A healthy dose of reality

Fifth year Wits medical students have learnt some harsh lessons about the conditions at public hospitals this year, after doing their practicals at Charlotte Maxeke Hospital.

Shortages

“The shortage of resources and supplies is a real concern for me,” said Massillon Phasha. Doctors had to improvise and work with whatever was available, she said, because they did not have the necessary equipment and medicine. This meant patients did not get the best treatment possible.

“The lab tests one can request are limited and results for specimens sent for pathology assessment take a long time to get back. All these factors largely influence the management of the patients.

Concerns voiced

“I have voiced my concerns to the doctors, but unfortunately there is not much that they can do about it because this is largely due to shortage of funds. So unless we can get the government to give the hospitals more money, there is almost nothing we can do,” said Pasha.

Keabetsoe Phello said she had never voiced her concerns as she was too scared.

Daily activities

Medical students go to the academic hospital as part of their fifth year studies, but do not manage patients.

“We help where we can under supervision from a doctor, but our duty in the hospital is to learn,” said Pasha.

On a typical day the students do everything from being tutored by doctors on specific subjects to running basic diagnostic tests, and they could even assist in delivering a baby, depending what rounds they are doing that day.

Despite the poor conditions, students appreciate the learning experience. Pasha said she was grateful to be at Charlotte Maxeke because she was able to learn a lot. She said she believed the doctors were doing their best despite the difficult working conditions.

Phello said she loved being part of a team and getting a “sneak peak as to what life after med school entails”.

All hospitals had problems when it came to resources and facilities, she said. But despite these, and the fact that medical students work hard, with no pay, she still loved her job.

“I could never imagine myself doing anything else. In some cases we do almost the same amount of work as the interns, yet we do not get paid. And some other medical disciplines, pharmacy and nurses to name a few, get paid a wage for working.”

The students will be stationed at the hospital until November 2014.

More to a mortuary than death

Dull-yellow fluorescent lights and the smell of industrial-strength antiseptic meet you when you enter the mortuary at the very edge of Braamfontein in Johannesburg.

5th year MBBCh students at the Johannesburg Mortuary

THE DEAD DON’T BITE: 5th year MBBCh students at the Johannesburg Mortuary                            Photo: Mfuneko Toyana

A sense of dread, of being in a mortuary, accompanies you when you enter the grey building wedged between Constitutional Hill and the Wits Esselen Residence.

What these experiences don’t prepare you for is the warmth and passion of the Wits medical students you find inside – there to fulfill the requirement that they learn to work with “fresh corpses”.

“A lot of these students see an autopsy for the first time and get turned off,” said Lawrence Hill, research student and entomologist at the Johannesburg Forensic Pathology Service (FPS) medico-legal mortuary in Braamfontein.

Hill explained how the small number of medical students who specialise in forensics end up working as pathologists. Most choose lucrative jobs as anatomical pathologists for private labs.

This leaves state pathologists working in one of the two main mortuaries in the province  Germiston and Johannesburg doing nothing less than 20 autopsies a week, almost double the weekly average.

Hill was frank about the difficulties of dealing with corpses on a daily basis and the kind of effect it can have on you.

“We see everything from [people who were] stabbed to death, jumped off of buildings, car accidents and burns victims who mostly came from informal settlements,” said Hill.

He said counselling was provided to students at the Charlotte Maxeke Hospital and they were encouraged to talk in groups about their experiences.

Scary reality

Fifth year MBBCh students, gathered at the mortuary on Wednesday morning for practical classes in dissecting corpses, had varying opinions of the experience:

A student called Trudie said the “scary reality didn’t really hit you” until you were faced with a recently deceased body.

“On Monday we saw a child who’d been hit by a car. It was terrible.” [pullquote align=”right”]”I had never seen a dead body”[/pullquote]

Asked how she coped with seeing death close up, she said: “As students we are not offered any debriefing. All you can do is go home and talk to your friends and family.”

Kirsten Morley-Jepherson said she was “really lucky to have a good support system at home”.

“Once you vent you really feel a lot better”.

Morley-Jepherson said although she had been fascinated by biology and the human body since her school days, she would not consider specialising in forensic pathology:

“I need something where I can have a life.”

Masello Phasha recalled how she was “literally shaking” when she faced a corpse for the first time.

“It was in our 2nd year andI had never seen a dead body. The toes of the cadaver were sticking out and I kept as far away as I could.”

Phasha said Monday was “very different”.

“The child was still fully dressed and still had shoes on,” Phasha said.

Despite this, Phasha said she’d “surprisingly” had no nightmares and she hoped to go into trauma surgery but feared the always-on-call lifestyle would be “too demanding”.

Abigail Keane is a student whose entire family is in the medical field. She said, despite realising “how quickly things can go wrong and how many lives we lose”, it was the daily opportunity of helping people in a tangible way that made it all worth it.

The mortuary serves as the “academic seat” of the Wits division of forensic medicine and pathology. It provides forensic pathology services to the SA Police Service and the Department of Justice and families of the deceased.  This is over and above its teaching and research responsibilities at the university’s Faculty of Health Sciences.