“I am currently sitting at home unemployed and frustrated as I am unable to fulfil my constitutional right to earn a living. The worst part is that I cannot be employed elsewhere without having done my community service work,” says Mavis Mokoena*. 

The 24 year-old is one of seventy-nine junior doctors still waiting for community service contracts from the Limpopo Department of Health.

On 15 June, the National Department of Health (NDoH) sent a letter informing them they were allocated to Limpopo for the 2023 mid-year cycle on the Internship and Community Service (ICSP) system. Over 1100 medical interns and junior doctors have been placed countrywide.

The letter stated the starting date was 1 July.

But almost two weeks later, Mokoena and her colleagues remain uncertain about the placement.

Funding issues reason for delay

Mokoena says they were told by the provincial department that a funding issue is why none of them have received contracts yet. She says they have not been contacted by the hospitals they were allocated to. 

Foster Mohale, NDoH spokesperson says they are in constant contact with the affected doctors, and all efforts are being made to ensure that they commence their duties at the beginning of August.

“We are aware of the matter of community service doctors in Limpopo who are yet to commence their duties because the Provincial Department of Health and Provincial Treasury are still finalising their contracts and budget to ensure that once they start, they will be able to receive their stipend,” explains Mohale.

But Mokoena who was supposed to have started her community service work on 1 July at Seshego Hospital, outside Polokwane, says that the delay is frustrating, and it is wasting their time.

“They must either employ us or release us from the obligation of doing community service so that we can go and look for employment somewhere else. We have been told that they are still waiting for ‘four signatures’ to conclude our allocation letters, and it’s a long process. What bothers me more is that they knew about this process a long time ago but they did nothing,” says Mokoena.

Critical shortages of medical doctors in South Africa

Nileen Gale, communications specialist at the South African Medical Association (SAMA) says that the delay is concerning as there is a severe shortage of doctors in South Africa. 

“Some of the communities served in the Limpopo province are located in rural, outlying areas and these factors further complicate matters”, explains Gale.

She says that the shortage of doctors at public hospitals in South Africa is at a critical stage where the ratio has widened to 0.8 doctors per 1000 population.

“Albania, which has a similar GDP to South Africa, has a doctor: patient ratio of 1.88 doctors per 1000 people. Peru and Thailand, also with similar GDPs to South Africa, have doctor: patient ratios of 1.35 and 0.95 per 1000 people respectively,” says Gale.

Mokoena says that she does not understand why a province with known shortages of medical doctors does not prioritise the appointment of junior doctors.

“Both patients and currently employed healthcare workers are suffering without us on the ground, as we all know that there is a critical shortage of healthcare workers, most especially doctors in Limpopo, but I do not understand why they are taking too long to send us to the ground,” she says.

The Democratic Alliance spokesperson on health in Limpopo, Risham Maharaj says that the poor planning by the health department in Limpopo is unacceptable as much needed community service doctors are now effectively unemployed until they are offered contracts to start work.

“These doctors come from all over the country and cannot be expected to uproot their whole lives at a day or two of notice. The provincial department must urgently ensure that funding for these posts is made available and that these doctors are placed, sign contracts and start community service as soon as possible to serve the people of Limpopo and for their own career progression,” says Maharaj.-Health-e News.

*Indicate that names have been changed.