RUDASA NEWSLETTER
26 February 2002

The past year has been an exciting one for RuDASA. The organisation is now 5 years old, and increasingly being recognised as an important role player. In the past year RUDASA has been involved in the following important activities.

National Health Summit
A RuDASA delegation was invited to the Health Summit held in Sandton, in November 2001. The purpose of the Summit was for the Department of Health to consult on implementation of policy. We had the opportunity to respond in the debate about public hospitals, and emphasised that district hospitals should be seen as part of the primary health care, and should not be separated from the clinics in a district health system. We could also give input at the different break away groups, and specifically at the Human Resources group. A lot was said about "professional migration" from public to private, from rural to urban, and international. Regarding training for rural practice, our recommendations focused on recruitment of rural origin students, bursaries being linked to contracts, rural exposure, community based curricula and role modelling. The role of foreign health professionals was discussed, and that migration can at times be positive, when others migrate to us, and when people migrate to learn skills, and then come back.

Equity was an important thread through the Summit, with inequities between provinces, urban/rural and public/private being discussed. Steve Reid spoke about equity as part of our response, and said that the measure would be whether a disabled rural woman would have the same access to health care as someone who lives in Sandton!

The future of general practice in South Africa
The GP committee of the HPCSA asked for our input regarding the future of GP in SA. Ian Couper prepared our submission to them, which include the following:
It is accepted that specific skills are needed for rural practice in South Africa, and specific training is needed. However, this must be seen within the context that very few doctors will choose rural practice as a permanent career, and will need to be able to slot into a career path, e.g. Family Medicine, when they return to a town or city. Training someone for too long prior to sending them out to a rural hospital is counter-productive as it merely shortens the total period of availability for public service, and even sometimes entrenches someone in the area where they are training, making movement difficult. It is therefore proposed that Rural medicine should be seen as a specific discipline falling under the umbrella of family medicine, and thus fit in with regulations developed for family medicine, and that Vocational training (VT) for rural practice should be specific, and should allow for the possible awarding of a diploma in rural practice. The full document is available from Ian Couper at couper@lantic.net.

HPCSA's HIV/AIDS Workshop
A representative from RuDASA was invited to the HPCSA's HIV/AIDS Workshop on 7 February. David Cameron reports that the meeting got down to the real business of working out some practical ways of tackling the very real problems facing us. There was unanimous support for a strong recommendation to be sent from the HPCSA to the Department of Health that there needs to be a radical about turn on the AIDS policy. Watch the press for a statement from the HPCSA.

National District Conference
RuDASA was given a slot to talk about "Key issues in rural health" at the National District Conference held in Port Elizabeth on 14 February 2002. Rudi Tethard spoke about factors that can push a doctor into or out of a rural district. He mentioned what a district management team can do, e.g. looking to creating the environment which may attract people, with good supervision and support of doctors; ensuring that housing and related issues are acceptable; and providing opportunities for training e.g. on-site diplomas, Family Medicine degree, rotation through regional hospitals, etc. He also said that doctors are multi-skilled, and that the DMT can capitalise on that, e.g. limited local specialisation through focus on a TB programme, HBC project, etc.

5th RuDASA Conference in Hartwater
The Conference in Hartswater in North West was very successful. Reps from the Human Resources division in National Health attended, to hear first hand about the difficulties facing rural docs. Two motions were passed at the conference, firstly about the tax on housing issue, and secondly about foreign qualified doctors. Prof. Khaya Mfenyana from UNITRA was elected as the first ever Honorary President of RuDASA, for his contribution to rural health.

Tax on hospital housing
The tax on hospital housing hit many rural doctors hard, and sadly some doctors even left. RuDASA wrote to the provincial departments of health, but they said it is the South African Revenue Service (SARS). SAMA faccilitated a meeting between the SARS and RuDASA, where the SARS acknowledged that there is provision for "unique circumstances", and rural doctors' housing should fall under that category. In most cases, the situation has been rectified. Anyone who still experiences problems, please contact us.

