Johannesburg: a city of two tales
BMJ 2003; 326 doi: https://doi.org/10.1136/sbmj.0305156 (Published 01 May 2003) Cite this as: BMJ 2003;326:0305156
- Shazad Aslam, final year medical student1
- 1Barts and The London Medical School, London
Johannesburg is one of the largest and most affluent cities in South Africa, attracting many immigrants from the surrounding areas in search of wealth and prosperity. The skyline shows off impressive buildings, large shopping malls, and man made mountains made from excavating land in search of gold and other minerals.
The many hospitals in Johannesburg range from the wealthy private hospitals to the poor government hospitals. I spent my time at Chris Hani Baragwanath hospital (Bara for short) in Soweto, working in surgery and trauma medicine.
REX/RICHARD SOWERSBY
Limitations of the system
Most middle class and some working class individuals pay insurance for health, termed “medical aid,” which the poor can't generally afford. There are limitations on what funds buy, and if the money runs out, patients often have to move to a state hospital. State hospitals also charge. Fees are usually based on the patient's income and marital status and range from Rand 13-194 (£1.07-15.50; a1.50-22.70) for an outpatient visit to Rand 129-194 per admission, which includes all treatments except in emergencies where all treatment is free.1 Maternity cases and children under 6 years are treated free of charge. Patients in Baragwanath often have to wait for long periods of time to see a doctor.
Baragwanath hospital is large, covering 173 acres and serving more than 3.5 million people in Soweto and its surrounding areas. It was originally a British army hospital and has long, winding corridors and large nightingale wards. The windows have bars on them, and the hospital is surrounded with wire fences, tall walls, and barbed wire. …
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