Introduction: South Africa
South Africa, a country that officially bears the name of the Republic of South Africa, has one of the largest economies among the countries on the African continent. However, despite this, the country is still stricken by numerous problems such as poverty, unemployment, disease, and extremely high mortality rates. Because of this seeming contrast (largest economy vs. social problems), which may appear paradoxical if one forgets that South Africa is perhaps “the richest among the poorest,” the country was chosen as an object of analysis for this paper. In this work, some aspects of the country (such as its geography, demographics, government, and economy) will be briefly described, after which information about the healthcare and nursing spheres in this country will be provided and discussed.
Location/Geography
South Africa is situated in the southernmost part of Africa, near the coastline of both the Indian and the Atlantic Oceans. The state shares its borders with such countries as Botswana, Zimbabwe, and Namibia to the north, as well as with Swaziland and Mozambique to the east; also, Lesotho is a separate state which is an enclave surrounded by South Africa. The country is mainly situated on a large Central Plateau (the altitude varies approximately from 3,300 to 6,900 feet), the edges of which are called the Great Escarpment; the southwestern part of the country has the Cape Fold mountain belt.
Population
The country’s population is nearly 55 million. The government’s statistical bureau describes the population by using five racial groups. According to the department, approximately 80.5% of the population are African, 8.8% are Colored, 2.5% are Indian or Asian, whereas Whites account for 8.3% of the population; there is also a little percentage of Other/Unspecified representatives of the population (Statistics South Africa, 2016, p. 2). There are somewhat more females than males: 22.574 million females vs. 21.653 million males (Statistics South Africa, 2016, p. 2). It is noteworthy that the country often serves as an asylum for refugees from several other African countries, such as Somalia and Zimbabwe.
Government
The government system of South Africa is a representative democracy that has a parliamentary system. The system includes the Parliament of South Africa, which is comprised of the National Assembly and the National Council of Provinces, and has the legislative power in the state; the President of South Africa, who is simultaneously the head of the State and the Head of the Government, and the main representative of the executive power; and an independent judiciary branch, which includes the Constitutional Court, the High Court, and the Supreme Court of Appeal.
The parliament is chosen in a general election, which takes place not more seldom than every five years; the President is elected by the members of the country’s National Assembly (“Government in South Africa,” 2015).
Economy
The economy of South Africa is the second-largest in Africa; the gross domestic product (GDP) of the country accounts for almost a quarter of the total GDP of Africa. Despite this, the population of this country still suffers from a high rate of unemployment and poverty. Interestingly, the informal economy in the country is relatively small, which is uncharacteristic of most countries stricken with poverty. The largest sectors of the country’s economy are finance, business, and real estate services, manufacturing, general services of the government, and wholesale and retail trade together with the hospitality industry (Statistics South Africa, 2013).
State of Health
The overall state of health of the South African population is rather poor. A major concern is the epidemic of HIV/AIDS; approximately 11% of the population is infected with the virus (World Health Organization, 2013). Tuberculosis affected nearly 0.97% of the population (World Health Organization, 2013). There is also an abundance of non-communicable diseases, with cardiovascular diseases responsible for the majority of death cases (Udjo & Lalthapersad-Pillay, 2014); the rates of these diseases are constantly increasing (Fryatt, 2013). Also, another significant problem is malnutrition due to hunger; also, poor quality of food often leads to obesity, including morbid obesity, which makes South Africa a “double-burden country,” stricken by both obesity and hunger (Britnell, 2015).
The violence rates are high, and deaths or injuries due to car accidents occur often (World Health Organization, 2013). There is a significant level of structural, gender-based violence, childhood abuse, and so on, which are related to the patriarchal society and the cult of masculinity, as well as to high levels of unemployment and the lack of social protection (Seedat, van Niekerk, Suffla, & Ratele, 2014).
Apart from significant rates of traffic accidents, there is also a high risk of achieving trauma due to accidents at work, for instance, in the mining industry (van den Honert & Vlok, 2015).
Culture/Traditional Medicine
The culture in South Africa is rather diverse. The country is home to representatives of numerous cultures and has 11 official languages. Many inhabitants of the country live in impoverished rural areas, but among them, the cultural traditions remain the strongest. On the other hand, however, urban dwellers often become westernized and lose their cultural peculiarity.
