Re-invigorating long-neglected rural health workers

It took the deaths of 121 babies after an outbreak of diarrhoeal disease in the poorly served Ukhahlamba District of the Eastern Cape to highlight how disillusioned and unsupported its health care management really was. Managers and staff at various admitting facilities were overwhelmed by a sudden surge of dehydrated babies for nearly four months from January 2008, triggered by terminally decayed township water reticulation and purification systems.1 To aggravate matters, grossly understaffed clinics and district hospitals and dismal infrastructure with a shortage of mobile clinics and medication meant that those on duty took the brunt of the stress and burnout induced by the crisis. (Empilisweni Hospital saw 107 admissions of severely dehydrated babies in January alone, of whom 28 died.) Some five months later, after much debilitating finger pointing up and down the chain of command during multiple official probes, a veteran rural public health clinician, Dr Tim Wilson, was sent in by Pretoria to come up with ways to prevent a repeat