Rural Health under the Spotlight at Clinical Conference

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“Rethinking Rural Health Towards a Health Care Revolution” was the theme of the 2014 Students Clinical Conference held at the Nelson R Mandela School of Medicine. 

With major staff problems outside cities and specialised hospitals with no specialist doctors, UKZN is focusing on assisting by creating teaching centres of excellence in rural areas. 

‘By refreshing our curriculum, students shall be trained to work outside Durban and Pietermaritzburg with staff helping to train students in these areas,’ said Professor Richard Hift, Dean and Head of the School of Clinical Medicine, who welcomed students and guests to the Conference. 

‘We will massively increase the time students spend outside modern hospitals and they will be graded on how they can function as young doctors,’ said Hift. 

Dr Pranitha Pillay of the Médecins Sans Frontières/Doctors without Borders (MSF) Rural Health Advocacy Programme, an international medical humanitarian organisation which works in about 70 countries providing medical care, spoke on Social Justice and Student Roles as Future Doctors.  

Pillay explained that ‘there is a superficial understanding to helping make a difference. As students, you belong to a proud tradition of doctors in South Africa and you want to provide a service that has quality and you want to draw patients to healthcare, not push them away. As a doctor, you should put yourself in the shoes of the people you serve. You have to help instead of turning them away. One doesn’t become a doctor to serve oneself.’  

Pillay, who has worked in areas such as Cape Town, Lesotho, India, South Sudan, Sierra Leone and Libya, left a very strong message with the students. ‘Your actions are defined by your inaction. As health care workers, you have to speak out. Our solutions need to revolutionise the issues for the patient and not the doctor. The system needs to be altered to take patients into account. You need to account to those patients who need the assistance more.’ 

Director of the Centre of Rural Health, Dr Bernard Gaede, addressed students on how the rural health agenda was now becoming a site for innovation. ‘Rural areas are often looked at as places that are backward, but with certain sites having reached their 2011 targets in terms of ARV rollout in 2007, this proves that they are not as far behind as people think. 

‘Those in rural areas experience real problems and they are able to function and make things better. Doctors in rural areas are able to improve care and bend certain rules to get positive and quick results.’ 

Dr Mosa Moshabela of the Department of Rural Health at UKZN, said medical research needed to translate what was happening in the real world. ‘Universities used to be places of philosophy and thinking, however that has changed. Coming from a community but not wanting to return there as a doctor to assist is usually the attitude of young medical students. Medical education shouldn’t disconnect students from the needs of people and their responsibilities. You have to experience the shocking realities of the world as a doctor otherwise it will be difficult to relate to reality.’ 

Moshabela also explained to the students how medical education needed to respect the relationship between society and health care.  

Mr Dumisani Gumede from Umthombo for the Support and Recruitment in Rural Health spoke about integration into the rural community and how by working closely with a group of people it was possible to get to know patients personally and be able to work closely with them. ‘A person working in a rural area can access and better the quality of life for the people living there and as students you need to remember that when entering a rural area, you should want to leave the community in a better state than the one you found them in. In rural areas, you get the chance to learn and experience more, as compared to a standard hospital in an urban area.’ 

Mr Mfowethu Zungu, Senior General Manager and Project Manager for the National Health Insurance Policy (NHIP) at the KwaZulu-Natal Department of Health, spoke about the National Health Insurance Policy and its accommodation in rural facilities. ‘As part of our social accountability, the Universal Health Coverage (UHC) defines that people must have access to health services. Most health outcomes will need to be achieved by 2015. The next wave of targets will depend on how countries succeed in universal coverage, as discussed by the WHO,’ said Zungu.  

The Clinical Conference was also a platform for students to present research. 

“Inequitable Access to Health Care in Rural and Urban Settings” was the title of the winning presentation by first year Medical student, Ms Joseline Norman, who won the Student floating trophy and a R 1000 voucher. 

Mr Bahle Tshoba was placed second with his presentation on “Isoniazid Preventive Therapy Implementation” and third was Mr Ndumiso Belunga with a presentation titled: “Implementation of the Principles of Primary Health Care in South Africa”. 

Zakia Jeewa