Public health gets a boost

Written by Noluthando Mkhize

The country’s public hospitals are receiving much-needed relief, thanks to the South African Cuban medical doctor programme.

The programme trains South Africans as doctors in Cuba. The candidates for the programme are chosen from rural, under-serviced areas. Once they complete their training, the graduates are placed in outlying rural areas as part of ensuring that health care services reach far flung corners of the country.

The SA-Cuba programme was started in the mid-1990s when South Africa and Cuba entered into an agreement known as the Cooperation Agreement in the Field of Public Health. This was to allow Cuban doctors to work in South Africa.

The agreement was revised in 1996 to include the training of South African medical students in Cuba to address shortcomings with regard to disease management in South Africa’s public health sector.

According to the Department of Health, the medical training programme has grown over the years.

When Deputy Minister of Health Joe Phaahla delivered his budget vote early this year, he said close to 3 000 South African students were studying in Cuba.

Limpopo gets a boost

Spokesperson for the Limpopo Department of Health, Billy Teffo, said since 1999 to date, 450 students have been awarded scholarships to study medicine in Cuba.

“A total of 121 students have completed their training and have been placed at various hospitals,” said Teffo, adding that 21 students graduated in July this year at the University of Cape Town and were doing their internship programme.

“A total of 295 students are currently in Cuba in various levels of study.”

The Limpopo Department of Health also sent 110 new recruits to Cuba in September this year to study medicine.

“The programme is delivering positive outcomes because the Cuban-trained doctors are sent to district rural hospitals.”

Teffo said this has a positive impact on primary health care because the Cuban-trained doctors’ training has focused strongly on primary health care, which is the most pressing need at local clinics and community health care centres.

Cuba’s medical system has a strong focus on health education and health promotion, and the success of this approach is reflected in their health statistics, with most Cubans only developing hypertension and other non-communicable diseases quite late in life. There is also a very low rate of communicable disease in the country.

Lessons from Cuba

Matsobane Lekalakala, 33, was trained in Cuba but now works in South Africa, ploughing his skills back into the community in which he lives.

Dr Lekalakala works at the rural Thabaleshoba Health Care Centre near Rebone, about 100 kilometres from Polokwane in Limpopo.

He says that if South Africa is to tackle its burden of disease, an effective primary health care model like Cuba’s is needed.

Primary health care can be defined as providing health care at community level, and making clinics and health care centres the first point of entry to community members.

Dr Lekalakala, who originates from Limpopo, says the major lesson he learnt in Cuba is preventing disease before it happens.

“The Cubans are taught health education at school from a young age. As a result, the rate of communicable disease is very low.

“The mortality rate and infant mortality rate is also very low. They see the doctor very early if they feel unwell because of their strong primary health care system. I dream and hope that one day South Africa will achieve the same kind of primary health system.”

Dr Lekalakala returned from Cuba in 2007 and in 2008 he did his final year of medicine at the University of Limpopo (Medunsa).

“I come from a poor background and going to university was not a given. But I was not discouraged because I knew that through education my life would be turned around.”

Dr Lekalakala explains that after completing matric in 2000, he registered for a degree in optometry at the University of the North.

“My parents did not even have money to pay for my registration, but because I had good marks the university gave me a bursary which also covered my registration costs.”

Optometry was not Dr Lekalakala’s first choice. He wanted to become a doctor but because the university only took a certain number of medical students, he had to settle for a related field of study.

“I did one year of optometry then one day when my father was listening to the radio he heard an advertisement that the government was looking to train young people from disadvantaged backgrounds in Cuba to become doctors. I applied, and I was accepted.”

He said going to Cuba changed his life and has encouraged him to serve his community.

“I have always had a desire to serve my community, especially in the health sector. Throughout my childhood, it was nurses who treated me and never a doctor. I wanted to bring change to my community.”

After graduating, he did his internship and community service at Mankweng Hospital Complex in Pietersburg before being appointed as a medical officer.

In 2013, the Limpopo Department of Health suffered a major blow when four babies died at the George Masebe Hospital in Mokopane because there were no doctors to treat them.

Dr Lekalakala was touched by the story and he resigned from Mankweng Hospital and asked the department to transfer him to George Masebe.

“I felt that the mothers that lost their children could have been members of my family. I felt obliged to help.”

When the Limpopo Health Department opened the Thabaleshoba Health Care Centre, Dr Lekalakala was the first to raise his hand to be the centre’s only doctor.

“My conscience did not allow me to live in an urban area while people in a rural area did not have a doctor.”

On average, he sees between 36 to 40 patients a day. “It’s hard work but seeing my patients happy after treating them is fulfilling. This is enough for me.”

Every year, provincial health departments advertise bursary schemes for young people to be trained in Cuba.

For more information on the bursary, contact your local health district office.