Welcome Notes from the RHC Partners

We are excited to present the 21st Rural Health Conference in Taung, North West Province.

The overarching aim of the Rural Health Conference is to create a platform for rural health practitioners, partners and stakeholders across the country to connect, share experience and challenges facing rural health care practitioners, learn from one another and advocate for good practice. We believe that by working together as partners in the rural health space, and engaging the government, we can overcome the numerous challenges South African Rural Health is facing.

The biggest strength of this conference is that it is a partnership of various and a diverse organisations: RuDASA (Rural Doctors Association of Southern Africa), RuReSA (Rural Rehabilitation South Africa), PACASA (Professional Association of Clinical Associates), and RuNurSA (Rural Nurses South Africa). We are guided by RHAP (Rural Health Advocacy Programme) to ensure that the conference programme recognises the diversity within South Africa, the importance of advocating for better services, and seeking presentations on innovations in care and service provision.

In a quest to respond to current challenges facing the rural health system in South Africa, we have developed the following themes:

  • Recognising Rural Health Challenges.
  • Working Together- Better and Smarter
  • Use of Innovations in Communications Technology and Healthcare
  • Using Trans-disciplinary Teamwork to Find Innovative Solutions.
  • Working Together to Advocate for Better Rural Health.

For us to have significant and meaningful impact we need all those involved in Rural Health to work together so as to achieve a better and efficient health system.

We call upon all involved in the rural health space to attend this conference, and look forward to welcoming you in Taung

Dr. Ndiviwe Mphothulo
Conference Chairperson
RHC 2017

Dear Delegates,

Welcome to yet another meeting of rural health partners in South Africa, and this year in Taung, NorthWest Province. It’s my greatest pleasure to welcome you all to this year’s Rural Health Conference, the 21st of our conferences.

We have been afforded yet another opportunity to come together and remind each other of the difference made by the paths each one of us have chosen and continue to choose, to serve the rural and the remote communities in our beloved country. This meeting also affords us an opportunity to offer support to each other, as we continue to serve and comfort our rural communities amidst trials and tribulations thrown at us by the dysfunctional aspects of our healthcare system.

Most importantly though, and most relevant to this year’s conference, we are afforded yet another opportunity to share in the lessons learned by our members, partners, friends and colleagues in the frontline and coalface of the work we do in rural health. Indeed, these lessons ought to be shared so we do not reinvent the wheel. We cannot afford to reinvent the wheel when we work in the times of political turbulence, nationally and globally, and financial austerity measures instituted on the healthcare system by decision-makers.

We now have to debate about what constitutes critical posts in the healthcare system, when many of us were taught every post in healthcare is critical, both the cleaner and the doctor, the guard and the nurse, and the administrator and the therapist. However, the current reality is such that these debates have to take place whether we like it or not, and to bury our heads in the sand behaving like ostriches is to perpetuate disservice and injustice on those we claim to serve, many of them not in a position to advocate for themselves.

In this regard, the little each and every one of us can do will certainly go a long way in bringing honour to our patients, clients and communities, and continue to promote their health and wellbeing, so they can all remain active and productive members of society.

I therefore humbly look forward to the lessons to be shared from all corners of this country on innovative solutions for rural health in this conference, through all the presentations, workshops, meetings and conversations that will be taking place.

I should also send a special welcome to all of you members of RuDASA, and invite you to the several discussions scheduled to take place throughout the conference on how we can reposition RuDASA to function as a community of practice in line with our Value Statement adopted in 2016.

Aluta Continua!
Mosa Moshabela

Welcome to the RHC 2017. We hope to see a growing contingent of nurses attending this annual event!

RuNurSA (Rural Nursing South Africa) aims to strengthen rural nursing leadership by harnessing the courageous commitment, inspiration and vision of nursing professionals in the face of rural health realities and challenges to influence the change required to improve rural health nursing care.

In South Africa a primary health care approach was adopted, as a social justice philosophy, and a combination of legislative, policy and resource allocation measures have been used to achieve transformation and improve population health.

However, these policies have not been enough to turn around the overall performance of the South African health system with around 84% of the population, who carry a far greater burden of disease, depending on the under-resourced public sector. South Africa is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal diseases, and injury-related disorders. NCDs, specifically cardiovascular diseases, type 2 diabetes, cancer, chronic lung disease and depression are on the rise in both rural and urban settings.

Three fault lines have been identified (Rispel, SAHR, 2016): tolerance of ineptitude as well as leadership, management and governance failures; lack of a fully functional district health system, which is the main vehicle for the delivery of primary health care; and inability or failure to deal decisively with the health workforce crisis.

