Point of View: South African Health Care – Lauren-Mae McBlain

Reflection

The photograph that I chose is of a Golden Orb spider that spun a web in my garden. Both the spider and its web can be used as a metaphor, to describe various concerns a patient might have when interacting with the South African Health Care system. 

The South African Health Care System consists of both public and private clinics and hospitals, day hospitals and tertiary hospitals such as Groote Schuur. Patients who have access to medical aid or who can afford higher tariffs, are treated at private hospitals. However, they are in the minority as the majority of South Africa’s population are treated at public hospitals and clinics. Tertiary hospitals are major hospitals which offer a larger range of services. These often serve as teaching facilities for future health professionals.

The spider’s web encompasses most of the photograph. The many intricate strands of the web represent the financial strain that patients face who aren’t covered by medical aid, nor are not fully subsidised by the government. The web could also be interpreted as the struggles patients face to receive ambulatory care from allied health professionals such as physiotherapists. In South Africa, many citizens do not have their own form of private transport, and have to rely on public transport — such as taxis and trains — to get to clinics. Like the multiple strands of the web, patients have to take multiple forms of transport to get to a clinic in time for their appointment. Some patients have to miss work to make it to the appointment on time, and due to inflexible working hours, patients stand to loose their jobs, to attend rehabilitation. The patients would rather forgo outpatient rehabilitation in order to keep their jobs, thus, worsening their impairment. Like a fly trapped in a web, the patient may feel trapped within their impairment due to difficulty of gaining access to rehabilitation. 

The spider at the centre of the image represents possible nosocomial infections. Much like a spider bite, which can be life threatening, a nosocomial infection can cause great harm to the patient. The looming threat of  potential spider bite, is similar to that of a potential infection. Infections in the hospital prey on the immunocompromised patients in the hospitals, much like a spider preying on a fly trapped in its web. 

Literature

The South African Health Department fully subsidises pensioners and the unemployed. There are partial subsidies available for those with individual or household annual incomes below a certain level (Western Cape Government, 2018). There are some exceptions, such as the issuing of medical reports and paternity tests, for which the patients are required to pay in full (Western Cape Government, 2018). Approximately 17% of the South African population is on medical aid (Pretorius, 2017), while approximately 25,2% of our population is considered to be living in poverty (Wilkinson, 2018). This implies that sections of the population have to pay expensive hospital fees, as well as outpatient fees such as physiotherapy themselves. These fees, as well as the cost of transportation will hinder patients from attending their outpatient rehabilitation.

A nosocomial infection is an infection that a person contracts within a hospital unrelated to the ailment for which they were initially admitted (McQuoid-Mason, 2012). Hospitals and clinics are full of immunocompromised patients that are susceptible to contracting nosocomial infections. A study conducted by Nair, Steinberg, Habib, Saeed and Raubenheimer stated that the longer the time one is in hospital, the higher one’s chance of contracting a nosocomial infection (Nair, Steinberg, Habib, Saeed & Raubenheimer, 2018). In addition, a first-person account of  an intern at the Lotus River Primary Hospital, claimed that the hospital was lax when it came to sanitation. The  student’s thesis explained how the urine cups used for urine analysis were not sterilised after a patient had used it, and instead was rinsed out and handed to the next patient (Young, 2016). If sanitation is compromised, then there is a higher chance of the spread of infection. 

Reference list

McQuoid-Mason, D. (2012). Hospital-acquired infections – when are hospitals legally liable?. Retrieved (May 01 2019) from http://www.samj.org.za/index.php/samj/article/view/5664/4125

Nair, A., Steinberg, W., Habib, T., Saeed, H., & Raubenheimer, J. (2018). Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa. South African Family Practice, 60(5), 162-167. doi: 10.1080/20786190.2018.1487211

Pretorius, L. (2017). Does SA’s private healthcare sector only serve 16% of the population?. Retrieved (May 01 2019) from https://africacheck.org/reports/does-sas-private-healthcare-sector-only-provide-care-for-16-of-the-population/ 

Western Cape Government. Subsidised Patients. (2018). Retrieved (May 01 2019) from https://www.westerncape.gov.za/general-publication/western-cape-government-hospital-tariffs-overview?toc_page=3

Wilkinson, K. (2018). FACTSHEET: South Africa’s official poverty numbers | Africa Check. Retrieved (May 01 2019) from https://africacheck.org/factsheets/factsheet-south-africas-official-poverty-numbers/ 

Young, M. (2016). Private vs. Public Healthcare in South Africa. Retrieved (May 01 2019) from https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=3752&context=honors_theses