Caring for doctors is caring for the community - RuDASA.

Take two dedicated, efficient doctor/ managers out of the mix at a deep rural district hospital and the local health care system begins to implode, leaving a nursing manager scrambling to re-assign remaining staff while the local population is left with the prospect of little more than a mediocre day hospital. The story of the 180-bed Madwaleni Hospital in the Mbashe sub-district (with a population of 262 000, and rated the eighth most deprived sub-district in the country) of Amathole on the north Eastern Cape coast, with its 33 attendant clinics, is a cautionary tale which sadly epitomises so much of South Africa’s human resources health crisis. That an entire community’s health needs can turn on the personal life of a single clinical manager (who left in February last year to marry a woman in Johannesburg, where he was promptly offered a top multi-facetted academic post), portrays the historical neglect of the country’s health care staffing. Dr Richard Cooke, recipient of two Discovery Foundation awards (Family Medicine in 2007 and Rural Health Care last year) told colleagues at the 15th annual Rural Doctors Association of Southern Africa (RuDASA) conference that he nearly ‘burst into tears’ at the prospect of several health care programmes he had initiated during his six-year Madwaleni tenure ‘falling flat’ and jeopardising the health of so many. Shortly before he left Madwaleni, his close ally, a local resident and the hospital manager, one Matron Vinjwa (who was past retirement age), resigned. Cooke’s departure reduced the doctor complement to 9 (foreignqualified doctors and community service medical officers, but without leadership). He could not bring himself to watch ‘from afar’ as all the programmes he had initiated started slipping.