The crisis of ineffective management, incompetence and failure of leadership and governance at all levels of the health system, is exacerbated by a general lack of accountability

These fault lines have negative consequences for patients, health professionals and policy implementation. Patients bear the brunt through negative experiences and sub-optimal care. Health care providers such as nurses on the front line and at the bottom of the hierarchy also suffer.

Faced with an unsupportive management environment, staff shortages and health system deficiencies, nurses find it difficult to uphold their professional code of ethics and provide good quality of care. The loss of trust and confidence in both our leaders and organizations is at the root of the workforce issues we face today.

A call for metaphorical ‘repair of fault lines’ to ensure success of the proposed national health insurance system includes addressing the leadership, management and governance failures. This requires political will; appointment of public service managers with the right skills, competencies, ethics and value systems; effective governance at all levels of the health system to enforce laws; appropriate management systems; and citizen involvement and advocacy to hold public officials accountable.

John Maxwell holds that good leadership changes lives, forms teams, builds organisations, and impacts communities .Leaders are always taking people somewhere. They aren’t static.

Nurses are called upon to proceed to lead, especially in rural environments by having the faith of their convictions-stepping forward and becoming a voice to lead and champion nursing issues which will positively affect health of communities in this country.

Nursing leaders have extraordinary responsibility, authority, and accountability. As a result, they also must have access to educational opportunities and the mentoring needed to develop and enhance their leadership skills. Supporting educational programs play an important role in developing leaders who are eager to engage colleagues and country on nursing issues and are adept at creating space for authenticity and mutual respect.

Healthcare is a partnership, so we embrace the rural health advocacy partners who are on the same trajectory. There is a lot of goodwill amongst rural health professionals and RuNurSA has to reach out more boldly to join forces. We must find a path to empower every direct care rural nurse to have a voice in decisions that affect their practice and the expectations of how that practice will be carried out. We salute our rural nurse of the year for doing just that!

We believe it is possible to create environments that allow nurse leaders to encourage and promote flourishing of the human spirit in the rural workplace. This ultimately creates space for positive returns on health investment and a healthcare culture shift that produces exceptional results to support the sustainable development goals. Join us as we find our way…..

Kind regards
Guin Lourens; RuNurSA

We are excited to welcome you to the 7th multi-disciplinary rural health conference, and the 7th year of RuReSA! Every year the programme reflects pressing and relevant issues faced by rural health care professions across South Africa, and this year is no different.

With widespread austerity measures being implemented, health care professionals are increasingly being asked to do more with less. Whilst this is never a pleasant task, it does force us to examine how we can work more efficiently and effectively in order to meet the desired outcomes. Health systems strengthening, improved multi-disciplinary undergraduate training and clinical practice approaches – as well as the integration of innovate health technology – all have the potential to drive effective outcomes in rural and under-resourced areas. This conference creates a much-needed platform for sharing examples of good practice amongst the most passionate rural health professionals, policy and decision makers, budget holders, activists and higher education professionals.

Maryke Bezuidenhout
RuReSA Chair
2016 – 2018

I would like to personally welcome each of you to this year’s annual RHC 2017. It is an exciting time
for PACASA as we continue to grow and adapt, remaining always adaptable, motivated and
responsive to the challenges and accomplishments of Clinical associates in South Africa. Our
organisation is confronting a time of many changes and we are meeting these changes during a
time of nation-wide and global change. The world of Rural Medicine is an exciting area in which to
work, study and play, and we will continue to bring and meet inspired people together in forums like
Tasks that PACASA has set for itself for the 2017-2018 period, that will require collaboration with all
of our rural health partners include:

  • Addressing the continued challenges of access to healthcare in rural areas
  • Urging NDoH to finalise the policy regarding ClinA’s, who remain an integral part of the
    healthcare system in the rural areas
  • Our continued pledge towards producing quality ClinA’s who can produce quality healthcare
    to all users

As you look around, you will see that there are posters here representing research done by Clinical
Associate students: we are getting into the research space, but we require more collaboration,
especially as it relates to assessing the positive impact of Clinical Associates in the provision of
healthcare. We at PACASA are transforming the way we operate to continuously improve our ability
to provide support and education to all our members as well as those within the community. We are
determined to fight against the negativity and expel all doubt and confusion about our profession
whilst providing support to our fellow members that have continued to meet the challenges of our
field and who have excelled despite setbacks. We should all be very proud of where we are today
and excited about where we are headed.
In closing, I would like to thank each of you for attending the RHC 2017 and bringing your expertise
to our gathering. You, as organisation leaders and fellow professionals, have the vision, the
knowledge and the experience to help us pave our way into the future. You are truly our greatest
asset today and tomorrow, and we could not accomplish what we do without your support and
leadership. Throughout this conference, I ask that you stay engaged, keep proactive and help us
shape the future of Rural Medicine.
Thank you
Zukisa Tshabalala,
Chairperson, PACASA