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Voices: Dr. John Garlick (UK)

Abridged transcript of interview with:

Dr. John Garlick (UK)
Placement: Mosvold Hospital, KwaZulu-Natal
Dates: September 2016 – current

AHP has a relationship with some of the educational deaneries in the UK. My deanery, for example, advertises the opportunity when you start general practice training. That’s how I heard about AHP.

I’m the kind of person that likes to take these kinds of opportunities, so I probably wouldn’t immediately have thought about coming to South Africa, but the way the opportunity was offered to me, it sounded very attractive.

I think it sounded attractive for two reasons. Firstly, the professional side of things, in that the way conditions present here are different, or completely new, in some cases. That professional challenge is something I find very interesting.

Then there was the fact that you are in a foreign country that is so far removed from what I’m used to. In other words, it gives you opportunity to travel, to see new landscapes and experience different ways of life – as well as the various different kinds of safaris and nearby beaches and all those types of thing to explore as well.

So it was a combination of those two factors that got me interested.

My deanery acted in a sort of middleman a capacity. They put me in touch with AHP, and AHP took it from there.

They took us through the process of registration, application and finding posts in South Africa. And I think that they made what could have been a very trying process, easier.

Look, I think the process is going to be difficult anyway. There are things AHP can’t control – for instance, within the government’s bureaucracy – but having someone with a knowledge of how the system works is extremely useful, and I’m sure the relationships they have with the hospitals here are helpful too.

For example, AHP helped me to get in touch with this hospital. They had a good relationship with the medical manager here, which made it easier to get a sense of the options beforehand – what was available, where the posts were, and how you could go about actually getting these posts.

South Africa has a relatively heavy bureaucracy, and there are a lot of hurdles to get past, and if you don’t know the system it makes it very difficult.

I know people who have tried to navigate the process themselves, without the assistance that AHP gives, and I think that they found it significantly more challenging. Doctors generally don’t have a lot of time to spend organising things like this.

I arrived in South Africa at the end of September 2016 – so I’ve been here just over eight months. I am at Mosvold hospital, which is right on the eastern border of Swaziland.

Before I got here, my expectations were based mostly on reports I’d heard from those who had come before me.

The picture they painted was one of a very variable and patchy public health system, where some hospitals had equipment and resources equal to the kinds of things you’d find in the UK, and other hospitals would be really broken down and without many resources at all. Which, all in all, I can now report from my own experience, is a quite an accurate picture.

In terms of the accommodation I’d have and the landscape I’d find, I was quite open to anything, I suppose. I looked at a map before I came and saw that I was going to be very far away from anything that looked sizeable.

Soon after I arrived, I met up with a few people from the UK who were coming at the same time, and we had an orientation course in Durban for two days before we set off for the hospital – so it was quite an easy introduction in that respect.

Driving up here, I was struck by the scenery, by how beautiful it was

And though it’s rural, I was surprised to find that we still had access to the internet. So it was not as disconnected or broken down as I thought it might be.

There is no doubt that in the last eight months I have learnt a lot. And while a lot of the things I’m learning about here are different from what I’ll need to know when I go back to the UK, they are transferable skills. Things like managing people, or managing time, or just the general approach to how to manage the unknown – these are all valuable skills that are not easy to teach to someone. These are things you can only pick up through experience.

So although I might not need to deal with a particular condition, or situation again – for example I don’t think I’m ever going to manage a snake bite again in the UK – still, having an idea of how to approach situations completely out of my comfort zone will be really useful to take back with me.

My experience with AHP since I’ve been in South Africa has generally been on a practical, logistical level – trying to get things sorted out. I’ve found the people who have worked for AHP are very relaxed and have a good idea of what goes on in South Africa, and they are always interesting to talk to.

So far I have certainly learnt a lot, and though there have definitely been trying times, overall I think it has been positive.

And I think it will probably influence the direction my medical career takes – though I think it’s one of these experiences that’s going to need a lot of reflection to draw conclusions from. And I’ll only be able to do that when I’m back home, and I have a chance to assimilate everything that I’ve experienced here.

I’ve always known that I liked the idea of practising medicine in a lot of different communities, in lots of different cultures and different places, and combining a desire to explore with my love of medicine and of helping people. But I’ve had a little taste of it before; this is the only time where I’ve stayed for so long in one place and worked with a community so different from one you might get in the UK.

And I think that now that I’ve had a taste of it, and have found that I enjoy the challenge of it, I’ll probably want to do it more in the future.