It was big smiles all round at the Wits Great Hall this past week, where 25 students received their Bachelor of Clinical Medical Practice degrees. These new graduates will become mid-level health workers positioned just above nurses and just below doctors. This new category of health professionals was specifically created to address the country’€™s shortage of skilled health care professionals, especially in the rural areas. Twenty-one year-old Tshegofatso Seinelo, from Taung, in the North West, is one the new graduates.

‘€œI feel very proud and very enthusiastic about the programme and I feel very honoured that I am one of the pioneers. I’€™ve always wanted to do something for my community. So, here I am, I have come to the end of the programme and I’€™m going into the field’€, says Seinelo. Seinelo, who graduated top of her class, says she is excited about going back to her community to help improve health care services there.

‘€œI feel everyone is running away from the rural areas to come and live a city life here. But we have to think about where we come from. In my community, people are very poor when it comes to health education. I want to go out there to improve that’€, she says.

Valentine Vilankulu shared top honours with Seinelo for best performing students overall. She says the mid-level health workers programme was not always a smooth ride.

‘€œI was a bit sceptical in the beginning, not sure where we were going. But after the three years of being at school, practising at district hospitals, I feel quite confident that we have a good role to play in the community. Initially, when they presented this to us, they said: ‘€˜You’€™re not nurses, you’€™re not doctors’€™, you’€™re in the middle. And the middle is where we are going to perform to improve health care and the well-being of patients’€, Vilankulu says.

Explaining the role of clinical associates in the health care system, Professor Ian Couper, the Director of the Wits Centre for Rural Health, says ‘€œclinical associates are trained with doctors in a medical school to work with, assist and support doctors in their duties’€.

‘€œThey are going to be doing things like seeing patients with chronic illnesses, doing procedures, looking after emergencies, working in theatre with doctors and doing ward rounds with doctors’€, says Professor Couper.

He says the clinical associates are being specifically trained to work in district hospitals, especially in rural district hospitals where there are not enough doctors.

‘€œThere is a lack of trained health professionals in rural areas.   We have a shortage in the country overall and the few professionals that we have are congregated in the cities’€.

The clinical associates’€™ programme, which is currently offered by Wits University, University of Pretoria and Walter Sisulu University started as part of the recommendation of the Department of Health’€™s Strategy on Health Human Resources. The programme aims to enable universities to increase the number of health workers they produce and to add to the pool and diversity of the country’s health work-force.

‘€œWe are really looking forward to these clinical associates being part of the health team and, also, we’€™re anticipating that they will join us to help achieve the Negotiated Service Delivery Agreement that was signed by the Minister of Health and the president of South Africa to increase life expectancy, reduce maternal, infant and child mortality, combat HIV/AIDS and TB and strengthen  the health system’€™s effectiveness’€, says the national Health Department’€™s Ramoth Fakrudeen.

Fakrudeen says she does not anticipate any problems with regard to the clinical associates fitting into the South African health care system.

‘€œThe clinical associates have a very defined scope of practice and they are to work within the district hospitals under the supervision of a qualified medical practitioner. We are also embarking on educating the health teams out there about the role of the clinical associates’€¦ the role they are going to play within the re-engineered primary health care approach’€, says Ramoth Fakrudeen.