Andrew W. Seefeld
South African Medical Journal, 2007
"South Africa’s health care system consists of an ‘underresourced and over-used’ large public sector and a private sector with abundant medical resources catering mainly to the middle and upper class.1 The public health care system aims to ensure health care that is affordable and accessible to all. It is stratified into primary, secondary and tertiary hospitals. Patients usually present to the primary health care clinics in their respective districts and may be upgraded to a secondary or tertiary hospital depending on their medical needs. The emergency medical system (i.e. paramedic ambulances) may transport patients directly to any of these levels. Lack of resources is a critical issue facing health care in South Africa, specifically emergency departments. However, I began to see a positive effect of this deficiency. While it has negative consequences in terms of patient care, it seems paradoxically to have had a significant positive effect with regard to general medical education and medical resident training. The challenge facing emergency medical physicians is to harness the system’s positive effects while mitigating the negative."