My first block for this year was an NMS (neuromusculoskeletal) treatment block. I was placed on campus at the Physiotherapy Clinic. The procedure at the clinic is that outpatients come or call the clinic to book an appointment to see a Physiotherapy student for treatment and assessment. The patients therefore have to pay a fee of R50 per session to see a physiotherapist. Just like most clinics, there is a receptionist that deals with bookings of patients and sorting out the diary according to the physiotherapy students’ availability.
A student came into the Physiotherapy Clinic complaining of shoulder pain, explaining that he dislocated his shoulder the previous day. He had gone to the doctor and was referred to a physiotherapist. The patient told the receptionist that he would like to book an urgent appointment as he was in pain. He pleaded for treatment as he did not have the funds for it. He then approached me because my face was familiar from campus and explained the situation to me. This was a difficult situation for me because I could not help the patient and I was not in a position to overrule the policy of the clinic. Another patient walked into the clinic with money and had an appointment booked for that afternoon.

I felt helpless as an individual that understands the frustration that he might be going through, being denied a human right simply because you have no money is blatantly unjust. I could not speak in front of the receptionist because I did not want to overlap roles in the clinic. I had to stand there powerless and repeat the policy of the clinic to the patient as he thought I would somehow bail him out of the situation.

This case is not only limited to the Physiotherapy clinic because students have to pay to see the doctor or nurse on the campus health center or have to use medical aid. With this institution being disadvantaged and having majority of it’s student coming from disadvantaged families and areas, having a medical aid is a luxury that most students cannot afford. The student therefore have to pay cash to receive health care services. In 2015/6, the campus was shut down due to students not being able to pay their fees. The question is therefore posed – if students are unable to pay their fees, which is the fundamental reason why they are here, how then will they afford to pay for health care services?

The right to health care is important to the well being of all individuals. The right to health care services is provided in 3 sections of the constitution. These include access to health care services that are inclusive of reproductive health and emergency services; basic care for children and medical services for prisoners. Section 27(1)(a) of the constitution states that “Everyone has the right to health care services, including reproductive health care…” , this right is somehow infringed by the clinic in the university. If this right was to be truly fulfilled, every student that comes to the clinic for health care services would receive such as guaranteed by the constitution. In a slight contrary, the constitution in section 27(1)(b) continues to state that the state will take reasonable legislative and other measures , within it’s available resources to achieve the progressive realisation of the right. This statement somehow gives limitations or simultaneously negates the initial right that is supposedly guaranteed by the constitution.
The issue then shifts to patients with financial capabilities being given first preference to health care services in our University/Clinic .

In a research done by Wagstaff (2019), it states that poor countries tend to have worse health outcomes than better off countries and within those countries, poor people tend to have worse health outcomes than better off people. The dilemma above is the perfect example of such, there are various factors that lead to this poor health outcome in poor people such as bad diet, lack of education etc, however this does not eliminate bad health care services that poor people receive as the cause of the worse health outcomes in poor people. Inequalities in health services are always a disadvantage to the poor.

We live in a world that prioritises the needs of the privileged and it is therefore difficult for the less fortunate to have access to basic needs such as health care services. In South Africa, this is worsened by the high level of inequality that is experienced by the lower class and the fact that we live in a developing country. There are situations which are beyond my control as an individual (student). These kind of situations are a result of a broken system and would take global and national interventions.

References

Metin, B. (2017). Right to health. Health Care Academician Journal, 4(1), p.46.
Wagstaff, A. (2019). Poverty and health sector inequalities.. [online] PubMed Central (PMC). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567730/ [Accessed 3 Mar. 2019].