Accessing Quality Healthcare

South Africans are very well aware of the inequalities which exist in our society. Health is one of the glaring issues we are grappling with. The country, along with the rest of the world, is finding ways of capacitating and improving the healthcare system to combat the coronavirus pandemic.

Access to quality healthcare “is a particular concern given the centrality of poor access in perpetuating poverty and inequality”’. Access, here, can be understood in two ways: availability and affordability. Without adequate healthcare facilities in their communities, people living in these communities are disadvantaged. Likewise, without the financial means to receive the required quality healthcare, many are deprived of the help they sorely need.

South Africa has come a long way since attaining its democracy. South Africa has also inherited and perpetuated many challenges. Quality healthcare is a tug of war, with many citizens who can afford it, opting to utilise private healthcare as it is perceived to be of better quality.

scineAccording to the Institute of Medicine, quality healthcare is “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”. Amidst COVID-19, we have seen drastic improvements; government has realised that this is also the most opportune time to start piloting the controversial National Health Insurance (NHI). President Cyril Ramaphosa, at a recent tour of Charlotte Maxeke Hospital in Johannesburg, mused,  “That is phenomenal, and in many ways this hospital, through the Covid crisis, [is] being transformed to be ready for NHI [National Health Insurance], and we are putting the building blocks in place.”

Dr Rampedi stepped into the STEAM Room with a view that our public healthcare system can do more to benefit those who need it most while ensuring that instead of “perpetuating poverty and inequality”, people’s livelihoods are improved.

bioTell us about yourself

I am Dr Reshoketsoe Rampedi, a general practitioner. I studied in Pretoria and did my internship at the Helen Joseph/Rahima Moosa Mother and Child Hospital complex. I have always believed in providing good quality healthcare for previously disadvantaged communities. At the time, I thought I wanted to be an obstetrician and gynaecologist, and super-specialise in fertility.

 Growing up I looked up to women like Dr Judy Dlamini; I always felt she was the epitome of the black female doctor I wanted to be. I grew up reading books on the first black woman this and that. I have had an interest, even outside of medicine, on how I can positively impact women.

I did my community service in a township called Refilwe in Cullinan. I spent a year there and enjoyed it. It was great. I think that’s where I mostly found my purpose; providing service for people who appreciate what you are doing for them. These people had little or nothing. It’s humbling being able to bring solutions to them; some have had these problems for years but there was no one willing to go the extra mile. This is where I had to say ‘if you are going to start something, finish it; if you won’t do it wholeheartedly, don’t do it all’.

 I have recently been appointed business development manager for Hutz Hospitec, a division of Hutz Medical which is a local medical device manufacturing company.  We offer cost-effective refurbishment and remodelling solutions to existing ailing healthcare facilities.

What does a day in your life look like?

A day in my life is balanced between being at the practice on alternative days, with the remainder of the time at the office. I would like to be part of the 5am club, but the days vary with increasing default with my home exercises ( LOL). But we will get there, baby steps.

That’s another thing about healthcare workers. You work long hours. How do you do it?

What’s important is that you do your work with purpose and passion. That’s what will drive you to get up and make a difference. Yes, we hate having to leave our families and sometimes miss out on dates with friends because ‘I’m on call’’ or  I’m at work… I have had the privilege of working in supportive teams, even from my internship days. I also come from a background where my father is also a doctor and before I started medicine he sat me down on the importance of humility. In our profession you must not forget to be humble. Humility will take you a long way, not forgetting your support structure.

How has COVID 19 impacted the health industry: directly and indirectly?

From the perspective of a general practitioner, we have seen a lot of foot traffic. People are more self-aware. There is also a lot of misinformation. Most of the patients I have seen don’t really understand what COVID-19 is. The impact of fake news has led to the belief that black people can’t get it… people must just drink ginger and garlic… one must swallow their cough because the stomach acid will kill the virus, etc.

Fake news is serious. The impact of someone like a prophet saying lockdown doesn’t work goes a long way because people believe them: if they could drink petrol because a priest said so… You can imagine the impact they have in our society.

People must rely on NDOH, WHO and NICD with credible information; The NDOH has a dedicated whatsapp number which contributes towards the latest updates and is quite informative. COVID-19 extensively covered by all news networks, and the information overload also contributes to the anxiety we see in many of our patients 

Indirectly, I have seen the social impact COVID-19 has had. Fortunately for us, we are essential workers so we are working every day. Some people, it’s no work no pay. On my way to work, I drive through the community of Diepsloot; we say wash your hands, isolate and social distance but they don’t have the space to social distance.

On the education front, especially in our poorer communities, children assume it’s a normal school holiday. Some parents are taking the initiative to help them with school work. But some don’t have that liberty, some of them are with grandparents.

 On the positive side of things, this pandemic has presented opportunities for telehealth and telemedicine. In already established rapport between healthcare worker and patient and depending on how sever the condition is, we can have video or telephonic consultations. You don’t have to close shop but use technology to adapt to the current situation.

It has also opened up a number of opportunities for the local manufacturing industry. This clearly indicates our capability as Africans.

Which takes us to our last question on life post-lockdown. What can the health sector do and what should people do to better equip themselves?

The reality is a lot of jobs will have to be shed based on the impact of COVID-19. If you can adapt and remain operational now, during COVID-19, it will be advantageous. Adapting post-COVID-19 will depend on the skillset you acquired during this time.

In as much as technology is an enabler, we need to adapt technology to suit our context. We can see this through collaboration. Collaborations with government and the private sector should not end when COVID-19 ends. It should be ongoing. This moment is a test to see if we can come together in the long term and work together to make our health system work.

Rural areas, for example, can have mobile radiology testing which can be operated remotely. We can train community healthcare workers to do these and people do not have to break their pockets every time they need healthcare services.

It’s an opportunity for us to not divert, but adapt. We have the opportunity to train, reskill and upskill the youth and community. 

What is clear is that we have been afforded opportunities to reset, rebuild and do things better than we have in the past. By improving our public healthcare system, we will be impacting on the livelihood of patients and concurrently creating employment opportunities. For South Africa to realise this, as Dr Rampedi has mentioned, we need to collaborate. There is power in unity.

McLaren, Zoe; Ardington, Cally; Leibbrandt, Murray. 2013.  Distance as a barrier to health care access in South Africa

About the Author:

Amandla Kwinana is a strategic content and communications specialist and member of the Womandla Foundation STEAM Committee.    

About the STEAM Room

The STEAM Room is a space for women in STEAM (Science, Technology, Engineering, Arts and Mathematics) to explore innovative solutions to the challenges facing our communities and share intriguing stories from their respective worlds. The platform also provides an opportunity for STEAM entrepreneurs to profile their ventures. As with a traditional steam room, women step out of the STEAM Room feeling rejuvenated. 

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