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Voices: Dominic Craver (UK)

Abridged transcript of interview with:

Dr. Dominic Craver (UK)
Placement: EG Usher Memorial Hospital, KwaZulu-Natal
Dates: 2012 and 2015-2016

I have done two AHP placements.

I did my first in 2011, and I came back in 2013 with my fiancé for 18 months.

Originally, I wanted to leave the UK for a couple of years, to do something different. But at that time I didn’t have too much experience. I had only been working for two years as a doctor. I also didn’t want to follow my friends to the Antipodes [Australia and New Zealand], which felt like home from home.

I hadn’t considered South Africa until I went to a careers fair in London. AHP was there, and they had some nice pictures up, and they explained that I could work in a rural environment, which is a halfway house to working other parts of sub-Saharan Africa.

So it just made sense for me at the time.

Working in South Africa it’s quite difficult without AHP. They help you to find a job and they help with all the paperwork. You can do it by yourself, but you need to know where you’re going, and you need to know people on the ground, and it’s quite a lot of hassle. AHP makes it much easier than it would be otherwise.

When I first came, in 2011, I specifically tried not to have any expectations, because I knew that I’d either be disappointed or overwhelmed.

And when I first arrived, it was very overwhelming. I started working at a hospital with three doctors, and almost 300 beds. And in my first weekend in casualty we had to deal with about 30 patients after a big road accident.

I knew it was going to be hard.  But I didn’t know it was going to be quite that hard to start with.

But you get into it quite quickly.

And in the end I loved it. I completely loved it. That’s what I came for. And that’s what I came back for a second time. I’m currently a registrar in trauma – emergency medicine – which is my specialisation.

The work is quite hard, but when you’re not at work, you can go and explore the country. I was staying in the Transkei so we had amazing national parks to go to every weekend.

The people are great. I learned some Xhosa. I got on quite well with my nurses and colleagues, though the community can be difficult to infiltrate initially.

There was also the added bonus, which bears mentioning, that doctors in South Africa get paid really well, perhaps even better than the UK.

My medical knowledge, my clinical skills, really improved during my time there, and after two years I was very competent coming back to the UK.  My bosses were all very impressed and very envious at the same time.

You get to do a lot, clinically. So you need to have a bit of confidence, but also some self-awareness, knowing that you could be doing something dangerous. It’s challenging – to know that if you do something, you might cause someone harm. That’s where the self-awareness comes in. You should never be a cowboy.

From time to time, people from AHP would come and visit you in hospital to see how you’re doing. I found that particularly the second time round, they were really good in that way.

AHP would also organise social events where you could kind of let your hair down. So after a busy few months you’d go to Johannesburg or Durban, watch the soccer, go out. They’d get everyone together and you’d meet other doctors, share stories. AHP are quite good at that: making people mix and mingle.

When I first came back from my first placement, I was one of AHP’s biggest advocates. In presentations to doctors, consultants, new initiatives I was working on back home, things like that, I was always talking about it – probably a bit too much – to the rest of my colleagues.

And obviously I went off again.

So if I could say one thing to doctors considering an AHP placement, I’d say that, for me, working in South Africa as a doctor is an experience second to no other place I’ve ever worked in the world. And I’ve worked in Somaliland; I’ve worked in Madagascar; I’ve seen the US system; the Bahamas; Papua New Guinea.

South Africa is just very unique. You get exposure to trauma. You get lots of hands-on experience. You see people in the most extreme circumstances because of HIV and TB. And at the same time it really is a gateway to the rest of the continent, if that’s the path you want to take as a doctor.

That’s why I came back, and why I’ll probably go back in the future.