Tuesday, June 19, 2007


i have often given a very critical opinion of our sangomas. to tell the truth i try not to write about them too much because if i were to write all the stories i'd probably not write too much else. but there is another side to the whole thing. so for balance, the following...

some time ago i went on a sort of tour around the lowveld to introduce myself to the doctors as a new surgeon. in one of the neighbouring little communities i met a gp. he told me a story that i actually believe. he said that a growing portion of his practice is made of hiv patients. some he keeps controlled on antiretrovirals. some present too late, basically in terminal aids. he usually tries to bustle them off to some or other hospital. (if you've been following my blog lately you'll know this is not too easy at the moment). these people, in their desparate state often ask for a drip, possibly thinking it some sort of powerful western medicine. he complies, reasoning it may not do much but a vitamine boost isn't the worst thing for them. he then told me he struggles to charge them for this. sometimes he doesn't charge. sometimes he works it out that the equipment costs about r40. he puts a small profit margin on and charges about r60. (this is probably around $5). but then he said some of his patients complained because he wasn't giving them the good drip. when he asked what they were on about he was told that other doctors in the area (medunsa graduates according to him) were charging r1000 for putting up a drip for these terminal hiv patients!

interesting. if you are charging that much you are selling the idea of a cure. even if you don't say it the fact that poor people pay that much means they believe it will cure them. the target audience is also a group that is particularly desparate for a cure. especially now that the state hospitals are basically not working. this is intensely shocking to me. they are willing to fleece poor people for their lasts cents just before they die.

now i wonder. who is worse? the sangoma who kills someone by giving him a cow horn enema that he truly believes will help or the doctor who knowingly charges more than the patient can afford for the promise of a cure he knows won't work. yes the modern sangomas are now amongst us.


Anonymous said...

It's really disheartening to see doctors who are actually out to fleece these poor patients instead of endeavouring to help them like your friend is doing.

I like reading your blog occasionally and some of the stories make better reading than a horror story! I'm amazed by your utter dedication to your profession and I salute you for it.

Hope you don't mind me linking to your blog.

Sid Schwab said...

Back before fees and reimbursement were controlled, I heard an OB/gyn tell this: he decided he wanted to cut back on OB, so, rather than simply refuse patients, he decided to raise his rates significantly above everyone else's. He did. And his case load INCREASED!

In depleted patients I generally added MVI (injectible vitamins) to IVs once a day. That yellow bag always impressed.

Bongi said...

we used to call that yellow bag jet fuel. don't know why but it really gave them power. yellow obviously does impress.