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MEC address interns and community service doctors
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Speeches and Media Releases
 Health

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 EASTERN CAPE PROVINCIAL GOVERNMENT
 SPEECH  BY  M.E.C. FOR HEALTH DR BM GOQWANA
ADDRESSING INTERNS AND COMMUNITY SERVICE DOCTORS
IN CAPE TOWN
3 FEBRUARY 2001



Master of Ceremonies
 Distinguished Colleagues and Guests
 Ladies and Gentlemen:

I am very pleased to be invited to this occasion and deliver this address to you. My intention today is to talk about our national agenda, 
that is, to redress the imbalances we have inherited from the past. Since the adoption of the Constitution, the objective of creating a 
society not defined in terms of colour of the skin has become a constitutional obligation. All organs of the state are therefore legally 
obliged to work towards the creation of this society.

To create a non-racial South Africa must that we do everything in our power for the upliftment of those groups who by virtue of their skin 
colour were marginalized and oppressed, so that these groups are brought to a position of equality with those that were privileged.

A consensus has been reached within the broader spectrum of our society that one of the instruments that should be used to advance this 
noble cause is transformation.

By transformation we understand a process, which would, inter alia, begin with soul searching and getting prepared for the future. 
Transformation is both physically and mentally. Mentally it means we must not only prepare ourselves to change outdated attitudes, but also 
to work towards achieving a society that is transformed.

What does this mean to the Medical Profession? Is it immune from the changes in our society? Are we to be armchair observers?

Before these questions could be answered I invite you to go back with me and reflect on what sort of health service we had in South Africa 
a few years back. If you were Black in this country you did not exist at all, even though you occupied a space. In other words, no health 
services were planned for Black people; hence today it is the Blacks who share the greatest burden of disease.

If we look at role of medical profession within the same period, we see a similar picture. Many medical students had no choice but receive 
medical education at the "infamous" designated Black institutions. For those who ventured to the "whites only" had to get a special 
permission from the government of the day. Some were not even allowed to practice medicine amongst African people, and yet risked their 
lives by going to the townships with or without permit or police escort to provide services to the poorest of the poor.

It was against this background that the organisations like Doctor’s Guilds, NAMDA, ESG, ect. were formed in the 1960’s and 70’s. The 
primary objective was to serve the communities irrespective of boundaries of race, colour or creed.

As we embark on a new form of social re-engineering in South Africa, the medical profession should not be seen to be immune from these 
changes lest it loses its relevance. Our Premier Rev. M. Stofile describes relevance as the will comes from social validation which flows 
from knowledge that your ideas, your knowledge, your efforts are making a visible and real change in the lives of ordinary people.

Let us consider some of the challenges, which face doctors in the 21st century in South Africa.

* In spite of many Technological and Scientific advances in medicine, there is greater suffering and the burden of diseases has increased;
* There are vast inequities between Black, Man and Women, Urban and Rural, in access to basic health care;
* Health Care is perceived by many health care providers as a booming business rather than a service to the public;
* Economic in every region in the developing world are becoming weaker and weaker, governments are operating on reduced budgets, and health 
care services are becoming unaffordable to the majority;
* Even though we have witnessed a rise in affiliation to private medical health insurance schemes, even by Blacks, medical insurance is 
rising at more that double the inflation rate and many of these schemes are in serious financial crises.

Master of Ceremonies; in line with what I have already stated above I wish to point out that in order for us to find relevance for our 
medical profession we have to critically evaluate our history so that we cannot become victims of it. Years of colonialism and apartheid 
have not only dehumanised our people but created a particular mentality within the Black communities that what is best is what comes from a 
white community. Obviously by mere being privileged the white community has been able to consciously and/or unconsciously influence the 
behaviour of those who were not privileged.

We need a new form of social engineering, which not only restores the dignity of the African well-being but that which recognises the 
intellect of the Africans in all aspects of life. In doing so we must be prepared to transform our perceptions and mentality. We cannot 
begin to talk about transformation if we are not prepared psychologically to transform.

Colleagues, Ladies and gentlemen as you are aware the Eastern Cape, especially the Transkei area is rural area which amongst other things 
lacks infrustructural development. Apart from being rural the majority of the population is concentrated in these areas. Consequently many 
of our hospitals are situated in remote areas. Many South African doctors especially the young graduates are unwilling to work in rural 
areas. At present we have Medical doctors - 6/10 000 nationally whereas in EC we have 1/10 000. Most of the doctors who work in these areas 
are foreign doctors, the majority being the Cuban and Asian doctors.

In view of this situation the Eastern Cape Department of Health is currently working on short-term and long-term strategies to deploy 
doctors in these hospitals.

* The deployment of Community Service doctors.
* The department is negotiating with private doctors to do sessions in these hospitals. Once there is a contractual agreement they will be 
able to do sessions in our institutions.
* The Department has set aside an amount of money that will be used to train students from rural areas so that they can come back and serve 
the community. However, this strategy has to be linked to the admission policies of the South African Tertiary Medical Schools. In most 
cases they are not accepted because they are considered not to be academically qualified, without taking into consideration the conditions 
that they had to study. Apart from this fund the Department has also sent a second group of 10 students to study medicine in Cuba. These 
students have been drawn from the ranks of the underprivileged from the rural areas. At present 19 students are doing medicine in Cuba. On 
completion of their studies they will be deployed in these hospitals. However, sending students to Cuba is not an end itself but as a short-
term means to address imbalances in these areas

Apart from these strategies the Department is also working hard to address the issue of incentives for doctors working in these areas. 
These include amongst other things providing adequate accommodation and other facilities such as communication so that they can have access 
to the latest information and many more.

As part of the incentive package, the Department of Health is also busy formulating a policy on Renumeration Outside Work (RWOPS) i.e. 
Limited Private Practice.

Let us continue to work together and let us make the medical profession relevant to the ever-changing environment. I strongly believe that 
this day signifies our vision of African renewal and the aspirations of our people. Let this be the end of the beginning!

Thank you

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