The role of healthcare workers in advocacy

 

bioethics

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“A good physician treats the disease; The great physician treats the patient who has the disease.” Sir William Osler, 1849- 1919

As Sir Osler beautifully puts the idea of patient-healthcare-professional it becomes evident that the most important person with in the entire healthcare system is the “patient” and how I interact with my patients behind those closed blinds in my treatment sessions is what will determine whether I become a good physiotherapist or ‘just another guy you gives patients a quick rub’

As my university career is coming towards it completion I am more aware that I will have to grapple with complex ethical dilemmas within the profession, the art of physiotherapy will become less about the science of the profession and more about ethical issues we face on daily bases. The unfortunate part about how I have been trained is that I was thought the science of the profession and not enough about the ethical issues we will face as physiotherapist on daily basis. We are not told how to deal with racist patients who won`t be treated by black physiotherapist, there are no lectures teaching us how to ask a rape victim to remove her bra so you can auscultate the mid lobes of the lungs.

I do not know what to say to my patient when she says she wants to die, these are very emotionally draining situations that I do not have answers for, the worst part of all it that my patients sometimes think we have all the answers. The truth is healthcare is made of many layers and dynamics of human interactions. When we recognize these dynamics of human interactions, it becomes apparent that the patient-healthcare worker relationship is in essence the foundation of healthcare.

The patients who come into our clinics, they come in search of help and a ‘good’ physiotherapist who will serve the patient with sincerity and professionalism. I recently learnt that a good sincere and professional physiotherapist is not the one who knows all the science but he who can interact with patients on an honest human manner, the one who is able to say I do not know the answer to that question, I do not know the cause of the sharp shooting pain you are feeling radiating down your leg, but I will be happy to find out for you.

Now does this relationship we have with our patient only confined within the bounders of hospital corridor, or does it extend into patients’ lives, do I even have to greet my patients when I see them at the mall? Are healthcare professionals obligated to play multiple-roles roles of advocates, social worker, psychologist and advisory to the patient?

To answer these questions one must know his defined roles within the healthcare system however you take into account the context and resources available at your disposal at any given event, the best question to ask is “what is the worst that could happen if I do this and what is the worst that could happen if I do not do/say this?” then you can weigh the risks and benefits of deciding on a particular route to follow.

Despite the harsh realities of conditions in public healthcare sector, healthcare-workers need to ensure that the patients get the best possible quality healthcare services, which is a basic human right. When delving deeper to this issue, it must always be remembered that to be a good healthcare practitioner requires a life long commitment to be sound professional and ethical practices and dedication to to the interests of fellow human beings and society.

 

References: Health Professions Council of South Africa. Guidelines for Good Health Practice in the Health Care Profession. Paragraph 2.3.8. http://www.hpcsa.co.za/conduct_generic_ethical_rules.php (accessed 16 March 2014) Constitution of the Republic of South Africa, 1996 (Act No. 109 of 1996).

Why black males do not become physiotherapist

caveman

Men are known for their strength violence and agility, we are known for being hunters, we kill beasts with our finger nails, or at least we used to in primitive times. That innate evolutionary instinct of always wanting to be domineering and strong has remained in our chromosomes.

Every once in a while I get this urge to climb a mountain to kill some animals and sometimes  I fell like building a structure that is twice my size or at least keep my beard like a real cave-man, maybe even go to the gym to build my upper body and improve my fist fighting abilities until I look like Stallone or  Schwarzenegger in order to display my  aggressive side.

Every man wants to be declared a man by other men. In my culture every boy must prove that he is no longer a boy by going through a series of initiation in the jungle, he must endure pain with no sedatives, he must survive or die in the jungle. When you reach a certain age where as a boy you feel like you worth more than just being a boy, you challenge the men of the community to declare you a ” man” through a Xhosa initiation process known as “ukwaluka”

After enduring tremendous pain and learning to survive in the jungle on nothing else but your wits, the whole clan declares you a”man” This process has been practiced by our Great grand father Abraham and it has been passed down from generation to generation.Every African child must undergo this rite of passage to be recognized and accepted in society.

