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…
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The Road to Better Healthcare … we are at a crossroads.
Following my last post, I have been reflecting further on the failures in public health care in South Africa since 1994. In doing so I reread a book, “Yenza – a blueprint for transformation”, published in 1998 that has been on my bookshelf since then. I worked with the author, Dr. Piet Human, on several occasions during the early days of my time as Head of the Free State Department of Health. Read some twenty years later, the optimism, idealism and hope of the years immediately after 1994, reflected in the book, are poignant given what has transpired since. The opening sentences of his book read as follows: “The present…
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Learning Lessons From The Past 25 years
Why are the public health services in a perilous state in many areas of South Africa? These shortcomings have been brought into sharp focus by the impact of the COVID-19 pandemic. It is true that in 1994 at the time of the democratic transition in this country, that the health services bore the scars of decades of racial segregation. Hospitals and clinics were divided along racial lines with facilities for patients of colour inferior to those available to white patients. When I moved into health management in 1995 as Head of the Free State Department of Health, this difference was a stark reality. It was mirrored by the realities experienced…
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COVID … is there another way to navigate through difficult times?
I have been reflecting on the latest response by Government to the COVID-19 pandemic. The “second wave”, it has been announced, is upon us in South Africa with even the addition a new COVID strain. Daily there are reports of an increasing count of positive COVID tests, intensive care admissions and sadly COVID-related deaths. So what has been the response to the increase in COVID cases? In a previous article I reflected on the need to develop a community-based response rather than a heavy-handed law and order response. As a seasoned health professional, I fully understand the need to carefully husband the health care resources at the country’s disposal to…