KWAZULU NATAL

BETHESDA HOSPITAL

Bethesda Hospital was founded in 1937 by the Methodist Church and although now run by the provincial government, it retains the atmosphere of a Christian mission hospital. It is situated in the north-eastern corner of KwaZulu Natal in the small village of Ubombo on the Lebombo Mountains. The nearest town is Mkuze 16 km's away at the foot of the mountain.

The hospital has 230 beds and employs ten medical officers, whose work includes both primary and secondary level medical care, serving a population of around 100 000 people in an area of about 1500 square kilometres. There is a busy outpatient department at the hospital. Eight residential clinics and two mobile clinic teams provide primary health care. The residential clinics are visited weekly by the medical staff, and are reached by a 4-seater aeroplane or by car/4x4. The aeroplane also flies emergencies to the referral centres.

The spectrum of illness is very broad and the work extremely varied including medicine, tropical diseases, surgery, paediatrics, obstetrics & gynaecology, anaesthetics and ophthalmology (including cataract surgery). We have weekly CME meetings, teaching ward rounds and monthly journal clubs.

TB and other infectious diseases are prolific, as are malnutrition and HIV related diseases. There is a minimal malaria risk at the hospital itself because of the elevated altitude and recent spraying programs have decreased the incidence dramatically.

Maternal and child health and Primary Health Care are priorities so a great deal of time and effort is being spent on improving our clinic services and standards, and health education. We teach Primary Health Care nurses and have a very active AIDS team, which has a growing home-based care programme.

Student accommodation is simple, i.e. bed, desk, light. There are also hot plates and some pots crockery and cutlery. Bedding is provided. You may have to share the room with another student of the same sex. Be prepared to battle with cockroaches, mosquito's etc! Bathrooms are communal. The minor inconveniences of the accommodation are far out-weighed by the wealth of experience you will gain here.

Fees
Accommodation: R15-00/ day. This money pays the hospital administration for your accommodation and the balance goes into our student fund, which will be used to upgrade the accommodation, buy sports equipment and to help local under-privileged students.

Meal tickets: R2-50 breakfast, R4-75 lunch, and R3-25 dinner. (Food is provided by the hospital caterers and is again very simple, usually chicken and rice! It is possible to buy some provisions at the general store across the road.)

Equipment:
You will need a stethoscope & protective goggles for theatre, Medical handbooks e.g. Oxford series & SAMF.

Clothing - summer is hot and humid, winter is cold (minimum about 9° C plus winds). Please dress as you would do at your teaching hospital; however, we do not insist on a white coat.

Torch, Binoculars and camera and sleeping bag if you want to go away for w/ends.

We provide a student fridge, saucepans, plates, cups and a two-ring cooker.

There is a swimming pool

Health:
Malaria used to be a big problem from October to May but even then there was very little malaria at Ubombo because of our high altitude compared the surrounding planes. Therefore the staff haven't taken prophylaxis. If you are travelling it is recommended that you take either Mefloquine or Chloroquine and Proguanil. The most common parasite we have here is falciparum. If you get malaria here or after you leave, most of our falciparum parasites are resistant to Fansidar and chloroquine so co-artemether (for mild infections) or Quinine (for severe malaria) are the drugs of choice.

AIDS is a very big concern and over 40% of 20 to 30 year old women and 25 to 35 year old men are HIV positive. Please take all the usual precautions. We have adequate supplies of gloves and visor masks to be able to practise safely but we still suggest you bring your own goggles.

Directions to get here:
Driving: Mkuze is about 300 km north of Durban on the N2. Turn off on the Mkuze road and keep on it through the outskirts of Mkuze up to the T-junction (~1 km). From here follow the signs to Bethesda Hospital and Ubombo (18km) along ~ 8 km of dirt road and then tar up the mountain pass. Just before the top of the mountain, there is a hairpin 180 degree turn to the left. The hospital gate is 100m further on to your right.

Taxi to Mkuze (direct) from the Johannesburg Berea taxi rank. At taxi rank ask around for taxi to Mkuze (Pongola, Mkuze, Hluhluwe route) - Cost ~ R70-00. Once at Mkuze ask for directions to taxi/bus going to Ubombo, Bethesda Hospital R5,00. This is the most direct route, but the taxi can be crowded and a bit of a hair-raising ride. Some of the hospital folk who have been in SA for a while think this is the most convenient, however there are risks.

Alternatively: the Baz Bus (this is less direct and a little more expensive but safe and reliable).

From the airport contact Airport Backpackers cell no: 083 758 4344 Free ride to backpackers. Baz bus will pick you up from here. They come to Mkuze via Swaziland. There is a stop over in Swaziland for one night so you have to then arrange accommodation at either backpackers or Mlilwane Game Reserve (discuss with Grasshopper information services) They require that you book, tel no: (+27)/ (0) 21 4392323. Cost: R145,00 excluding accommodation.

Third option: Greyhound bus from Johannesburg (Rotunda bus station) to Piet Retief, daily at 08:00, 10:00, 14:00, 23:00. Tel no: 011- 839 3037. Ask for taxi to Mkuze, about R5,00.

From Durban:
1) Purchase Grasshopper tickets from tourist junction R115,00. Departs Mon, Wed, Fri, Sun at 08:00.
Can catch bus from Durban international backpackers in Aliwal street tel: 031- 3059939. Drops you off at Engen Garage in Mkuze. Ask directions to taxi rank. Catch taxi/bus to Ubombo, Bethesda Hospital
2) KZT bus to Ubombo or Mkuze (also called lucky bus) leaves from municipal bus station on Soldiers Way. Leaves everyday except Sunday at 7-9 am. Costs R40,00 and takes 4 hours (most go past hospital gates and will drop you here - If not catch taxi up hill).

Contact:
Dr. J Schoevers
Student co-ordinator
Bethesda Hospital
Private Bag 602
Ubombo
3970
E-mail: docandyg@yahoo.co.uk