Disturbing letter highlights frustrations of SA’s doctors

I am chronically exhausted, feeling disrespected

Excerpts from a letter written by an an aggrieved doctor who asked to remain anonymous for fear of victimisation:

A great many things throughout a medical career can cause one to become disillusioned or disappointed. It is a shame that so many otherwise easily preventable things, such as this, occur in our local healthcare system.

Aside from the obvious difficulties in the application processes for posts, all healthcare workers (nurses, therapists, support staff and others, not just doctors) are subjected to quite poor working conditions. This is both in terms of the physical condition of workplaces and in a broader sense.

Many hospitals do not pay their staff on time, with overtime and regular salaries being delayed for months on many occasions. Attempts to rectify these errors are met with resistance and if followed up often still take a great amount of time and effort to resolve.

Facilities are made to run on very little staff, causing those employed to work longer hours and take up more work. Workers are almost always forced to work the maximum amount of legal overtime hours. Many workers, in fact, regularly exceed the maximum recommended hours of overtime on their contracts but they are never compensated further and no effort is made to recruit more staff to ease the excessive workload burden.

Labour laws are not adhered to very well, or at all in some cases. People are not given time to take breaks after long hours of work. Workers on duty overnight (working shifts longer than 24 hours, usually up to and above 30 hours) are not always provided with safe resting quarters, or opportunities to eat and sustain themselves.

This becomes a frequent feature of working life in the health system, as patient numbers increase while staff dwindle across the board.

The increasing frequency of fatigue, mental health disorders and related consequences in the government health system paints a fairly bleak picture for the future of any of its hard working employees.

These staff who put themselves at significant risk, even on quiet working days, are now pushed to being so exhausted that they can barely prevent themselves from becoming injured or involved in traffic accidents.

The fact that it has even gotten this bad with no sign of improvement indicates a level of neglect from the department of health.

Something that has become so consistent that it is almost expected and even unwittingly/implicitly accepted in some cases; a process that threatens to further hinder any attempts at progress or improvement in this field of work.

These experiences and many more have inspired me, for one, and a lot of my colleagues to steer away from the government health system. Quite an undesirable development considering how much the health system needs more staff. Many are eager to get into private practice or leave the country in order to practice in an environment where they feel their expertise is more appreciated and welcomed, rather than abused and disrespected. There is a persistent feeling that well-trained medical staff are being used almost as though they are expendable; simply loading them with more and more work while assuming they will remain agreeable to the deteriorating conditions and labour law violations.

There have been multiple instances of accomplished medical staff being disrespected by their workplaces, being forced to work in positions for which they are over-qualified in the hopes of being hired for a post they could easily have obtained in the private system or another country.

These and many other instances seem to hint that the South African health system tends to show a certain disregard towards the value of their health professionals.

I actually love being a doctor in South Africa, a place where health professionals get ample experience and comparatively frequent exposure to a multitude of health conditions.

I love interacting with our immensely diverse population and being able to bring positive impacts to their health.

I do, however, enjoy these things a lot less when I am chronically exhausted, feeling disrespected and unappreciated. I have always wished to use my years of training in an environment which respects the effort it takes to be a health professional and doesn’t exploit or inconvenience its employees on a daily basis.

It is because of the multitude of negative experiences I have had and witnessed in the healthcare system that I am now in the process of applying to work abroad.