There are strict set standards of living that a man is expected to up-hold, unfortunately covering peoples bodies with oil and massaging them is not one of those standards a “real man” is suppose to live up.

A “real man” can be: miner, engineer, doctor or a farmer, these are real manly jobs, because they require a great amount of physical strength and wits. Unfortunately this is the kind of society that millions of black men grow up experiencing and are bound to conform to these standards for the rest of their lives.

I believe it is important that our society starts producing more black male physiotherapist, for a number of reasons which are:

1.Our country needs more physiotherapists in general irregardless of whether they are white or black, male or female.

2. To show the society that we come from that it is OK to be a physiotherapist and it is OK to be a male nurse. 

3. Most importantly I would love to live in a community that allows me to define manhood in my own special way, a community that would allow me to practice what I love, a community that will not limit peoples ability because of their gender.

We need more black males who can dare to challenge the status qoumen

Clinicians of a divided society.

healthcarevalueequation_chalkboard

I had the pleasure of working in small middle class area within the Western Cape. This part of Cape Town presents a different social dynamic as it is situated in a place that is both accessible to the upper-class of the suburban Cape Town and the masses of the lower class in the Cape-flats. Because of these social dynamics I was treating both the rich and the poor.

I often had very interesting conversations with my patients while treating them and I was surprised to hear how much our people do not know and understand each others backgrounds. This is because South Africa is a very divided society, we do not care about the people who die in skwatta-camps (informal settlements) because we do not have to see them dying of malnutrition. We still have an unacceptable gap between the “haves” and the have-“not`s”

Unfortunately this gap is evident even when it comes to accessing good quality healthcare in public hospitals. Generally in South Africa the rich people have their own hospitals and clinics, and the poor people have their hospitals, the rich do not have to see the struggles of the poor and the poor do not have to see the luxuries of the rich.

This statement of a segregated healthcare system sounds rather crude and unacceptable in a democratic state, however when you look at the role that private hospitals seek to serve in our society it is exactly that of further dividing our society.The private healthcare sector in South Africa is solely here to serve the rich.

Poor people are dealt with in over-crowded hospitals that do not even have half the resources that the private sector has. Unfortunately the concept of the :”rich” and poor in South Africa still continues to trend along the racial lines.Why do we need to have two healthcare systems the private sector for the rich and the public sector for the poor?

The private sectors continues to suck the living day light out of the public sector, because it entices the fresh  graduates with money to slave for it. Professionals who serve the public hospitals either still the resources of the public sector to feed the private sector if its not resources that they still it “time” which they should be spending in public hospital.

I believe that South Africa can have one healthcare system that will be accessible and affordable  to every citizen of the country irregardless of their money they have, or do not have. So what are the alternatives to the privatization of healthcare? Where is the health “Rand” to fund an inclusive healthcare system going to come from?

To answer the above questions, I think by the virtue that we will be working together as one we stand a ood chance of running a sustainable healthcare system that serves everyone who is sick. Every healthcare professional that once served a small segment of society will be working together with others to ensure that people are served.

We will not only be getting the professionals we have lost in private healthcare, but we will be getting amazing skills in regards to the management of a healthcare system. The National Healthcare insurance will ensure that every citizen is taken care of.

Lastly my last solution in ensuring the sustainability of a more inclusive healthcare system, I because when one speaks of an inclusive healthcare system we might think that we are speaking of “free services” well that is not necessary the case, I suggest that people who can afford to pay for their healthcare services should be allowed to do so by means of paying a healthcare levy. Citizens will pay 5% of their salary towards their healthcare, and you might ask what about those who are not working, truth is we are already paying for them either way.

How is the 5% levy going to be different from the taxes we are already paying is that, when a person has accumulated enough money or a person never gets sick or find any reason to use his healthcare fund, then s/he  transfare it to a family member that really needs the money or even get some of it back as a

These are feasible ideas that can only work with good governance and create a more inclusive society where everyone can benefit from healthcare services that they so much need.