EC Syndrome

I'm not sure if you're aware that there is a plague invading the Western Cape.

It is not the recent measles outbreak that has caused so much anxiety.

No.

Far more severe than that.

Far more frightening.

This disease is a conglomeration of the most purulent, macerated, chronic and cancerous iniquities of pathology.

To diagnose it is easy.

To cure it, an impossibility.

It is what we in the Western Cape call: Eastern Cape Syndrome.

Something is not happening in the Eastern Cape.

Something is not happening a lot in the Eastern Cape.

And that something is health care.

Patients, on death's door, are making the arduous journey all the way down to Cape Town in droves, in the hope of better treatment.

Like the bastard child you forgot to tell your wife about, these poor patients from the Eastern Cape rock up, unwanted, at the holy doorstep of the nationally renowned Western Cape Health Department.

I have had three such patients in the last two locum shifts in casualty, who literally arrived in Cape Town on the morning train from somewhere East of the Hinterland, and were on a stretcher in casualty before the noon gun had a chance to blast them back to where they came from.

At medical school they talked to us about the "heart sink" patient - ie the patients that literally make your heart sink...

These are they...

I don't even write notes on them anymore. I just document: "Arrived from Eastern Cape today..."

and then hand them over to the medical registrar....Who will then write down what we all know to be wrong, a combination of, or variation of one of the following

• HIV stage four, and all of the complications that come with it
• disseminated extremely drug-resistant TB
• some fungating cancerous metastasised mass with superadded infection and no hope of cure
• septic and gangrenous legs, unsalvageable and ripe for amputation
• spinal pathology that if treated early could have prevented the total lower limb paralysis of some poor teenager...
• etc
• etc
• blah
• blah
• blah

You will forgive me for being so dismissive...

It's just that I cannot expend any more energy cursing the Eastern Cape Health Department for not getting their act together...and after months of being faced with the embarrassment of having nothing to offer these dying guests from another province...I've kind of just given up on ever being the brilliant host they hoped for...if only they had presented earlier...or if something had been done for them in their home towns...

Welcome to the Eastern Cape, enjoy South Africa's finest beaches where dolphins play in warm waters, game reserves full of wildlife, where people greet with smiles and enjoy the holiday adventure of a lifetime. Explore the Eastern Cape and experience the best South Africa has to offer, absolute tranquillity and relaxation...

This is a description of the Eastern Cape as promoted by the Eastern Cape's tourism website

However, in terms of health care, the Eastern Cape can only be described as a big black hole of disease.

p.s. Any Dr's out there working in the EC who want to disagree with me please go right ahead and prove to me that I'm just spouting my mouth off when I know nothing of the true state of affairs... My opinion on this matter is of course entirely biased and based only on first hand experience with the patients, not a gold standard randomised control trial.

But I think I know what you're going to tell me...that the fault lies not with the staff, or the facilities, but at the feet of the administrators and managers who are supposed to use their provinicial health budgets to enhance their health service, not drive their patients to seek help in other provinces...