To stay or not to stay, that is the question

2010-02-11 00:00

WHEN you enter the surgery department on the ninth floor of the Orange Block at the Charlotte Maxeke Hospital in Johannesburg, you’ll find photographs from cities across the globe posted on the walls, an upmarket doctors’ quarters, sparkling floors and friendly staff. I enter the reception to find the man leading this troop of health-care professionals, ready and waiting.

Professor Ken Boffard, head of surgery at Charlotte Maxeke (formerly Johannesburg General) Hospital, has recently been appointed president of the International Society of Surgery. It’s the first time in the organisation’s 150-year history that the position has been filled by a surgeon from Africa.

But Boffard isn’t quite sure what all the fuss is about. In fact, this self-effacing surgeon is genuinely bemused. It’s not that he doesn’t realise the magnitude of the appointment; it’s just that he knows how good the South Africa medical sector is.

“My appointment is recognition of the health care that we can provide. I’ve been elected because I’m a representative of our health-care system. I don’t enjoy being the hype of it all, I’d rather just get on with it,” he says emphatically.

We’ll let Boffard get on with it gladly so. But, it is worth taking a moment to acknowledge the significance of his appointment. The world’s oldest society of surgeons consists of 4 000 members from 134 countries. It’s an international voice that isn’t dominated by a Western presence and South Africa has already played a significant role in the organisation.

“We’ve developed major education courses worldwide, to a large extent they were engineered here,” says Boffard. “We’ve trained 5 000 Indian doctors in emergency trauma techniques; we’ve taken courses to India, Sri Lanka, Nigeria, Ghana and Uganda. And in the Southern African Development Community (SADC) countries we’ve run major programmes that originated in South Africa.”

Boffard wants to maximise his position to lobby for developing countries and make sure that their voices are heard. Is he inspired by his appointment? No. Terrified?

“Absolutely,” he says with a grin. “I’ll be very disappointed if I don’t achieve something. I also know that I can’t achieve everything I want to, but if I can just get the ball rolling and broaden surgery education to developing countries … In the same way that the World Health Organisation improves incentives for world health, I aim to make the International Society of Surgery (ISS) into a world health organisation of surgery.”

But it’s not all good news. South Africa’s competence in the medical sector has resulted in its doctors being poached. Boffard says that developed countries haven’t trained enough doctors of their own. Australia is short of some 20 000 doctors and it would take them 15 years to train enough doctors to cover the shortfall, he says. So they’re stealing from New Zealand, the United Kingdom and from South Africa. This is a problem.

Boffard recalls that in May 2008, an Australian company arrived in South Africa and obtained a list of all registered anaesthetists from the Health Professions Council. Of the 800 anaesthetists in the country at the time, around 100 of them left. That was catastrophic.

South Africa trains about 1 400 doctors a year and about 650 doctors are poached every year, a practice that Boffard will lobby to end as president of the ISS.

In the L ancet medical journal of February 23, 2007, there was an article on the recruitment of health-care professionals and they asked the question: “Should the wilful recruitment of health-care professionals from developing countries be regarded as a crime against humanity?” That is a heavy quote, but it’s a reality, says Boffard.

So why hasn’t Boffard left? Here medicine is still fun, he says.

“The fun for me is trying to provide a good service with limited resources. To do that you need to have good people to work with. I’m here because of the sort of care this hospital gives.”

He acknowledges that it’s the environment that pushes people out, not medicine. And that’s why he’s doing all he can to make sure that the doctors at Charlotte Maxeke are taken care of.

And it always helps to have a good boss. Boffard reports to Qedani Mahlangu, the MEC for Health and Social Development, who sent out the news to the media of his recent appointment.

“Mahlangu is a most extraordinary woman,” he says with obvious excitement. “I sent her an e-mail at 10.30 pm on a Monday night to tell her about my appointment. At 11.15 pm she replied. I’ve never known an MEC to respond to her own e-mails, let alone at that time of night.”

It’s good news indeed for Gauteng health and despite the lack of resources, it’s obvious that South African medical care is still enviable.

“Our medical care is world class,” Boffard says with a straight face, and I know I’d better believe it. — From South Africa’s source of good news, www.sagoodnews. The Good News

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