RUDASA NEWSLETTER
27 March 2004

Rural allowance
Those members working full-time in the public sector would have received the scarce skills allowance and rural allowance by now. RuDASA is delighted that an agreement had been finalised at last - we had first reported on the new rural allowance in our newsletter in March 2003, and had been expecting it to be implemented since July 2003. The negotiations were complex since other health professionals also had to be included. We are positive about the inclusion of other categories of staff. It gives some recognition to the pharmacists, occupational, speech and physiotherapists, psychologists, professional nurses, dieticians and radiographers who work under the same difficult conditions as rural doctors and dentists do. We have written to the Minister of Health commenting on the categories of staff that qualify for the rural allowance. RuDASA recommended that advanced midwives be added to the list of scarce skills, as they are a scarce resource, and very valuable in rural hospitals. In addition, we asked the Department to consider the inclusion of part-time general practitioners for the rural allowance, as they provide a crucial service in many small rural hospitals. We also commented on the classification of hospitals as rural. It is not clear how "rural" was defined, and what the rationale was. South Africa needs a clear definition of "rural". Some hospitals that have been left off the list find it extremely difficult to attract staff.

The new rural allowance is calculated as a percentage of one's annual salary. This is encouraging for senior staff, as the previous rural allowance was the same whether you were an intern or a principal medical officer. We hope that this will act as an incentive to retain senior and other staff in rural hospitals.

SAMA March
RuDASA took part in the SAMA march to Parliament on 6 February 2004. Hoffie Conradie and Elma de Vries carried a poster with the RuDASA logo stating "Rural people deserve quality care". It was a historic occasion, where a clearly united profession made its voice heard. Doctors from many different fields were represented - rural, urban, public, private, academic, black and white. SAMA is now playing the role it should as the union for doctors, and RuDASA will continue to be a special interest group of SAMA.

Next RuDASA conference
Come to each annual RuDASA conference and tour the country! The conference is held in a different province each year, and this year it will be in Limpopo Province. The venue will be the Thohoyandou Nursing Campus, and the date 24-26 September 2004. The RHI will hold a pre-conference on 23 September 2004. The conference theme will be "Quality improvement". The chair of the organising committee is our vice-chairperson, Dr Ntodeni Ndwamato. You may contact her for more details at ndwamato@samedical.co.za or 082 8782855. Abstracts may be submitted to Dr Muwonge at muwonge@samedical.co.za and the deadline for submission of abstracts is 31 July 2004. Diarise it now!

Midlevel workers
The Department of Health has a plan to introduce a new category of health worker, called a midlevel worker or physician assistant. This is based on experience elsewhere in Africa where such workers make a large contribution to health care. RuDASA produced a statement at the 2003 conference in Worcester in which we said that we wish to contribute positively to discussions on the place and development of midlevel medical workers as part of the process of addressing the healthcare needs of rural people. We stated that any plan on midlevel health workers should be part of a comprehensive rural health strategy and, especially, a clear human resource plan for rural health care. We feel strongly that second-rate care for rural people is not an option. Any midlevel worker must be part of the primary health care team and must enhance access to high quality, comprehensive primary health care, in any context, not just the rural one. We have now been consulted and will take part in a two-day workshop at the end of March 2004, organised by the Department of Health.

Membership fees
It was decided at the AGM in August 2003 that the annual RuDASA membership fee would remain R100. Please find a membership form attached. The money is used for teleconferences, travel expenses to meetings (e.g. with the Department of Health), rural research and postage of newsletters. This year we have decided to also give some money to rural student clubs, to be used for rural placements during university vacations.

Rural student clubs
It is an exciting new development that rural student clubs are being formed at more medical schools. They play a role in supporting rural origin students, and in keeping their interest in rural medicine alive during their studies at an urban medical school. The clubs give students the opportunity to work at rural hospitals during university vacations. If you or your hospital can assist with such a placement, please let us know! There is a list of hospitals that take elective students on our website www.rudasa.org.za - add your name to the list!

We will continue to work towards our vision of quality health care for all rural people. Thank you for your contribution!

I hope to see you in Thohoyandou in September!

Elma de Vries
RuDASA Chairperson

PS Please feel free to contact our provincial representatives: