| Abstract: | The concept of health for all by the year 2000 envisioned by the WHO can be achieved only by making strides against poverty-linked population growth and economic stagnation. 80% of the 1.9 million population of Bophuthatswana that became independent from South Africa in 1977 live in rural areas. Before independence virtually no health service existed. The Department of Health and Social Services envisions health care for all by providing a treatment center in every village; 3 beds/1000 population is targeted by 1992; and a doctor-patient ratio of 1/10,000 people (the ratio in South Africa is 1/1423). Most doctors are foreigners on contract and their qualifications are often inadequate. The shortfall of black doctors and nurses is attributable to apartheid policies. The health services structure has 3 branches: medical and paramedical, preventive and promotive, and social welfare. Primary health care is developed with traditional healers. 50% of children aged 12-36 months are immunized by the preventive branch. Alcoholism is a serious issue, and glue sniffing is frequent among delinquent children in shanty towns. In less developed countries good medical care tends to vary inversely with the needs of the population. Africa's debt situation and the freeze on new loans has pushed the idea of privatization of health services into the forefront. The US example has shown that commercial medicine is expensive because of entrenched medical and insurance interests often leading to superfluous operations. The state should allow private entrepreneurship in health care while guaranteeing protection for the patients and recycling taxes imposed into rural clinics. |
