Cuba-trained doctors ‘not ready for the worst in SA hospitals’

Health Minister Dr Aaron Motsoaledi welcoming students
Health Minister Dr Aaron Motsoaledi welcoming students

The next 18 months will be a test of mettle for the returning 714 Cuban-trained medical students.

More than 500 of the students, who spent six years in Cuba as part of the Nelson Mandela/Fidel Castro Medical Training programme, have arrived back in the country over the past two weeks to a hero’s welcome from the department of health and their families.

For the department, the arrival of these sixth and final year students represents a boost in much-needed human resources in the public sector, which Health Minister Aaron Motsoaledi a month ago confessed was “very distressed”.

But for Steve Pheeha, an alumni of the programme, having trained through it in 1999 and currently working at a government hospital, this period the students are entering, in which they will have to put their theory into practice training through university medical schools starting on August 1, is where the challenge begins.

“The first challenge they’ll have to contend with is language. They spent a year studying Spanish because they would be taught in it throughout. And now, coming back, they will have to readjust to understanding medical terminology in English. Some will find that difficult academically, and it will take a while for them to catch up and keep up with their local counterparts. It will depend on an individual’s will and intellectual capacity,” Pheeha told City Press.

Secondly, Pheeha said, Cuba is world-renowned for its comprehensive approach to healthcare, which focuses primarily on disease prevention, health promotion, treatment and rehabilitative medicine, so this presented a training challenge.

The downside to the country’s proficiency in healthcare is that students who have trained there are not exposed to trauma and severe illness beyond textbook theory.

These are rife in this country and the state hospitals they will be entering have backlogs in surgeries and overcrowded emergency rooms.

“Because their system has been so good in addressing preventive health, it’s rare seeing patients come in with severe illness. Cuba is a protected environment, and when you come back to Bara [Chris Hani Baragwanath Academic], you see illness in its worst form.

“There, you rarely see a person go into hospital with bullet wounds. At Bara, you may see 10 people come in with these wounds in a matter of hours,” he said.

“It’s also rare to get any practical experience in birthing a child on that side. These cases are handled by senior doctors and specialists and students are last in line for an opportunity to help deliver,” Pheeha said.

Speaking from experience about his time as a Cuban-trained student, Pheeha said the incoming crop would need to spend as much time doing shadow work as possible to catch up with their local counterparts, who most certainly have been exposed to most of these procedures first hand.

“No one wants to burst their bubble but it’s going to be hard.

“They will be entering some of the best institutions around the country and will find the environments very different.

“This last year of their studies this side offers them a great opportunity to really catch up. There’s no doubt, the sector needs them.

“In South Africa we don’t run short of training opportunities in hospitals. In a way our country’s problems are good for learning so it’s good that they’ve returned,” he said.

Matthew Apostolou, national director of the South African Medical Students’ Association, also highlighted the differences in training style and focus between South Africa and Cuba.

He said it left students trained there at an unfair disadvantage when they were met with the realities of the high local disease burden.

“In Cuba, for example, the mother-to-child transmission rate of HIV is 0%, which is great, but when you get here and find so many cases you have not been prepared for, it’s unfair. They are going to have to put in a lot of work to adjust,” Apostolou said.

Despite the mountainous task ahead of her, Ramatsobane Makgalemane (25), who came back last week, was resolute in her eagerness to get started.

“South Africa needs us, no matter what anyone says. We’ve been called ‘bush doctors’ but we’ve gone through thorough training.

“I’m just praying hospitals give us a chance. We are here to help effect change in the public sector. We’re here for everyone who could never afford medical aid.

“I pledge to work in the public sector for the rest of my life,” said Makgalemane, who is originally from Limpopo but now lives in the Vaal in Gauteng.


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