One wheelchair, one lesson. – (Magerman.A)

The frame of a wheelchair is the main structure, which connects the rest of the components together for a long-lasting period. The South African healthcare system represents this wheelchair frame due to the fact that it also consists of different components.

There are 5 layers that form part of the healthcare system which represent the wheelchair wheels: Primary Healthcare (Clinics), District hospitals, Regional hospitals, Tertiary (Academic) hospitals and Central (Academic) hospitals. The right rear wheel represents Tertiary Hospitals where the most crucial challenge with the concept of tertiary medical care is that it is centred on the disease instead of the individual that has the disease. The other challenge is that the term means that normally the affected person is cared for by working up through the three levels of medical care (primary to tertiary) instead of applying tertiary care first. The left rear wheel represents Central Hospitals in which patients suffer because of significant abnormalities going on in these hospitals. There is an extraordinary quantity of individuals who experienced discrimination, regardless of public or private health care. Discrimination changed into additionally one of the primary motives for dissatisfaction in all aspects of provided health care. The principal sources of discrimination recognised by patients are the lack of money, social class and race. The right caster wheel represents Primary Health Care (PHC). Poor service delivery, heavy workload, increased staff turnover, time constraints and uneven distribution of resources had been said as common hassle in PHC clinics. Insufficient staff influences patient care negatively due to the fact that clinicians have trouble in dealing with patients because of the alleged high patient load and lack of skills. As a result, the quality of services can be compromised, as workforce is rushing through all of the patients. The left caster wheel represents the District and Regional Hospitals which paints a concrete illustration of overcrowding‚ shortages of workforce and beds and abandonment of patients. These hospitals ought to work to enhance staff attitudes and duties‚ increase bed capacity and establish a permanent medical institution committee and a strong hospital board. The wheels are what drives this healthcare system. The push handles represents rehabilitation services, another part of the healthcare system, which propels patients to achieve full restoration of function. Poor referral systems, a shortage of staff, lengthy travelling distances and a lack of support are indicated to be the main demanding situations recognised by patients who need to receive rehabilitation in rural areas. Despite the negatives, the patient’s experiences regarding their interaction at rehabilitation were related to them being respected, appreciated and cared for. This resulted from the fact that the rehabilitation professionals were able to provide time to relate to and communicate with the individuals. The patients expressed that they were given the opportunities to express personal goals for rehabilitation and also explained treatment procedures. The wheelchair brakes are the components that permit the wheels to be locked in place, which prevents any unwanted movement therefore it represents hospitals services constantly placing people on hold and inflicting them to wait for hours. One of the motives for the elevated waiting time is the longer duration of consultations due to all the interruptions because of insufficient staff. The back seat represents the backbone of the healthcare system that is supposed to put the patient’s needs as their top priority as well as support them and not take a backseat when it comes to their health. Patients succumb and are left paralysed due to the healthcare system therefore they take a seat in the wheelchair and are unable to revert to overcoming these conditions. Overall, these above components are attached to the wheelchair frame (healthcare system) to generate, not a good, but a functional and operational system.

Public healthcare is government funded and offered to all citizens of South Africa, but there are multiple challenges such as rushed appointments, old facilities, poor disease control, poor quality of care compared to private healthcare and so much more (Young, 2016). Healthcare access, communication and discriminatory experiences are identified as priority areas for actions to improve responsiveness and patient satisfaction in South Africa. The PHC services and facilities sustain a huge burden and responsibility for the availability of health care in South Africa. PHC is the basic mechanism for offering health care (Mahomed, 2019). Physiotherapy forms an essential part of rehabilitation, which in turn forms an integral part of services offered at a PHC level. Provision of physiotherapy services at a PHC level are based completely on the four pillars of PHC particularly promotive, preventative, curative and rehabilitative care (Douglas, 2008). Regional and District Hospitals offer access to high care and short-term ventilation, while Tertiary Hospitals offer services that are further specialised and feature in Intensive Care Units (ICU’s) (Peltzer, 2009). Central Hospitals supply specialised services, regularly in sub-specialities that require skilled employees and costly technology featuring specialised ICU’s (Mahomed, 2019). To conclude, the current state of the South African healthcare is fragmented and does not effectively meet the health care needs of its citizens in a comprehensive delivery system therefore a defragmented system that emphasises the protection and well-being of all citizens could inhibit future challenges (Conmy, 2018). A good health-care system should be based on a medical approach to all the citizens of South Africa’s health.

References

Conmy, A. (2018). South African health care system analysis. Public Health Review, 8.

Douglas, M. (2008). Physiotherapy Services Required at Primary Health Care Level in Gauteng and Limpopo. South African Journal of Physiotherapy, 1-6. Retrieved from https://sajp.co.za/index.php/sajp/article/download/92/89

Mahomed, S. (2019). Cost of intensive care services at a central hospital. SAMJ Research, 35 – 39.

Peltzer, K. (2009). Patient experiences and health system responsiveness in South Africa. BMC Health Services Research, 1-12.

Young, M. (2016). Private vs. Public Healthcare in South Africa. Western Michigan University, 6-24.