Mosvold Hospital, Ingwavuma, South Africa
Anna-Karin Ahlsen, Sweden
Where and when did you work abroad?
Mosvold Hospital, Ingwavuma, South Africa for 2 years 2007-2009. A 250-bed district hospital situated in the green hills of the Lebombo mountains on the border of Swaziland and close to Mocambique. 4,5 hours north of Durban. Mosvold has a catchment area of about 130 000 people and in 2009 they had 2200 in house deliveries. The doctors also serve in the 10 midwife/nurse run satellite clinics. There is a male ward, female ward, paeds ward, tb ward and maternity and an out patient department. Two operating theatres. None of the doctors is specialised but some have 20 years experience of rural medicine. As a junior doctor you will quickly learn to take a lot of responsibility but there is always someone to ask. All doctors do all medical fields but if you are an OB/GYN registrar you would likely do more obstetrics than others. The population suffers heavily from HIV, about 30% of the pregnant women are HIV-positive.
Did you need a visa or a working permit? If yes, how did you arrange it?
Yes. You need a medical license for South Africa. Scandinavian doctors don’t need to sit exams but need approval of the HPCSA. This process involves sending a lot of documents to South Africa and takes about 3-4 months. Once approved, you apply for a job in a hospital and apply for a working visa at the embassy. There is a South African organisation that works to recruit foreign doctors to South Africa. African Health Placements, APH, they help you through this process and also put you in contact with hospitals in need of staff. Send them an email! www.ahp.org.za.
How much experience did you have before going? Was that enough?
I did 6 months of obstetrics and 1 year of general practise after my internship before going. Therefore I learnt many of my medical skills during my time at Mosvold.If you are more experienced you will be useful sooner than me. But I recommend you to stay for at least 6-8 months and more preferably at least 1 year as it takes time to understand your new medical and cultural context. Before I went to SA, I also did a 2 months course on health interventions in low income countries, which was very useful.
What kind of work have you been doing?
I did all medical fields, from running the neonatal unit , dealing with patients with fractures, psychosis, diabetes, children with malnutrition, tuberculosis and obstetrics and so on. Each doctors usually do the same ward for at least a few months. You do your ward rounds in the morning and work in opd in the afternoon. A couple of days a week you do surgery in theatre. Mainly caesarean sections, D&Cs and tuba ligations in the gynae department but also male circumcision (to prevent HIV), skin grafts, cleaning of infected wounds, chest drains, fractures and other things. You will take turns to do the surgery and to do the anaesthetics. You do the spinal before caesarean sections (easy as you do a lot of lps in the opd). The job is very much hands on. The South African internship is very much hands on and even many of the junior doctors are very skilled. When I worked at Mosvold we were down to 4 doctors running the hospital, but I think there is about 15 doctors at the moment. When you are on call there is a senior doctor who is second on call that you can ask for advise and who will come to the hospital to help out if needed.
How did you find out about this possibility? Did you have a contact person who will be willing to organize a stay for another trainee (or at least give some information) and whose name you can pass on?
The AHP had an advertisement in the Swedish Läkartidningen.
How did you finance your stay?
I was employed by the hospital and hence got a salary. They arrange accommodation in the hospital area and you stay for free. I paid for the plane ticket myself.
Are there any ongoing research projects at the hospital?
I don’t know.
Your e-mail-address in order to answer questions from interested trainees: annakarinahlsen@gmail.com
