As we observe World Health Day on 7 April, health and
wellness is on everyone’s minds. But a question seldom asked is: Who cares for
the caregivers?

The South African Society of Anaesthesiologists (SASA) held
a round-table discussion in Johannesburg this week to take the pulse of South
Africa’s clinicians – specifically those working in the demanding field of
anaesthesia.

 Experts, including clinicians and researchers, backed up by
solid data, argued that doctor wellness is not viewed as a priority in this
country compared to other nations. This often results in high levels of stress,
burnout, substance use and depression among the overworked medical fraternity.

 “If we don’t tackle this issue urgently, quality patient
care may become unsustainable in the future,” warned Dr Caroline Lee, an
anaesthetist in private practice and convenor of the SASA Wellness Support
Group.

According to Dr Lee, burnout is universal but especially
worrying in the healthcare sector because of the of work and the ty type of
people working in the sector.

“The situation is serious, but the impact is not obvious
because doctors prioritise patient needs over their own,” Dr Lee noted.

“To achieve systemic change in the health sector and expand
support to doctors, South Africa needs collaboration among administrators,
regulators, hospital groups, policymakers and other bodies, as well as a
culture change,” she said. “It’s time to recognise that the health of our
healthcare providers is critical. Everyone must invest in creating and
maintaining a healthy, sustainable healthcare workforce. Doctors must be
involved in healthcare policymaking at every level in the public, private and
academic sectors to achieve this.”

Prof Johan Coetzee of the University of Stellenbosch said
that according to a 2018 survey, 18% of anaesthetists working in South Africa’s
public sector suffer from extreme burnout, with 7% of their private-sector
counterparts affected too. The international average for anaesthesiologists
suffering from extreme burnout is 6.2%.

Unlike in South Africa, clinical burnout is recognised as an
illness in countries like the Netherlands and Sweden, Prof Coetzee said. Those
who are diagnosed in those countries are given government-funded support and
are able to take generous sick leave for the condition.

People who abuse substances are three times more likely to
commit suicide, observed University of Cape Town registrar Dr Justine van der
Westhuizen. An alarming statistic is that in the United States, the death rate
of anaesthesiologists is twice that of other doctors – and they are
proportionately seven times more likely to check in to rehabilitation centres
for substance abuse.

She said that up until recently, no data existed on substance
abuse among South Africa’s anaesthesia practitioners, but a recent survey
yielded telling results. While only 1% of respondents fell into the high-risk
category of substance abuse (alcohol only), there is still a relatively high
use of alcohol and sedatives. What is clear, Dr van der Westhuizen noted, is
that the country’s doctors are sacrificing themselves – and will continue to do
so – before they allow patient care to suffer.

Dr Lee said SASA is committed to helping its members look
after their physical and mental health, achieve a better work/life balance and
recognise the signs of burnout.

SASA has made remarkable strides in
ensuring its members have an understanding of the importance of this issue, and
in encouraging and supporting them to take better care of themselves, she
added. SASA is aiming to expand its efforts to be more proactive, collaborating
with others and working with institutions, as well as continuing to lobby for
greater emphasis to be placed on doctor care.

SASA CEO Natalie Zimmelman added: “SASA is committed to representing the interests of
anaesthesia practitioners and patients – whether that be on a policy level or a
personal level. Our wellness committee is tackling these issues for individual
SASA members, and also systemically for the greater good of patients, the
profession and the healthcare sector in general.”