A Day in the Life

            The South African government, like most governments, don’ t have enough resources to support all of the programs or people in need.  The South African public health care system is allocated about 25% of the health services budget and the remaining 75% is allocated to the private health care system.  While the private health care system in South Africa is estimated to be one of the best in the world, the public sector struggles to provide life saving services.

 Grote Skoor Hospital

            On July 20^th, I had the opportunity to experience a day in the life of a hospital social worker at Grote Skoor Hospital.  My fellow social work interns and I arranged to meet with the social work department.  The department allowed us to each shadow a social worker.  Stephanie shadowed the Medical social worker and Taylor shadowed the Maternity social work.  I shadowed the Renal and Transplant unit’s social worker. 

            I met the renal unit social worker in a flurry of paper work, nurses, and clients.  After a quick introduction, we delved into his daily work.  I helped him interview and inform patients about their medical situation, grants, and job status.  I also observed an end of treatment discussion with a man whose transplant was failing him.  While we ran from ward to ward to check up on paper work and patients, the social worker explained how the renal until admitted patients. 

            The social worker told me that due to the lack of resources the unit is unable to treat all patients in need of dialysis and a transplant.  Therefore the unit decides who is admitted into the program based on a list of criteria.  The criteria are formed into three categories.  Category 1 patients are young and healthy South African citizens.  They cannot have any medical complication such as obesity, diabetes, or be HIV positive.  These are the patients that are put onto the program immediately.  Category 2 patients are employed South African citizens that may have a few health issues or be older than the recommended age with a family to support.  Category 3 patients are unemployed, have a number health issues, and maybe incompliant to following medical advice.  They are not admitted into the program and are “sent home to die”.   The social worker told me that, “they do the best they can with what they are given”.  I agree.