Currently (2007) we have 16 doctors and plan to increase that to 18 in 2008.
The structure of the medical section can be summarized as follows:

  • Medical Manager
  • 3 Chief Medical Officers
  • 6 Principal Medical Officers
  • 9 Senior Medical Officers/ Medical Officers/ Community Service Medical Officers

Doctors are allocated in the following proportions to the following sections based on the workload in the different sections and rotate on a 4-monthly basis to optional sections:
1 CMO, 2 PMO's, 3 SMO's - Surgery and OPD
1 CMO, 2 PMO's, 3 SMO's - Maternity, HIV, TB and PHC
1 CMO, 2PMO's, 3 SMO's - Medicine and Paediatrics
Senior support is ensured and available.

Current nationalities:

  • South African-12
  • Rwanda-1
  • Congolese-1
  • Dutch-1
  • Zimbabwe-1

Confirmed for 2008:

  • South African-10
  • Congolese-1
  • Dutch-1
  • Zimbabwe-1
  • UK-3

TYPICAL WORK DAY
07h30-08h30: Drs. Meeting - handover, morbidity and mortality reviews, journal club, telemedicine session once per week, paramedical reviews, meetings with nurses etc.
08h30-10h30: Ward round / OPD/ PHC clinic visit
10h30-11h00: Tea
11h00-13h00: Ward round/ OPD/ PHC clinic visit
13h00-14h00: Lunch
14h00-17h00: OPD/ ANC/ PHC clinic visit/ Post-mortem/ Septic Theatre
In general, in-patient doctors do ward rounds from 08h30-13h00, where as the OPD doctors will be allocated to OPD. The exception is on the day when an in-patient doctor is on call (intake), when he/she will be allocated to OPD from 11h00. PHC doctors leave the hospital at 09h00 to visit PHC clinics. Special clinics at the hospital include ANC, HIV, TB, Mental Health, Disability Grant, Orthopaedic, Chronic etc. OPD doctors are usually allocated in the afternoon to another clinic/ theatre.

AFTER HOURS CALL
Two doctors are on call every night and 3 on weekends. As far as possible it will always include one senior doctor. The doctors are responsible for the whole hospital, including any operations that may be required. Usually the calls are not busy and many times doctors finish by 10 pm and may be called out once during the night. Duties include clearing OPD, seeing emergency patients, keep an eye on Maternity and review the sick patients in the wards. On weekends 2 doctors are doing ward rounds, while the 3rd doctor will cover OPD. After the ward rounds are finished, the doctor who was on call the night before may go home, while the other 2 continue with OPD. When OPD is finished the 2nd doctor may also go home and will only be called when there is an operation to be done or very seldom for a disaster e.g. a bus accident. The day after being on first call, the doctor gets the afternoon off. In general doctors are doing 5 calls per month (in total 5 days which may be 1st,2nd or 3rd calls weekday or weekend - works one weekend in 5).

LEAVE
Annual leave: 22 workdays per year
Sick leave: 12 workdays per year
Study leave: 10 workdays per year - short courses may be funded
For the above you retain the payment of commuted overtime.
Special leave: e.g. family responsibility, maternity leave (4 months)

LONG WEEKEND
Once per month you are entitled to either a Friday/ Monday off, provided that you work until 5 pm daily and have not taken any other leave during the month. This enables doctors to go to Mozambique/ Durban to de-stress!!!

DUTIES OF PHC DOCTORS

  • See referred patients
  • Review chronic patients every 6 months
  • In-service education to PHC staff
  • Assist with administration e.g. medicines
  • Review antenatal patients
  • Visit all 10 fixed clinics at least once per week
  • Visit the 4 clinics with the most ART patients once per week
  • Visit mobile clinics on a rostered basis
  • Medical support to programs
  • Liaise closely with PHC matrons re PHC services

DUTIES OF HOSPITAL DOCTORS

  • Diagnose and treat patients
  • Assist section with administration e.g. medical equipment
  • Quarterly morbidity and mortality reviews
  • Special projects e.g. Malnutrition, ART, Mental Health,TB etc.
  • Improve quality of care e.g. protocols, clinical audit

REFERRALS
CHW-Mobile/Fixed clinic
Hospital - Visiting specialists (Physician, Paediatrician, Gynaecologist, Surgeon, ENT) Mseleni (MJD only) - Bethesda (TOP only) - Empangeni (Referral Hospital) - Durban (Tertiary hospitals)
Ambulance base at the hospital for emergencies
Shuttle bus service daily between clinics and hospital and referral hospitals
Approximately 5% of patients are referred

ACCOMMODATION
Accommodation (fully furnished on request), is provided to all doctors and allied health professionals on site. Accommodation varies from shared houses to one bed roomed flats to prefabricated park homes to one, two and three bed roomed houses. The allocation is done by a housing committee and depends on availability. The monthly rental is minimal - for shared accommodation R200 (20 Euro) per month, and single accommodation R450 (45 Euro) per month which includes water, electricity and refuse removal charges.

