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Durban - “Cadre deployment” was a driving force behind the exodus of young doctors from the public health sector, the SA Medical Association has warned.

Association chairman Dr Mzukisi Grootboom said it was only politicians who believed doctors were leaving because of poor pay.

“You have someone with no medical background or experience running a medical institution, which in itself lacks adequate necessary equipment - or where the machinery is available, it is found to be dysfunctional,” he told the Daily News in an interview on Monday.

“These young doctors are fresh from university and they need mentors. They get frustrated when they are unable to attend to patients, some in critical condition, because of dysfunctional machinery and shortage of medicine.”

Grootboom said it was a fallacy that doctors were looking outside the public sector for better salaries and working conditions. “The exodus of young doctors from the public sector is caused, among other things, by cadre deployment.”

And the government was wrong, he said, in thinking the solution to filling the gap lay only in sending students to places like Cuba for medical training.

The exercise was yet to be proven successful, in KwaZulu-Natal and the country at large, said Grootboom.

There had also been a growing concern that existing medical schools could not accommodate huge numbers of students, but sending students overseas was not the answer, he said.

“We train between 1 350 and 1 500 students per year, and that’s not enough because the demand is huge. We need to train about 15 000 to 20 000 students (across all medical disciplines) a year to meet the demand,” he said. “We therefore need to establish more medical schools in our own country. Those universities can be programmed to emphasise primary healthcare, as is the case in Cuba.

“We need a serious dialogue on what needs to be done to improve and provide quality healthcare services,” said Grootboom.

DA MPL on health, Imran Keeka, agreed there was a need for more medical universities in South Africa.

“Our position is that to close the gap in the healthcare sector, we need to spend every cent on improving and developing our own healthcare system,” he said.

Since the Cuban programme started in 1999, 85 KZN students had been trained as doctors and were practising in the province.

More than 700 first to fifth year students were currently on the programme. Next month KZN is sending 110 first year students to Cuba.

Health MEC Dr Sibongiseni Dhlomo said on Monday that the programme was a success.

But, addressing about 200 medical students who were back home on holiday from Cuba, the MEC said eight students had been sent packing this year for various transgressions, including alcohol abuse, drug possession and damage to university property while under the influence of alcohol.

Two were expelled after a student from KZN impregnated another student from the Free State, he said.

All the expelled students were in their second and fifth years of study.

“The rules are strict in that country and crime is not tolerated. We feel bad about those who misbehaved because some of them were on their final year in Cuba,” he said. “They would be coming back home by June next year. This is a loss to their families because now they are back with nothing. They only have their matric certificates in their names because they can’t go to a South African medical school to complete their studies. You start the programme in Cuba, and you can only finish it there. If for some reason you get expelled, you get no credit here in South Africa for the years you have studied over there.”

Three years ago, two students were expelled after they stole another student’s bank card and withdrew her money.

Asked if the government would demand a refund from the expelled students, Dhlomo said they could not expect cash repayment from the transgressors or those who failed their studies.

“We will look at their various cases and see what we can do to help them. There’s no policy in place to say students who are expelled must be absorbed into another programme. But because they have started their studies, we could say ‘go and do nursing and work for the department for a certain period of time’,” he said.

“Logic tells me they wouldn’t be able to pay back the money and we can only help those who want to mend their behaviour so that they can contribute to the betterment of their communities.”

The 200 students, who will return to Cuba soon, said it was difficult at first to cope with the food, language barrier and the climate.

Nonhlanhla Zuma, a fifth year student, said she found it difficult to cope in the first six months, but because her focus was on achieving her dream of becoming a doctor, she took each day as it came.

“It wasn’t easy. The food (rice, beans and pork sometimes) was awful but through perseverance I pulled through to my fifth year,” said the beaming 26-year-old. “Next year in June I’m coming home for good.”

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