Foreign doctors
RuDASA acknowledges that foreign doctors play an essential role in the delivery of health care in rural South Africa. Ian Couper was invited to make presentations at two international conferences, and an international agency, Locumotion, now hosts information on working in South Africa, see their website :http://www.locumotion.com/southafrica/sa.htm

We submitted a proposal to the HPCSA to request that it be made easier for foreign qualified doctors to be registered in South Africa.

SAMA
Steve Reid represents us on the SAMA Board (as part of the Sedhasa grouping), and with the restructuring of SAMA we will have a seat on the smaller Council.

5th WONCA World Conference on Rural Health
The 5th WONCA World Conference on Rural Health will be held in Melbourne, Australia, 30 April - 3 May 2002. Anyone still thinking of going, there is a group discount of 10% available until 31 March. Please contact elmadv@mweb.co.za for more details.

2002 RuDASA Conference
This year's conference will be held at Barberton in Mpumalanga, in keeping with our decision to meet at rural venues. Andrew Cumberledge, Gboyega Ogunbanjo and Julia Blitz are planning an exciting program. Diarise 8-10 August 2002 now!

New Committee
A new committee was elected at the 2001 AGM on 10 August 2002:

RUDASA COMMITTEE MEMBERS 2001/2

Chairperson: Elma de Vries
PO Box 1833, Brackenfell, 7561
elmadv@mweb.co.za
Tel (W): 021-3925161
Tel and fax (H): 021-9825734
Cell: 082 9688796

Vice Chairperson: Rudi Thetard
25 Cannasingel, Beacon Bay, 5241
thetard@eci.co.za
Tel and fax: 043-7481984.
Cell: 083 417 3776

Secretary: John Tumbo
PO Box 14124
Hatfield 0028
Tel 0125214314(W)
0829747087
tumbo@lantic.net

Provincial Reps:

Ex officio members

Previous chairman: Steve Reid
CHESS (Centre for Health and Social Studies), University of Natal, P/Bag X10, Dalbridge, Durban, 4014
sreid@iafrica.com
Phone: 031-2601569
Fax: 031-2601585
Cell: 083 4471907

Previous chairman: Edward Bowen Jones
45 Constance Cawston Rd, Westville, KZN, 3630
ebjones@mweb.co.za
Tel: (W/F) 031-3016527; (H) 031-2664557
Cell: 083 2507190

Previous chairman: Ian Couper
PO Box 1368, Hartbeespoort, 0216
Couper@lantic.net
Tel (w): 012-5214314
Fax: 012-5214172
Cell: 082 7548586

Chairman of Academy of Family Practice/Primary Care:
Marietjie de Villiers
Dept of Family Medicine, PO Box 19063, Tygerberg, 7505
mrdv@gerga.sun.ac.za ,
Tel (w) 021- 9389563; fax 021- 9389153
Cell 082 9251191

RHI Director:
Julia Blitz
PO Box 38268, Faerie Glen, 0043
africsky@mweb.co.za
Tel: (W) 012- 354 2145
Fax: 012- 354 1317

Membership fees for 2002
The AGM held on 10 August 2001, decided to keep annual membership fees at R60. The money is used for sending out letters like this one, teleconferences, sending representatives to meetings, and sponsoring students to attend the RuDASA Conference. A membership form is attached, you may return it to our Honorary Secretary John Tumbo, at PO Box 222, MEDUNSA, 0204, or tumbo@lantic.net . The membership fees may be paid directly to RUDASA bank account the details of which are included in the form.

RuDASA is there for you and your colleagues! Please contact your provincial rep (or volunteer to be a rep!)

Yours sincerely
Elma de Vries
Chairman

Chairman: Dr Elma de Vries 082 9688796 elmadv@mweb.co.za
Secretary: Dr John Tumbo 082 9747087 tumbo@lantic.net

Rural Doctors Association of Southern Africa
PO Box 222, MEDUNSA, 0204
Fax (012) 5214172