There is a swimming pool and a tennis court on the premises and the secure environment of the grounds is ideal for small children. There are many options for recreation; visiting the world heritage site of Kosi Bay and Kosi mouth (about 30min away) as well as the many other beautiful beaches in the area and in Southern Mozambique (e.g. Ponta de Oura). There are three Game parks within the district (Tembe, Ndumo and Mkuze) and Swaziland is within easy reach. The hospital staff are a close knit community and do many things together; braais, parties, and visits to the various places of interest occur regularly.

REMUNERATION (1 Euro = R10)

  • Principal Medical Officer: (Qualification plus at least 4 years experience) R311 358 per annum plus scarce skills (15%) plus Rural allowance(22%) plus commuted overtime (R4500 per month) Take home salary approximately R20 000 per month;
  • Senior Medical Officer (Qualification plus at least 1-3 years experience) R196 815 per annum Plus Scarce Skills (15%) plus Rural allowance (22%) plus commuted overtime (R4000 per month) plus 13th cheque. Take home salary approximately R17 000 per month;
  • Medical Officer (Qualification) - R157 686 per annum Plus Scarce Skills (15%) Plus Rural allowance (22%) plus commuted overtime (R3500 per month) plus 13th cheque. Take home salary approximately R14 000 per month.

A salary increase is expected in January 2008, but the details are not known at present.

Other benefits:

  • Pension fund: Contribution to the Government Employee Pension Fund is compulsory. The official pays 7.5% of the basic salary every month and the government is contributing an equal amount every month. If you resign before 10 years of service, your contribution will be paid back after tax had been deducted. If you resign after 10 years of service, you will get your contribution and the government's contribution after tax had been deducted. If you work until retirement age, you will get a monthly pension.
  • Medical insurance: This is optional. The government will pay 2/3 of your monthly contribution up to a maximum of R1200 p.m.
  • 13th cheque: SMO's and M.O.'s get a 13th cheque in their birthday month equal to their monthly basic salary (excluding allowances). PMO's may structure their salary to get the same, or to get a slightly higher monthly salary if chosen not to.
  • Accommodation: Inexpensive on hospital grounds (see earlier)
    In general living expenses for a single person eating the local cuisine is about 50% cheaper than in Belgium. You can live comfortably on R3 000 per month if you have not got a vehicle. A good second hand 4x4 may cost up to R100 000 and insurance and running costs may add up to another R2 000 per month. Income tax is deducted automatically every month and is calculated according to sliding scales (20-30%).

LANGUAGE
The official languages of the Province of KwaZulu-Natal are English, Zulu and Afrikaans. English is the language used in the hospital. Interpreters (nursing staff) are used in OPD and wards for the Zulu - English translations. A small section of the patients still speak Tsonga, but usually understands Zulu. A crash course in hospital Zulu can be arranged.

HOW TO APPLY IF YOU ARE INTERESTED

Are you the type of person who loves the outdoors? A team player? Interested in seeing Primary Health care principles in action? Able to work well with minimal supervision? Warms to challenges easily? Whatever your health care discipline may be; we have a place for you!

  1. Contact the Medical Manager to find out whether posts are available, what level and from when. E-mail address:manguzimed@kznhealth.gov.za
  2. Contact Rural Health Initiative (Tracey Hudson), who will assist you with all the necessary documentation. web address: http://www.rhi.org.za
  3. Register with the National Department of Health's Foreign Workers Program, stating clearly in which province you want to work and preferably which hospital, or else you will be allocated to any hospital with a need for doctors. Web address:http://www.health.gov.za
  4. Register with the HPCSA (Health Professions Council of South Africa).
    The whole process takes approximately 3 months and you will be offered a contract for 1 - 3 years.

OVERSEAS DOCTORS

The rural health initiative has been set up to facilitate the registration and placement of foreign doctors wanting to work in rural areas in South Africa. The registration process is quite long and candidates are advised to start the process as soon as possible. RHI is very helpful and will assist you with all of the steps necessary. It will involve registering with the Foreign Workforce Placement Program as well as with the Health professions Council of South Africa and finally completing an interview ( can be by telephone) at Manguzi. Please contact RHI at www.rhi.org.za

Please note that this does not apply to doctors from other developing countries that South Africa has agreed to not recruit from, to avoid contributing to the skills shortage in those countries.

More info on KwaZulu-Natal Department of Health can be obtained on their website http://www.kznhealth.gov.za

There are also posts available at MOSVOLD and HLABISA HOSPITALS in the same district - contact their Medical Manager.

Mosvold: Dr. Williams - e-mail: hervey.williams@kznhealth.gov.za

Hlabisa: Dr. Adam - e-mail: aadam62@webmail.co.za