Traditional medicine is stated to be on the rise in South Africa (McFarlane, 2015). In particular, it is stressed that approximately 200,000 traditional healers can be found in the state and that they provide services for approximately 27 million people, which is more than half of the country’s population. The indigenous medicine in this country is based on the use of minerals, plants, and animals, and is aimed at treating “both spiritual and physical components of personhood” (McFarlane, 2015, p. 61).
It is possible to suspect, however, that this form of healing may be of suboptimal efficacy; for instance, some healers claim they are capable of addressing the disease of AIDS, which is doubtful; also, there is a “dark side” to the traditional medicine, such as the belief that certain body parts may bring healing and good luck, which in certain cases leads to kidnappings and further use of parts of bodies of the kidnapped victims (McFarlane, 2015).
Healthcare System and Delivery
Governmental Health-Related Agencies and Health Regulatory Organizations
The state healthcare system in South Africa is controlled by the governmental Department of Health; the latter has the responsibility for controlling the public sector of the healthcare industry in this state (South African Government, 2015).
Only nearly 16% of South African inhabitants are covered by healthcare schemes, whereas the rest of the country’s dwellers are forced to “payout of pocket” or utilize the services of private medical services providers. However, it is stated that “South Africa is in the process of introducing an innovative system of healthcare financing with far-reaching consequences on the health of South Africans,” which is supposed to be fully implemented over 14 years (South African Government, 2015, para. 36-37).
Healthcare Personnel and Hospitals
According to World Health Organization (2011), the total number of physicians in South Africa in years 2000-2010 equaled 34,829, whereas the corresponding number of nurses and midwifery personnel was 184,459 (p. 122). Simultaneously, in 2000-2010, the number of doctors per 100,000 population was 77, whereas the number of nursing and midwifery personnel was 408 per 100,000 population (World Health Organization, 2011, p. 122).
Approximately 200 private and 400 public hospitals are to be found in the Republic of South Africa. It is important to note that the Department of Health conducts direct administration of 10 large teaching hospitals in the state. Also, the third-largest hospital in the world, the Chris Hani Baragwanath Hospital, can be found in this state, in the city of Johannesburg; the hospital is public.
Nursing Education System and Accrediting Organizations
In South Africa, nurses are trained at universities and public nursing colleges. In 2009-2011, universities have trained nearly 1,900 and 6,700 nurses (Department of Health, 2013, p. 18). As for nursing education, the following is stated:
Nursing education takes place in a complex environment, which includes 20 out of 23 public universities, 12 public-sector nursing colleges (with numerous satellite training campuses) that are the responsibility of the nine provincial health departments, a nursing college run by the defense force, private nursing colleges run by the three major private hospital groups in South Africa, and private nursing schools that are run for profit. (Armstrong & Rispel, 2015, para. 7)
There exist national standards about nurse accreditation, regulation, as well as their vocational qualifications, which are overseen by the South African Government (Armstrong & Rispel, 2015).
Nursing Associations
There exist several nursing associations in South Africa. These include the South African Nursing Council, Democratic Nursing Organization of South Africa (DENOSA), Allied Nursing Association of South Africa (ANASA), South African Democratic Nurses’ Union (SADNU), and some others.
Health Priorities
From the information provided above, it is possible to see that, even though the country of South Africa is one of the wealthiest countries on the African continent, it still suffers from several serious health problems. In this country, it is paramount to dedicate attention to the epidemic of HIV/AIDS, which is unimaginably large; as was stressed, 11% of the population is infected with the virus. The high rates of tuberculosis also need to be addressed. Also, the government should provide the population with a satisfactory number of jobs and/or social aid, to address the problem of child malnourishment. It is also important to emphasize that the country lacks medics; the training and, importantly, employment opportunities for physicians and nurses require to be provided.
Conclusion: Nursing Implications
Therefore, it should be stressed that, despite the privileged position of South Africa on the African continent, the population of this country suffers from numerous social problems, as well as from disease and poor medical service. These problems should be addressed if the quality of life of the country’s dwellers is to be improved. To help handle these issues, local nurses might take part in public life.
In particular, it might be recommended to conduct political activism aimed at creating workplaces for nurses and other medical personnel, for the country experiences a significant dearth of medics; the working conditions and wages of medics should also be paid attention to. It is also possible to demand more places in local colleges and universities for nurses, as well as for other healthcare professionals. The issues of lack of medical insurance among the population should also not escape the nurses’ attention.
References
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