This path has been chosen to help address the needs of South Africa: training doctors who are sensitised to the nation’s challenges of poverty, unemployment and inequality, and who at the same time have rigorous clinical skills which equip them to work anywhere on the continent, or in the world.
Medical School director Prof Fikile Nomvete outlines how the school’s vision is to train general medical practitioners who also have a deep understanding of primary health care.
He hopes this will become so deeply ingrained in the students that when they graduate “they'll always remember that the greater population of South Africa requires primary care”.
“They will understand what it means to be working in an African context, and know how to offer a service to that population.
“Mindful of our responsibility as the only university bearing the name of the late former President Nelson Mandela, we want to develop graduates who have a heart for our beloved country, its ugly disparities, its deep challenges and its ongoing needs.
Culturally sensitive and holistic
“This means we want to send our medical graduates out into the world knowing how to practise primary health care in holistic, culturally sensitive and comprehensive ways.”
International studies have shown this is the most inclusive, just, economical and efficient approach to enhance physical and mental health, as well as social well-being. The wide-ranging impact of investment in this has been growing around the world, particularly in times of crisis such as the Covid-19 pandemic.
“Add this to South Africa’s severe shortage of doctors and healthcare workers in general nationally, which over the past 20 months has seen public and private health systems stretched almost to breaking point, and you can see the need for a medical school with this orientation,” said Prof Nomvete.
It is a holistic approach and, internationally, the ideal of inclusive and equitable health for all is enshrined in the UN’s 2030 Agenda for Sustainable Development and Sustainable Development Goals.
Health Sciences Deputy Dean Professor Dalena van Rooyen outlines how the university’s interprofessional education and collaborative practice (IPECP) model builds bridges between disciplines relevant to primary health care.
“As a Faculty of Health Sciences, it’s vital to understand health disparities in underserved communities, accounting to large parts of our country and continent, and how to address these. This is a major part of our mission to co-create with our partners a socially just, healthy and sustainable world.
“In alignment with the National Development Plan for 2030, there will be a focus on primary and preventative health care, with interprofessional education and collaborative practice (IPECP) an essential building block.”
Mandela University’s Faculty of Health Sciences has a very strong IPECP approach, offering qualifications in 11 health professions. These include nursing, emergency medical care, radiography, biokinetics, human movement science, dietetics, pharmacy, environmental health, medical laboratory services, psychology, and social development. Medicine is now the 12th.
“The golden strand is that of a full interprofessional team who will hold hands with others in changing lives and making health care accessible and visible to the under-resourced and under-served,” said Prof Van Rooyen.
Aligning with the principle of ubuntu
Prof Nomvete emphasises that this primary health care orientation involves co-creation, as it places agency within the hands of the community.
“We see individual well-being as intimately connected with community health – the principle of South Africa’s much lauded ubuntu where the concept of community is one of the basic building blocks of a thriving society.
“However, this ideal can only be achieved in the context of social equality in wider society.”
Primary health care also has a strong focus on reaching out and educating to prevent disease, and the MbChB programme takes the students out to the community from their first year.
Dr Yoshna Kooverjee, who lectures Theory and Practice of Medicine, emphasises the need to put the patient at the centre of care.
“We want community-oriented, fit-for-purpose doctors who are skilled to practise medicine that meets the needs of our communities,” said Kooverjee.
“Everything that we teach spirals up through the six years, but the emphasis from year one is to teach the students how to communicate effectively and what it means to be a professional,” she said.
“How do we communicate information to patients without too much jargon so they understand what we're trying to say to them?”
Sharing knowledge with patients can be an effective tool to help prevent disease, maintain good health, and provide ongoing support for chronic conditions.
