WOZA Internet (Johannesburg). January 19, 2001. Marjolein
Harvey. allAfrica.com
While 34% of current medical interns are reported as saying they want to
leave the country on completing their studies, the fifth group of Cuban doctors
will be arriving in SA on Friday and on January 26. "The group of Cuban
recruits consists of 75 medical doctors and 14 medical lecturers,"
ministerial spokesperson Sibani Mngadi said in a statement.
The Free State is to get four doctors, Gauteng 12, North West 13, KwaZulu-
Natal 18, Mpumalanga four, Eastern Cape 12, Northern Province 10 and Northern
Cape two.
Most of the recruits will be allocated to family medicine, while the medical
lecturers are specialised in orthopaedics, radiology, forensic medicine,
biochemistry, physiology, anatomy, otorhinolaryngology, obstetrics,
microbiology, haematology, laparascopic surgery and biological sciences.
"Presently there are 353 Cuban medical doctors and 22 medical lecturers
[University of Transkei] working in SA," says Mngadi.
He explains that the doctors have been recruited to provide health services
to rural and other disadvantaged communities within which there are no such
services, develop adequate health services in hospitals and other institutions
throughout the country and train and encourage local doctors to work in such
areas and institutions.
"The Cuban doctors already working in SA have brought relief to the
sick and been useful in addressing the problem of shortage of medical personnel,"
says Mngadi.
Research has shown that remote and under-serviced areas are not getting the
doctors they need, even with compulsory community service for doctors. The 1999
Health Systems Trust SA Health Review pointed out that "Doctors' community
service is not fulfilling its aim to get doctors to the peripheral and remote
areas of the country: only 25% of community service doctors are placed in rural
hospitals, while 55% are working in regional, tertiary and specialised
hospitals."
The Democratic Party (DP) has shared its concern in the past that there is
too much emphasis on redeployment and importing doctors from Cuba, and not
enough on retaining doctors in the country.
Local doctors are unhappy. In "A profession under siege", a report
by the Ethics Institute of SA launced in November last year, doctors have
indicated that inadequate remuneration is a major source of stress (91% of
doctors surveyed), while government intervention in the profession (87%) is
another.
What iClinic readers had to say about doctors leaving: * "People that
want to use the resources of SA to become doctors, can't expect to just then be
allowed to emigrate scot free. They should pay their dues back with community
service and until that is completed, they should be barred from emigrating the
same way as someone who hasn't got their proper tax clearance." * "Considering
how much of my tax money went into their education and training, perhaps we
should make them pay it back before they emigrate to another country, or at the
very least the host country should refund ours for the expense." * "I
think we should stop giving professions to people who have a vested interest in
resettling elsewhere anyway. Everyone knows that education and food in SA is
still at least 60% cheaper than the favourite destinations of NZ,OZ, the US, and
the UK." * "Good for all these well-educated doctors. They are needed
elsewhere, where they will be paid a better salary and where they will not be
always looking over their shoulders to see if there is a mugger or burglar or
car hijacker." * "I do not blame them - the conditions in this country
for doctors are dreadful - they sit with study loans and the conditions that
they have to work under are dreadful especially in our state hospitals. AIDS is
such a threat - and what is the government doing to fix this? Further, if they
have their own practices, the medical aids drag their feet to pay the bills -
why should they stay?" * "Please ask how many dentists that completed
their studies in June are still in the country. I know of a large number that
reported for community service, and left quite soon - because of the
circumstances. Not surprisingly these people (some white some black) are now
working in the UK, earning around 6 000 pounds a month after deductions. Why
would any right minded person stay here with the high risk of contracting HIV by
accident from a patient? If Mbeki wants them to stay, he first has to make the
environment such that people will voluntary prefer to stay." SA and Cuba
entered into a health cooperation agreement in October 1996, under the then
Health Minster Nkosazana Dlamini Zuma.
The declaration of intent signed then served to broaden assistance over and
above the deployment of Cuban doctors countrywide. It covers health research,
academic co-operation, health policy and programmes, biotechnology, vaccine
production and pharmaceutical development.
Cuban health minister Dr Carlos Dotres said at the time that Cuba was
assisting more than 25 African countries, but was giving special attention to
SA.
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