern Cape

 

2015: Dr Ndiviwe Mphothulo from Taung District in North West Province

 

2016: Dr Nomolindo Makubalo from Nelson Mandela Bay District  Eastern Cape

 

CALL FOR NOMINATIONS

 

The RuDASA Committee calls for nominations for the Pierre Jaques Award between April - July each year. Any interested person may nominate a rural doctor working in Southern Africa for consideration of the  Rural Doctor of the Year.  Nominations should be submitted to: This email address is being protected from spambots. You need JavaScript enabled to view it.

Nominations should be accompanied by details of the nominee, including his/her place of work and contact details, as well as a clear motivation as to why the nominee should be considered for the award. Nominators should also provide all their contact details in case more information is required. Please note that current members of the RuDASA committee are not eligible for nomination.

 

The award will be made during the Annual Rural Health Conference.

 

 

 

 

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SA needs Rural Doctors - Opinion Piece

Although working conditions are tough in rural areas, doctors need to go where they are most needed, says a medical student.

Although working conditions are tough in rural areas, doctors need to go where they are most needed - writes medical student. (AFP)

I am a medical student; one of a mere 1 200 that will graduate each year in a country besieged by challenges in delivering health care to a primarily disadvantaged population.

It is not hard to imagine that medical students (and the doctors into whom we are moulded to become) have an inherent social conscience. As students, we want to help and heal people. All of us have worked incredibly hard to access one of the most sought-after study programmes in the country, and continue to work hard to graduate after six intense years of non-stop exams, clinical rotations, skills-building sessions, and hours spent in teaching hospitals around the country.

There is, however, a significant disconnect between student idealism and professional reality, which has been made apparent by the application to the Constitutional Court that junior doctor Miguel Desroches brought against the minister of health and the Health Professions Council of South Africa in February. Desroches objected to being placed in a rural area for his compulsory community service year, which follows two years of internship at a select group of state hospitals or clinics, and is required for doctors to be able to practice medicine in South Africa. The court challenge revolved around him being placed in an area he did not choose to be in, the hospital’s lack of resources, and unreasonably lengthy and exhausting hours.

SA doctors don’t work in rural areas Despite the court dismissing Desroches’s case on February 19, this incident underscores a painful reality: South African trained doctors do not end up working for the people of South Africa. According to a 2009 survey conducted by the Health Systems Trust and Africa Health Placements, of the doctors that graduate annually a tiny fraction – 35 out of 1 200, or just 3% – end up working in rural areas. Yet, just under half of the country’s population resides in rural areas. Each statistic rubs further salt into the wound: According to a 2011 health department document, the three provinces with the highest number of rural inhabitants have the lowest number of medical practitioners, and rural provinces have an average of only 13 general practitioners and two specialists per 100 000 people. The same document noted that in 2010 more than three quarters of all medical posts in Limpopo were unfilled.

The districts with the highest HIV prevalence, such as the Sisonke district in KwaZulu-Natal and the Gert Sibande district in Mpumalanga, are all more than 50% rural. As someone preparing to enter the system, these statistics weigh heavily on my mind. More importantly, so do the people that they represent. Desroches may be able to cite plenty of reasons why he is entitled to avoid the often gruelling working conditions in rural areas. But how far does entitlement extend in a profession where lives and livelihoods are at stake? Dr Mzamo Jakavula, a senior medical officer who served at St Barnabas Hospital in Libode in rural Eastern Cape for his community service year, offers up another perspective. Rural areas provide opportunities He believes that rural work shouldn’t be simply endured, or if possible avoided, but rather viewed as an opportunity to refine your craft and gain an understanding of the real face of South African patients. His words are passionate and inspiring: “Community service is an invaluable tool by which the government forces us medical practitioners to develop a conscience and to serve the poor and neglected. How many young doctors would have otherwise run away immediately after internship? Young doctors have very negative perceptions about rural medicine; the government has to intervene.”

Jakavula admits that his community service year was difficult and frustrating, fraught with substandard accommodation, salary and human-resource issues, and a lack of resources with which to serve patients. However, his resolve and commitment is evident and admirable. “Despite … [the issues] there isn’t a single day that I did not look forward to going to work. You know why? The patient. The typical rural patient is so appreciative of your efforts. “They made me enjoy my work so much. I learnt a lot from working there. I learnt how to be humble. I learnt to love older people and how to communicate with them. I wouldn’t substitute that experience for anything for it is exactly what is lacking in my colleagues today. It is the rural experience which gives doctors the humanity our patients yearn for in us.” Make rural positions attractive Current and future doctors like myself have inherited a health system fragmented by historical inequalities, interspersed with ongoing financial, administrative and logistical challenges that make patient care that much more difficult. It is a field where the rewards and the pitfalls are equally enormous, and the insecurity of operating in a rural area can be so intimidating that we may feel compelled, like Desroches, to fight to stay in our comfort zone.

