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With respect to David Barr’s piece, I commend him on writing the
article highlighting aspects of South Africa that are convenient to
ignore. However this piece is essentially a personal view and this must be
borne in mind in reading this piece.
The focus in the health care system in South Africa does sometimes
appear to be on other disasters like floods and H1N1 when it should be on
the more obvious disaster manifesting daily and that is something to be
addressed urgently. But one-sided reporting oversimplifies rather complex
issues into bite-sized chunks. More specifically:
Doctors’ cars: This view seems rather paternalistic. I commend him on
his work in rural South Africa. But the view that doctors should not seek
to improve their economical situation until their hospitals are better
equipped is rather absurd. I agree the expensive cars serve to highlight
the glaring inequality but to single this out as a uniquely South African
issue without pointing out that the same thing exists in the UK and other
developed countries is unjust. Inequality exists! Added complexities
related to expectations of doctors, South African and non-South African,
aligned to their race and place in the community exist in post-apartheid
South Africa. But to deny an individual of the right to career and
economic advancement is to ignore what is truly lacking. People will
always seek to improve their lives and governments need strategies to
address retention of doctors. The comment about the doctors working much
less is, in my experience in Cape Town, false. Perhaps hours are kinder in
rural parts; but considering the tougher circumstances within which they
work, it is hardly surprising. Again the view is extremely singular.
Traditional doctors: It is a good point to raise especially as this
sector flourished due to a lack of provision of ARVs by the previous
government. However, it seems a shame that in trying to get a point across
that beneath the world cup much more needs to be done (which is true),
positive or even controversial points have been ignored. For example,
there is currently debate on the potential benefits of formalisation of
traditional healers as practitioners. Despite what doctors are told,
patients visit traditional healers, although rarely in isolation. More
commonly, people take their drugs and supplement them with medicines from
traditional healers. As a result, increasingly some traditional healers
are working with local clinics/hospitals, being trained to give HIV
counseling and testing, to recognize signs of tuberculosis, and to advise
patients to inform their doctors that they are taking traditional
medicines. This seems a much more pragmatic approach than simply advising
patients not to visit traditional healers which only serves to stigmatise
traditional medicines making it less likely that patients inform their
doctors/nurses of traditional medicines they may be taking. So again much
more complex an issue than is portrayed and the “So it’s business as usual
for Dr Feelgood of Zululand and his peers” statement might be true on the
surface but is oversimplified and somewhat misleading.
If progress is to be made, a balanced debate must be had,
acknowledging all sides of the argument. If more balanced information were
readily available then a single point of view would simply add to that.
But in the absence of this, it is irresponsible not to attempt to give a
more comprehensive view because it might take away from one’s argument.
None of what Dr Barr mentions in his article is untrue per se. However
much needed context is often ignored in this piece.
Frenzied Reporting on South Africa
With respect to David Barr’s piece, I commend him on writing the
article highlighting aspects of South Africa that are convenient to
ignore. However this piece is essentially a personal view and this must be
borne in mind in reading this piece.
The focus in the health care system in South Africa does sometimes
appear to be on other disasters like floods and H1N1 when it should be on
the more obvious disaster manifesting daily and that is something to be
addressed urgently. But one-sided reporting oversimplifies rather complex
issues into bite-sized chunks. More specifically:
Doctors’ cars: This view seems rather paternalistic. I commend him on
his work in rural South Africa. But the view that doctors should not seek
to improve their economical situation until their hospitals are better
equipped is rather absurd. I agree the expensive cars serve to highlight
the glaring inequality but to single this out as a uniquely South African
issue without pointing out that the same thing exists in the UK and other
developed countries is unjust. Inequality exists! Added complexities
related to expectations of doctors, South African and non-South African,
aligned to their race and place in the community exist in post-apartheid
South Africa. But to deny an individual of the right to career and
economic advancement is to ignore what is truly lacking. People will
always seek to improve their lives and governments need strategies to
address retention of doctors. The comment about the doctors working much
less is, in my experience in Cape Town, false. Perhaps hours are kinder in
rural parts; but considering the tougher circumstances within which they
work, it is hardly surprising. Again the view is extremely singular.
Traditional doctors: It is a good point to raise especially as this
sector flourished due to a lack of provision of ARVs by the previous
government. However, it seems a shame that in trying to get a point across
that beneath the world cup much more needs to be done (which is true),
positive or even controversial points have been ignored. For example,
there is currently debate on the potential benefits of formalisation of
traditional healers as practitioners. Despite what doctors are told,
patients visit traditional healers, although rarely in isolation. More
commonly, people take their drugs and supplement them with medicines from
traditional healers. As a result, increasingly some traditional healers
are working with local clinics/hospitals, being trained to give HIV
counseling and testing, to recognize signs of tuberculosis, and to advise
patients to inform their doctors that they are taking traditional
medicines. This seems a much more pragmatic approach than simply advising
patients not to visit traditional healers which only serves to stigmatise
traditional medicines making it less likely that patients inform their
doctors/nurses of traditional medicines they may be taking. So again much
more complex an issue than is portrayed and the “So it’s business as usual
for Dr Feelgood of Zululand and his peers” statement might be true on the
surface but is oversimplified and somewhat misleading.
If progress is to be made, a balanced debate must be had,
acknowledging all sides of the argument. If more balanced information were
readily available then a single point of view would simply add to that.
But in the absence of this, it is irresponsible not to attempt to give a
more comprehensive view because it might take away from one’s argument.
None of what Dr Barr mentions in his article is untrue per se. However
much needed context is often ignored in this piece.
Competing interests:
None declared
Competing interests: No competing interests