Young doctor exposes unfair systems in SA hospitals

“Medicine is a military hierarchy. Juniors are constantly told, ‘This is what your seniors went through,’ and we must just do our time and get it over with.”

These are the words of Yumna Moosa, a former medical intern, who took to Youtube to express her resentment towards the treatment she received from her supervisors. In her video, she plays recordings made with her cellphone, which are concrete proof of senior doctors’ blatant disregard for, and flippant attitude towards, the abuse of interns.

Institutionalised abuse

To begin with, Moosa was compelled to categorise herself by race. Despite her hesitancy to do so, she was shoved into the racial group of “coloured”, irrespective of whether she approved or not. The video makes it apparent that in South Africa’s medical sphere, comments of racism and sexism are only acknowledged if all people who endure such are offended by them. Individual offenses are clearly not considered to be deserving of recognition.

Should interns wish to voice their bitterness over this, they are dismissed by being told that without a formal hearing, no complaint will be addressed. However, even when harassment continues, complaints are not formalised. Based on the response that Moosa received, when speaking out against sexual harassment, this is not surprising.

It seems, that in an effort to conceal the misconduct of his peers, Moosa’s senior doctor attempted to intimidate her. She was warned that by revealing herself as a victim, she would be wrecking her professional future. “You’ll never get another job!” her superior cried. She was made to believe that she was alone in her fight for justice and that no department would welcome someone who is a “loner”.

Although the Health Professions Council of South Africa (HPCSA) offers interns a logbook to record their experience, including feedback on harassment, this book was supposedly useless to Moosa.  As said by Moosa’s superior, “My advice to you - chuck that book away.” This begs the question of why manuals such as this exist, if their use will only hamper the progression of doctors’ careers.

She was warned that by revealing herself as a victim, she would be wrecking her professional future. “You’ll never get another job!” her superior cried.

It appears that that is precisely what Moosa’s Head of Department endeavoured to do. He refused, after Moosa’s two years of rigorous work in hospitals, to allow her to resume practicing as a doctor. He deemed her to be a danger due to underperformance. Fortunately for Moosa, the HPCSA overturned his ruling. She however, has decided that enjoying the benefits of the overturning would not be in her best interest. Instead, she opted to draw attention to the “systematic culture of abuse in medicine”, with the hope that others will be spared the damaging encounters that she underwent. She came to the realisation that following an alternative path would help her find her niche.

Moosa’s video acts as a vivid, rude awakening of the struggles of South Africa’s junior doctors, and the worrying state of the country’s health system. It is a call for change, which is evidently crucial, for South Africa to advance for better health.

UCT's formal response

We contacted the University of Cape Town for comment, which made it clear that the institution recognises this need. The University made the following statement, which appeared on their Health Sciences Faculty website, in response to Moosa’s video:

“The University of Cape Town’s Faculty of Health Sciences notes the actions of Dr Yumna Moosa with regards to the publicising of a video containing audio clips of conversations with senior doctors in KwaZulu-Natal during her internship there. We are incensed at the treatment of Dr Moosa, who graduated from this university and is currently registered to do her PhD in Bioinformatics.
 
We applaud her bravery in taking a stand to raise awareness of the ill-treatment of junior doctors.  We note that disciplinary proceedings of the doctors who are alleged to have victimised her are underway, and appeal to the Health Professions Council of South Africa to attend these expeditiously, appropriately and with the seriousness this warrants.
 
Racism and sexism have been embedded in the health services environment for too long. This is abhorrent and unacceptable.  Senior doctors have the responsibility for coaching and mentoring junior doctors, nurturing values and practices imbued with the highest ethical care. This Faculty is committed to addressing any situation that causes its health professionals to experience any other. Where appropriate, this is dealt with by the Faculty’s Professional Standards Committee.
 
Ill treatment of young doctors works against the values many of us are so passionate about - the basic right of all people to be treated with dignity and respect. The health services workplace is no different to others, and health professional colleagues should not have to be subjected to abuse by senior colleagues. We in the health professions must ensure that we are not part of a system that protects abusers. We call on health professionals who have experienced abuse to come forward and report this to the appropriate bodies so that these practices can be eradicated.  
 
It is the responsibility of health sciences faculties across the country to continue working with health departments to ensure that our junior health professionals are protected from abuse and provided with appropriate support within a system that has made them vulnerable to more senior colleagues.

The health services workplace is no different to others, and health professional colleagues should not have to be subjected to abuse by senior colleagues.
 

In a country where there is a critical shortage of doctors, where our juniors are the future of the health system, we can ill-afford to lose young newly trained doctors.  We must build a health system based on equity and justice where everyone is treated with dignity and respect.”

W24 speaks to Moosa

We also contacted Moosa directly, who said that the above statement by the University, her alma mater, has left her feeling astonished, and thankful for their advocacy. She in addition pointed out that they spread the word about her cause by posting her video on their website.

When speaking of the reaction from the public, Moosa said: “The response has been overwhelmingly supportive and positive. The most powerful part for me has been the number of women doctors (and other professionals) who have messaged me about how they've had similar experiences. This appears to be a common problem.”

She ended off by mentioning that she has thus far been very pleased with her experiences in Durban. Here, she is preparing to register for her PhD in Bioinformatics at the University of Kwa-Zulu Natal, and completing a research fellowship at the Centre for the AIDS Programme of Research in South Africa (CAPRISA).

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