Marion Edmunds and Andy Duffy
WHILE Minister of Health Nkosazana Zuma is inviting Cuban and German doctors to South Africa to heal the nation, the Department of Home Affairs is refusing to give foreign doctors already in the country permanent residence status.
And while Zuma welcomes Cuban doctors with open arms and cigars, other foreign doctors are granted only a years’ registration at a time by the Interim South African Medical and Doctors Council, and they have to pay the ministry a R350 a year work permit fee for every member of their family to remain in the country.
Indian-born Dr Amitabh Mitra, who represents the South African Qualified Doctors Association and works as an orthopaedic surgeon at the Cecilia Makiwane Hospital in the Eastern Cape said efforts to meet both Zuma, and Minister of Home Affairs Dr Mangosuthu Buthelezi to discuss registration had been unsuccessful.
This is despite Zuma publicly mourning the flight of South African doctors to overseas hospitals and emphasising the need to encourage doctors to work in the rural areas in South Africa.
Her ministry is planning to recruit another 200 foreign doctors, extending the programme which has already cost taxpayers R1,4- million in airfares.
The doctors will be recruited from Cuba and Europe between now and June, filling posts in the Northern Province, the Eastern Cape and KwaZulu-Natal.
The programme brings experienced doctors into the country on a short-term basis, filling gaps in under-privileged areas with staff, until local doctors are enticed into the positions permanently.
Around 210 Cuban doctors were brought in under the programme earlier this year, with their flights – totalling $300 000 – paid for by the South African government.
In many provinces, the recruits enjoy free furnished accommodation and official transport between their home and place of work.
Around 8% of the doctors’ salaries – the normal pension contribution – is paid to the Cuban government; the doctors also have Reserve Bank clearance to send part of their wages home. The ministry is now planning to pay for their families to fly across from February.
The decision to recruit more Cubans and Europeans is likely to irk the 1 900 foreign qualified doctors who work in the same underprivileged areas – but outside the ministry’s initiatives.
The ministry, in collaboration with the South African Medical and Dental Council (SAMDC), last year imposed a moratorium on recruiting foreign doctors outside the government’s initiative.
The council has stopped holding the exams which would enable those foreign doctors already here to gain full registration. These doctors are also not allowed to move from their jobs.
A representative for Zuma says restraints on foreign doctors are an attempt to regulate the influx of foreign medical skills. In the past, South Africa has been criticised for draining African countries of their best medical brains.
Mitra said that they were trying to organise a meeting between representatives of the two departments, his association and the SAMDC, but there seemed to be a lot of confusion between departments.
Mitra, who has been working in South Africa three years, said his application for permanent residence had been turned down, and he was currently having to pay for a work permit for himself, his unemployed wife, and one each for his two sons, both below the age of five. Altogether this adds up to R1 400.
Mitra said problems had arisen when the former homeland states had become re- integrated into South Africa, and the foreign doctors in those hospitals – who, he claims, make up 75% of the foreign doctors in South Africa – had been integrated into the national health system, but without holding the necessary documentation.
These doctors, he said, were given only restricted registration, renewable annually. This means that they cannot move into private practice or into other provincial hospitals without permission from the interim SAMDC and they are only allowed to practice under supervision.
The SAMDC president, Dr S Kallichurun, downplayed the problems this week, saying full registration was only denied in the cases where foreign doctors had not written the South African final year medical exams.
“This is not true,” responded Mitra, “This is not a question of exams … we were working in the former homeland states and we have been absorbed into the health system and there are no exams for us to write.” he said.
It appears that South African doctors with foreign qualifications, many of whom were trained in exile, are having as many problems getting full registration. In fact, a group of about 200 such doctors have taken up their case of limited registration with the Human Rights Commission.
The commission has set a provisional date of December 2 for a public hearing where the SAMDC and the foreign doctors can argue their cases.
Commissioner representative Liesl Gerntholtz said these doctors would be arguing that the restricted registration was discriminatory. Many of these doctors, she said, claimed to have been lecturers in medicine in Eastern bloc countries before 1994 and did not want to write exams again.
In the meantime, the Parliamentary Portfolio Committee on Health, has been peppered by representations from both foreign-trained and foreign-born doctors in South Africa, pleading for full acknowledgment of their degrees and skills.
And while some are turning to the authorities, others are looking elsewhere in the world.