The poem translated from the original Portuguese is attributed to a Brazilian poet, Mario de Andrade, although there is some doubt if he was the author as there is indeed regarding the title of the poem, “My Soul has a Hat” “I counted my years and realized that I have less time to live by than I have lived so far. I feel like a child who won a pack of candies. At first, he ate them with pleasure, but when he realized that there was little left, he began to taste them intensely. I have no time for endless meetings where the statutes, rules, procedures, and internal regulations are…
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Thoughts on Governance and Leadership … what has gone wrong?
I have not posted on Househam on Health for some time for two reasons. Firstly, as with many others I am sure, I have been shocked, disillusioned and depressed by the scandal that has unfolded at the highest level in the South African public health sector. Secondly, I have been engaged in a project to assess financial management in a provincial department in South Africa which has been both an interesting and challenging experience. These events have led me to reflect again on a question that I was asked some time ago and one that I have asked myself many times. What are the differences between a department of health…
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Walking the Road of Healthcare in South Africa now available!
My book is now available a little earlier than expected on the link below. Your comments are very welcome! https://publisher.co.za/product/walking-the-road-of-healthcare-in-south-africa-my-40-year-journey/
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A reflection on “Echoes of Austerity” … the truth should be told!
I recently, completely by chance, came across a paper published in 2019 in a peer-reviewed journal, Focaal – Journal of Global and Historical Anthropology, authored by a United States based, South African academic, Theodore (Ted) Powers entitled, “Echoes of Austerity”. (https://www.berghahnjournals.com/view/journals/focaal/2019/83/fcl830102.xml?rskey=kneG81&result=1) It was disconcerting to find that I featured as a less than flattering central point of this anthropological discourse on, “Policy, temporality and public health in South Africa”. Further investigation revealed that Powers is an Associate Professor at the University of Iowa having previously been affiliated to the University of Pretoria. In the abstract of the paper he indicates that his intention was “to explore how policy principles associated with…
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The state of South Africa is not good!
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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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…
