14
Ourwomenfearthattheywill
not
be
treated
with
respect
or
compassion,intheirhoursof
greatestvulnerability.
Theywonderaboutwhotheycan
trust,whotheycanrelyonandwho
will
give
them
honest
and
appropriatecare.Theyareafraidthat
theywillbeturnedawayfrom
hospitalsortheywillnotreceivethe
correcttreatmentwhentheyare
admitted.Theyfearcruelty.Theyfear
humiliation.Theyworrythattheywill
notbehelpedtothetoiletiftheyare
immobile,givenfoodwhentheyare
hungry,painreliefiftheyareinpain
andmostly,theyfearthattheywill
diewhileinhospital,fromanother
conditionwhichiscontractedthere,
duetopoorqualityofcare.
Someofourwomenare
uncertain
ofthecoveragethattheirmedical
schemes
willprovidethemwithand
theydon’tunderstandwhyabenefit,
whichiscoveredat'100%',is
sometimesonlypaidforuptoathird
ofthefullcost.Themedicalaid
premium,whichtheypayevery
month,seemstobeofpoorvalue
whentheyareslappedwithalarge,
unexpectedout-of-pocketbillon
discharge.
They
fear
that
the
escalatingcostsofhealthcarewill
soon
make
care
unaffordable,
particularlyinretirement,asfew
organisationsofferpost-retirement
medicalschemebenefitsanymore.
Inaddition
,
thedisconnectbetween
the
general
practitioners,
specialists,
allied
healthcare
workersandalternativehealth
practitioners
often
results
in
conflicting
messages
regarding
treatmentandmanagementoftheir
conditions.Itseemsasifnooneisin
fullcontrol.Andthe‘Internetof
Everything’cancompoundtheir
senseofbewilderment,asthereare
blurredlinesbetweenmisinformation
andrealinformation.AndDrGoogle
isn’tdiscerning.
ManySouthAfricanwomenalso
believe
thatconsistencyofcareis
generallypoor
,
especiallyinthe
publicsectorwhereapatientmaybe
treatedbyadifferentsetofdoctors
ornurseseveryday.Patientmedical
information
isn’t
shared
in
a
collaborativemannerandpatientsare
oftenexpectedtorelayinformation
betweenavarietyofdifferent
healthcare
providers
or
repeat
diagnostictestsunnecessarily.The
managementofcomplexorchronic
conditionsaretypicallynotwell
coordinatedwhichconfusespatients,
especiallywhenmorethanone
conditionisinvolved.
Medicinesareanothersourceof
concern
as
not
all
patients
understandtheside-effectprofile,
correctdosage,durationoftreatment
andmechanismofactionofthe
drugstheyareprescribed.Some
patientsdefaultfromtheirtreatment
for
conditions
like
tuberculosis,
hypertensionorhighcholesterol,if
theydonotperceiveanydifference
inthestateoftheirwellbeingorthey
experienceadverseeventsdueto
thedrug.Herbalorhomeopathic
productsareoftenpreferredto
pharmaceutical
products,
even
thoughthesemedicinesarenot
currentlyregulatedbytheMedicines
ControlCouncil
.
Whenfearandmistrustsurface,
patients
commonly
disengage
fromthehealthcaresystemand
seekcarefromothersources.
This
emphasizes
the
fundamental
importanceofthepublics’perception
andtrust,whenitcomesto
healthcareissues.
“Myhopeisthatalladolescentgirlscangrow
upcompletinghighschool
HIVfree
and
notfallingpregnant.WomeninitiatedHIV
preventionisrealisedinmylifetime.”
Quarraisha Abdool Karim (Associate
Scientific Director –CAPRISA)