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Voices: Dr Caroline van der Werff (Netherlands)

Abridged transcript of interview with:

Dr Caroline van der Werff (Netherlands)
Placement: Canzibe Hospital, Eastern Cape
Dates: 2014 – 2018

I am a doctor; my work is to help sick people.

I came to South Africa to work in a rural area because people are very poor here and do not have easy access to healthcare facilities. Also, there is a huge shortage of doctors because local doctors are often not interested in working in rural areas.

AHP recruits foreign doctors and helps them with registration and paperwork. They facilitate their placement process and introduce them to rural hospitals where the need for help is greatest.

They also help the South African Department of Health with the recruitment of doctors who are motivated to work in rural areas. In that way the government is able to sustain their health care services, and the local people receive the care they need.

The story of how I came to be here began when I was a medical student in the Netherlands, and I had the opportunity to do part of my internship abroad. My university requested that I have a Dutch supervisor in the hospital where I did that internship.

I wanted to work in Africa, just in general, so I was looking for a Dutch doctor, working in any African country, who was willing to supervise me.

I got in touch with a friend from my hometown, who knew one of the Dutch doctors working in Canzibe [in the Eastern Cape, South Africa], where I’m working now. My friend said, “Why don’t you contact him? I’m sure he’d be willing to advise you.”

He was indeed willing, and so, in 2007, I spent four months in the hospital here as part of my internship.

I then went back to Holland to finish my studies, but I’d had such an enjoyable internship that when the doctors I’d worked with here suggested I consider coming back to work in Canzibe after I’d graduated, I took it very seriously.

And that, basically, is how I ended up here.

I returned through AHP because a friend of mine, who was a teacher working for a non-profit organisation in this area, was friends with Saul [Kornik, CEO of AHP].

I was telling her that I wanted to come back to South Africa to work here, but that I didn’t really know where to start, and she put me in touch with Saul and AHP.

I faced a challenge, initially, in that the Health Professions Council of South Africa (HPCSA) wanted me to have two years of postgraduate working experience, and they didn’t acknowledge my internship as working experience.

So I was faced with a choice: I could either work in Holland, and get that work experience there, or else I could come and work here in South Africa as a volunteer.

I preferred that second option, so that’s what I did. AHP helped me to register as a volunteer, and an American organisation supported me with a stipend during that two-year period.

So AHP has actually helped me twice: first for my volunteer registration, and then, second, when I got this job working for the government.

The bulk of AHP’s support started once I got my HPCSA registration. They helped me with all the paperwork during the various the bureaucratic processes, like handling job applications, and the Foreign Workforce Management Programme, and all the other relevant documentation.

The registration process took a long time. AHP helped me to sit it out. They facilitate the process, help you with all the documents, but they’re still reliant on the HPCSA, who take their time.

The mental support AHP offers is important, though. They tell you, “You can’t give up. You’ll get it eventually” – that kind of thing.

Once your job offer is secured, or once you’ve signed your contract, the next stage begins, and you work together with AHP to finalise everything. I felt they really supported me at that stage, too. Even if it took a while, I felt supported.

Canzibe is very rural, so we are quite isolated here in a way. I’ve seen a lot of people come and go. Some people hate it here. To them it’s boring, there’s nothing to do, you can’t go out for dinner. Other people love it. It’s really what you make out of it.

I’ve gotten involved, aside from my hospital work, in a local non-profit organisation doing projects in the community. From them I’ve learned a lot about how local Xhosa people live, their life and their culture. Which is very valuable for me in my work: you try to help your patients, but if you don’t know how they’re living or what their living environment looks like, you miss out on some very important things.

By getting involved in community projects you meet local people; you make local friends. And for me, that makes a big difference.

In the hospital itself, you have to be creative. All the fancy stuff you have access to in the western world, you don’t have it here. So you try your best to figure out something that is almost like what you need.

If I can give you an example: we used to have children with asthma and they need an inhaler. For children these particular inhalers can be difficult to use. So, to make it easier for them to use the inhaler, I started to use these 500ml plastic water bottles. You just empty them, cut a hole in them, and it’s almost like a homemade inhaler.

Sometimes it’s frustrating, when you can’t figure it out. Sometimes you just want a piece of equipment that you don’t have, and at those times you ask yourself, “Why do I have to figure out an alternative all the time or come up with a homemade thing?”

So it has two sides. Working here is a complicated experience. Challenging, inspiring and frustrating, all at the same time.