Advocacy and activism are two skills that rural doctors might need to develop if they hope to be able to offer decent healthcare to patients. This was the message delivered by Dr Trudy Thomas, the former MEC for Health in the Eastern Cape, in one of the keynote addresses delivered to the conference of the Rural Doctors Association of South Africa (Rudasa) last weekend. She said that the promise of the Reconstruction and Development Programme of 1994 had largely been betrayed by budget cuts and a lack of political will to transform and extend health care to the country's poor and rural people.