Medical carers need care too

On Friday Mayosi took his life, a tragic decision that followed what his family said was a two-year battle with clinical depression.

You can hear the admiration in Fundile Nyati’s voice when he speaks of Bongani Mayosi.
The two men share a history dating back to high school at St John’s College in Mthatha more than three decades ago.
“St John’s was the best public school at the time,” Nyati says proudly.
“So if you were the number one student at St John’s you were the number one in the whole Transkei. Bongani was number one.”
They would later go to medical school where Mayosi’s flair for genetic research kicked off a phenomenal career that saw him become one of South Africa’s best physicians and a pioneering scholar of our time.
On Friday Mayosi took his life, a tragic decision that followed what his family said was a two-year battle with clinical depression.
At the time of his death the renowned professor was the dean of health sciences at the University of Cape Town, an Arated National Research Foundation researcher and one of our nation’s most revered citizens.
It was only natural, therefore, that many would ask how a man of his stature would be on the receiving end of what is dubbed as a silent killer of our time.
Let me be clear.
I have no interest to speculate on the circumstances of Mayosi’s death.
Nor do I wish to entertain the different narratives, beyond his family’s word, about what may have been behind the ultimate decision to end it all last Friday.
It will serve no purpose to do so.
My interest is to engage on the important national conversation brought hereon about mental illness and its prevalence in the medical fraternity in particular.
Global research has shown that doctors around the world suffer from depression or other mental illnesses.
For some it is a lifelong condition that is prompted by or exacerbated by the trauma of their work.
Yet, despite its prevalence, too many health professionals suffer in silence, often with devastating consequences.
This is not necessarily because of predisposition, but because they, unlike the rest of us, are socially burdened with the expectation to be super human, to have it all and to know it all.
It is a phenomenon the world over.
The American Psychiatric Association estimates suicide among doctors to be higher than in any other profession in the US.
Its latest research presented in May has found that 28 to 40 per 100,000 doctors take their own lives.
This is double that of the country’s general population.
Research by author Pamela Wible also found that horrendous work conditions such as sleep deprivation, or even the guilt of losing patients at times increased the risk of suicide among doctors in particular.
Similarly to other countries, the social stigma and misconceptions here in SA around mental health, as well as the pressure on medical professionals, prevents many from seeking help.“Even when we know that things are not going right, we are reluctant to open up even to other colleagues,” Nyati explains.
“Even with all the technical knowledge about these illnesses, the issue of stigma and discrimination, even among the colleagues, is quite rife.
“Competition among the professionals is quite high so it is not easy for guys to open up for fear of exposing that they are not coping.”
And then comes the financial pressure.
“The situation in the private healthcare in SA is such that medical specialists and even GPs are squeezed out of the financial cake of private healthcare. They are squeezed by the bigger players like the hospitals, pharmaceuticals, laboratories.”
It is estimated that GPs only receive between 5% and 7.5% of the financial benefit of healthcare, down from about 15% about 10 years ago.
“The financial pressures that have come with that are so devastating that a lot of guys are in financial trouble.”
But perhaps most problematic is that South Africans in general do not understand mental illness.
The social language we often use in our homes and communities, intentionally or otherwise, renders those who suffer from some form or other as sub-humans.
At best, it is condescending and attributes their condition to weakness.
At worst, it is downright derogatory, even violent.
This social landscape alone makes it difficult for practitioners to speak up.
This must change.
Yet we must be mindful that it is one thing for doctors to be able to speak up, it is quite another to build systems that create efficient avenues for help.
Encouraged, Nyati says some groups of doctors have begun constructive conversations privately about how the kind of work they do demands that they, too, be looked after. They must be supported. The wellbeing of our nation depends on it.
-Nwabisa Makunga is The Herald editor.

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