SOUTHERN CAPE NEWS - The Uniondale and Haarlem area's population is over 13 000 and with a small 12-bed hospital, one ambulance, no private doctor or pharmacy where patients can get over-the-counter medicine and a farming area stretching up to 70km in all directions, administrating medical health care is a challenge.

Challenges
Dr Hannelie Louw, medical manager of the Harry Comay Hospital, Uniondale Hospital and George Primary Health Care, says that chronic diseases such as hypertension and diabetes are the biggest burden of disease in Uniondale and Haarlem, bigger than HIV and TB. 

Another challenge is alcohol-related injuries and substance abuse. The normal bouquet of diseases are also dealt with.

Facilities under pressure
Two mobile units service the outlying farm areas. In the summer months the influx of seasonal workers involved in the fruit packing industry adds more pressure on the health services. Public transport and the vast distance between farms also adds to the challenges of the area. 

Deon Joubert, chairman of the Harry Comay Hospital facilities board in George, which includes oversight of the Uniondale Hospital and the surrounding clinics, paid a fact-finding visit to the area last month. 

He said that the population figures served by the Uniondale Hospital and the clinic in Haarlem are much higher than 13 000, as many patients from the Eastern Cape come to these facilities for treatment every day.

Haarlem is 10km from the Eastern Cape boundary and for some Eastern Cape residents the Western Cape facilities are closer than the facilities in the Eastern Cape.

Dedicated staff
"It was good to see an Eastern Cape medical record book with regular entries of visits to the Haarlem clinic. After all, our constitution says everyone has the right to access to health care services and no one may be refused emergency medical treatment," said Joubert.

On top of that, the nursing staff gladly go out of their way to provide services. "A nurse proudly said, 'Never mind the constitution; I will always devote myself to the service of human welfare. I uphold the Florence Nightingale Nurse's pledge. I read it once a year on International Nurses Day."

A medical worker at the Joubertina hospital told the George Herald, "It's not necessarily that the Western Cape offers better medical services than the Eastern Cape. The provincial boundaries drawn in 1994 artificially divided the Langkloof community. Now residents choose where they want to go, and yes, some are going to Uniondale and Haarlem."

Facilities inadequate
Joubert questions why the provincial authorities do not take the proximity to the Eastern Cape into account when allocating funding and manpower to the region. "The staff complement seems to be correct for the area's population, but once the day visitors from the Eastern Cape section of the Langkloof and the Willowmore area are included, the staff numbers are hopelessly inadequate. This means that staff training and upgrading often has to be put on the back-burner as there just aren't relief staff available."

Another concern Joubert has is that there is only one ambulance stationed in the area. "If a patient is transferred to the George Hospital, which is 120km away, the ambulance is out of the area for the greater part of the day. The area should be allocated a second ambulance. 

We acknowledge that the department stations an extra ambulance during the holiday season as Uniondale is on the busy N9, which is used by taxis operators plying the Cape Town/PE route. But locals need the assurance of quality services all year round."

At the Avontuur satellite clinic which operates one day a week, there was a general chuckle on learning that the building was once a butchery. Joubert quipped, "They sure knew how to build cold rooms in those days. It is freezing inside. It must cost an arm and a leg to heat the clinic in winter."

Patients have responsibility
The challenge to operate medical facilities in sparsely populated far-flung rural areas is that the costs are disproportionately high. "Luckily we have a team of dedicated, hard-working personnel who keep the clinic open and operating, no matter the difficulties, but there is also an onus on the patients to maintain a healthy lifestyle," said Joubert with regards to the large number of chronic patients in the area.

ARTICLE:  MYRON RABINOWITZ, GEORGE HERALD JOURNALIST
(Myron Rabinowitz is a member of the Harry Comay Hospital facilities board )

'We bring you the latest Southern Cape news'