Day 125, It is probably no secret that the highlight of my working week is usually my Friday clinic trips. The flights there play a big part of the attraction but increasingly I am finding the nature of what is done at the clinics to be fascinating.
It is the coalface of healthcare, except it isn’t merely an alternative to the gp surgery. These clinics maybe the only medical health that many of the people here will receive. They deal with acute emergencies, manage anti retroviral therapy provision and even help disseminate social support. Of course the degree to which they succeed is variable and extremely dependent upon the nursing staff and to a lesser extent the doctor that attends.
Last week my clinic, Ezimpondweni, held a special function for Christmas and invited many of its regular patients to attend for a lunch. Before the food were speeches by notable people in the community and some public gift exchanges and a DJ spinning African beats. I was of course not informed of the day’s events in advance and when I arrived there I was told that I would be called out to make a speech about the service and HIV.
Half way through my clinic I was summoned to the podium and with the help of my translator I had to address the hundred or so hungry attendees. I was a little bit embarrassed but managed to blurt something about making sure people take treatment, thanking the staff and saying how HIV is a perfectly manageable condition. They seemed to enjoy it and I was presented with a gift, it didn’t make it any less meaningful that they had spelled my name as Data
I was then invited to eat at the head table with my fellow speakers. Lunch inevitably included chicken, rice and the now familiar staples of chakalaka and butternut. As I ate I noticed that most of the patients in attendance were women and children. I asked one of the clinic staff whether this was because the men were at work during the day but it turns out that it is because mostly it is the women that regularly engage with the clinic services.
If South Africa’s health service is to thrive I feel that it will be through the strength of the clinics that it will do so. It is a shame that often a top down approach means that hospitals tend to get a larger share of the resources to provide for a smaller portion of the population.
Mmmmm... Chicken....
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