But patients in rural areas need us to be their voice and advocate for equitable health care for all South Africans. Government and civil society efforts need to focus on making rural health an attractive career option for aspirant doctors, and resources must be diverted into equipping and restoring rural facilities. Over and above, I believe that we need a change in mindset. Students and young doctors need mentorship from doctors like Jakavula, need to hear from the dedicated health professionals who endure the difficulties of rural medicine because it shapes them into practitioners who are versatile, skilled, compassionate and courageous.

We need to be reminded why we do what we do and who we do it for. We need to be constantly reminded of a fundamental truth: community service should not be regarded an inconvenient period in a medical career. A medical career should be cultivated as a continuous act of community service.

Michelle Robinson is a fourth year medical student at the University of the Witwatersrand.

Source: http://mg.co.za/article/2014-04-08-comment-sa-needs-rural-doctors/

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No Mountain Too High for the 2013 Rural Doctors of the Year

RuDASA Press Statement: 

In a context where there are many bad-news stories, it is important that we recognise and celebrate good news. The stories of many dedicated rural doctors who provide amazing care to communities in need are seldom told. The Rural Doctors Association of Southern Africa (RuDASA) inaugurated an annual award for the rural doctor of the year in 2002, to acknowledge some of those unsung heroes.

The award is presented to a rural doctor, working at the coal face, who made a significant contribution towards rural health in the previous year. The award was named after Dr Pierre Jacques, a founder member of RuDASA and a doyen of rural practice in South Africa. He spent most of his working life at Elim Hospital in rural Limpopo province and was a tireless advocate for rural health and the role of the rural doctor in South Africa. The award is presented jointly by RuDASA, the HIV Clinicians’ Society and the Rural Health Advocacy Project.

The award was again presented at the 17th Annual Rural Health Conference in St Lucia on 9 August 2013.

Dr Ben and Dr Taryn Gaunt: Teamwork and Outstanding Local Leadership
The Pierre Jacques award for 2013 was awarded to a doctor couple, Ben and Taryn Gaunt, from Zithulele hospital in the Eastern Cape. The past year has seen some outstanding achievements at Zithulele, including the first cataract operations as part of the Mercy Ships Eastern Cape Mercy Vision Project (there are now cataract lists every 2 weeks at the hospital), a year-on-year perinatal mortality rate that has dropped to under 20 deaths per thousand (a remarkably low number for a rural district hospital), survival for the first time of extremely premature babies with birth-weights of under 1000g (five in total since September 2012 with the record standing at 900g), the award of nearly R2 million from the Anglo American Chairman’s Fund and the Discovery Foundation to build more accommodation for professionals, a dramatic expansion of the ARV programme to more than 4000 patients with the majority of them collecting their treatment at their local clinic and the first hearing aids being fitted at the hospital.

Dr Karl le Roux, who nominated them, said: “Ben and Taryn would be the first to contest that the achievements of the past year are entirely due to the remarkable team of doctors, nurses, therapists and many others that work at Zithulele.  Yet, the existence of this team is in large part due to their obedience to what they felt was God’s call for them to work in rural medicine when they were still students. They themselves are an amazing team – Ben, an excellent clinician, visionary clinical manager and gifted administrator with incredible drive and focus, Taryn, a perfect counterfoil to Ben’s work-aholism, as a homeschooling mom of four kids, and a compassionate clinician with a love for paediatrics and impressive expertise in paediatric TB and HIV. 

Ben reflected on the fact that the health system needs good leaders as well as good followers to make it work, and that every individual is an important member of the team.

Dr Kobus Viljoen: “Sharing a common humanity with patients is fun”
The provincial rural doctor of the year is Dr Kobus Viljoen from Mseleni Hospital in KwaZulu-Natal. He was nominated because of his willingness to go the extra mile for patients. He has been at the hospital for 10 years and speaks isiZulu fluently. In his acceptance speech, he said, “It is actually fun”. He acknowledges that working in a rural hospital can be stressful, but that there is an inherent worth that makes it meaningful. He enjoys the diversity of the work, and is convinced that there is something in our human makeup that thrives on being challenged. He enjoys the common humanity one experiences in a consultation and says that it is important to laugh with patients, to make them feel cared for.

Prof Elisabeth Weiss: Pioneering Passionately for Mental Health
Prof Elisabeth Weiss was awarded a long service award for her tireless work in Limpopo province, where she established outreach and training in psychiatry as well as forensic psychiatric services. Before she established the forensic service in Limpopo in 1998, patients requiring forensic psychiatric assessment had to be sent to Pretoria. A colleague described her as such: “one wonders how she does it, travelling to almost the whole of Limpopo doing community based work, she is one of her kind. She pioneered the whole service but she still works continuously with passion as if she started yesterday.”

The selection committee had a difficult task, as excellent nominations were received from different provinces. Professor Steve Reid spoke at the conference about the values that health professionals in rural areas hold in common:  social justice, a commitment to a community, teamwork, patient relationships, making a difference (agency), being part of a community, a sense of identity and a love of open spaces. Those values were clearly described in the nominations and embodied in the award recipients.  

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