As I write this, I am challenged by the state of South Africa today. Echoing the words of an American President, Gerald Ford, addressing the United States Congress in his 1975 State of the Union Address when he memorably told his nation that, “the state of the Union is not good” I would say that “the state of South Africa is not good”. South Africans are challenged daily by failures of service delivery from local, provincial and national government as well as State-owned entities. As a South African health professional I am particularly concerned by the impact of these failures on the public health service that serves the majority in this…
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Walking the Road of Healthcare in South Africa … is now available!
As possibly the longest serving head of a Provincial Health Department in South Africa, Dr Craig Househam shares his autobiographical journey: From a youth growing up in apartheid, to a doctor, specialist paediatrician, and the extraordinary career in public service that followed. From the advent of democracy to the AIDS crisis, Dr Househam was at the coalface of South African healthcare. Journey with him as he regales the reader with analysis, anecdotes and insights into the people and decisions that have influenced healthcare in South Africa over the past 25 years. Walking the Road of Healthcare in South Africa: My 40-year Journey
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COVID-19 vaccination … it cannot be a government alone!
This week I accompanied my wife to apply for a new South African passport at a Home Affairs Office that I will not name but located within the Greater Cape Town area. The office opens its doors at 8am but when we arrived just after 6:30am on a midweek morning the queue stretched along the front of building and around a corner. This was where we joined the queue of South Africans patiently waiting in an orderly fashion in the dark for the doors to open. While most people were wearing masks there was no social distancing. Only as it became light did I notice the red lines painted on…
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The COVID-19 pandemic … is the message the problem?
Bill Maher is an American political commentator and television host of a talk show “Real Time” flighted on HBO. Recently he launched into a monologue on this show, as is his wont, addressing the issue of media reporting on the COVID-19 pandemic. Always controversial and provocative I enjoy his take on various issues with an understandable focus on America and things American. The monologue entitled, “Give it to me straight Doc!” started me thinking about the manner in which the South African media has and continues to report on the COVID-19 pandemic. Maher referred to the penchant of media to focus on the negative referring to their approach that, “If…
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National Health Insurance … is the time right?
A recent media report in TimesLIVE (8th April 2021) quotes the National Health Minister, Dr. Zweli Mkhize, as saying that “one of the glaring lessons highlighted by the COVID-19 pandemic is the urgent need for universal health coverage (UHC) to ensure no-one is left behind”. Further “the implementation of National Health Insurance (NHI) is seen as a critical intervention that will assist in restructuring the core components of the health system”. In his opinion central structures such as the Coronavirus Command Council and the Ministerial Advisory Committees created during the pandemic to support governance were able to foster confidence in the interventions proposed and implemented especially those that required a…
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The COVID-19 jab is here … but not for everyone
In mid-January 2021, I wrote a post entitled “Successful Healthcare Delivery … a missing link could be logistics” and at that time I referred to the then stated target of vaccinating 67% of the South African population by at the latest the end of 2021. It has now been admitted that the country will be unable to achieve this target and at best achieve a target of 40% by February 2022, as implementation has “lost a little time”, far removed from the “herd immunity” referred to by the Minister of Health earlier. While the inability of South Africa to procure vaccines due to “richer countries hogging vaccine supplies” and the…
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Piles of Refuse are relevant to Public Health
My thoughts reflected in this post were stimulated recently while driving past both formal and informal housing areas occupied by the less affluent communities in towns and feeling aggrieved by heaps of refuse piled against fences and in gullies in close proximity to homes both formal and informal. As a health professional my immediate thought was of the health risk that this posed to the residents with the rodents and vermin that are likely to flourish in this environment. On a human level, however, I reflected on how unpleasant it must be to live alongside these unsightly and I am sure malodorous piles of rubbish. It was unclear to me…
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Effective people make quality healthcare affordable
Healthcare is people intensive exercise and the cost of employment is the largest component of the budget of every provincial health department in South Africa and elsewhere. It follows that only staff who are skilled and essential at all levels of the organisation to the delivery of quality and affordable healthcare should be employed. Unfortunately, in my experience, the South African Public Health Service has too many people who lack the required skills or are wrongly placed in the organisation resulting in poor performance. It follows also that a person unable to effectively perform his or her allocated tasks, for whatever reason, or who is not essential to the delivery…
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Decisions and Decision Points … the challenge of leadership
Now in my 73rd year, I have the benefit of looking back on decisions that affected the direction of my life. As a schoolboy, I was attracted to the law but a strong dislike of Latin, then a requirement to study law, lead me to enrol as a medical student. Many years later with a successful career as a paediatrician in academia, the politics of South Africa lead me to change direction and move into health management after 1994. Twenty years later, I ended my management career, retiring as the Head of the Western Cape Department of Health. An unplanned course but as the title of my valedictory address delivered…
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Successful healthcare delivery … a missing link could be Logistics
The term “Logistics”is defined in the Merriam-Webster Collegiate Dictionary as “the aspect of military science dealing with procurement, maintenance and transport of materiel, facilities and personnel” or stated otherwise “the handling of the details of the operation”. While the term was initially used in a military sense, the term is now used widely in commerce, to refer to how resources are handled and moved along the supply chain. A brief scan of the internet reveals a multitude of universities offering under-graduate and post-graduate degrees in logistics and logistics management. Promoting these courses universities encourage prospective students that embarking on the these courses will prepare them for a successful career in…