Stephanie Ortynsky has recently spent a 6-month internship in South Africa as a Research Assistant position with the organization Health Systems Trust (HST) in Cape Town, Western Cape.
The position was funded by the Canadian International Development Agency (CIDA) and organized through the Canadian NGO, Human Rights Internet (HRI).
Ortynsky said she saw the position as an opportunity.
"Eventually wanting to play a role in health care improvement here in Canada, while still wishing to spend more time abroad, it seemed like a logical step to apply for the internship program," she told Yorkton This Week. "There was a really quick turn-around as they needed the position filled right away. Within a week I had submitted my application, had a Skype interview and was accepted and booked to travel to Cape Town in less than a month.
"Another reason that led me to South Africa was the common knowledge that anyone who has come into contact with our health care system is well aware of: a considerable number of our physicians originate from South Africa or another developing nation. Keeping this fact in mind and knowing that one should at all times be aware of all stakeholders involved in making our system what it is, made me realize the importance of experiencing and learning what perceptions and experience they are coming to Canada with. I thought it essential to know the type of environment in which they have trained and the cultural context from which they come.
"Maybe it was also the business side of me doing a PEST-EL (Political, Economic, Social, Technological, Environmental and Legal) analysis of the Canadian system that led me to the land of the Springbok rugby team? As a side note, sport is very popular here. You name it, they have it - except ice hockey, unfortunately."
Ortynsky said the process of involvement was an interesting one.
"After working in Geneva with the World Health Organization last summer I was advised that if one would like to work in global health it is necessary to have a significant amount of professional developing country experience," she said. "At that point, I was open to working in various regions around the world. When South Africa came up as an opportunity, initially I did not associate the nation with 'developing country' status. Globally it is ranked as a Middle Income country by the World Bank but that is probably due to its disparities. There is massive wealth here that you could only imagine or see on television coming from Yorkton, SK, but you also see extreme poverty all within one day or even in the same area. Near the end of my Master of Public Health (MPH) program an email was circulated about potential internship opportunities with the non-governmental agency Human Rights Internet. HRI, a NGO located in Ottawa, ON, administers the Youth Internship Program funded by the Canadian International Development Agency.
"The main objective of the Agency is to promote international development (the term in itself could take on another whole article to explain properly) in developing countries be it in healthcare, environmental projects, business opportunities, etc. I was involved because they provide opportunities for young Canadians to travel abroad and work with a reputable partner organization, funded by the Government of Canada. Therefore I must thank you, the taxpayers of Canada for continuing to support such a worthwhile endeavour. It is quite a beneficial partnership for all stakeholders involved. A NGO in the selected country will have half a year of work provided by a university-educated Canadian intern, who will consequently become better informed about other regions of the world, while gaining useful workplace skills that may not have been as easily obtained in Canada. Health Systems Trust was the foundation that I worked for."
In terms of health care Ortynsky said she saw obvious differences between Canada and South Africa.
"Canada's healthcare system is very hospital and pharmaceutical-based which tends to be a huge driver of costs as it deals with health issues that are usually in the critical stage and by that nature are very expensive to treat," she said. "This involves knee, hip and back surgeries, severe obesity, etc.
"There still is a strong need for the promotion of primary prevention that encourages healthy lifestyles in this country, even though it takes years to observe and report on the return on investment for this type of approach."
In South Africa the approach is taking a different approach.
"The National Department of Health in South Africa and health administrators have been enthusiastically adopting a focus on Primary Health Care (PHC) by strengthening their community clinic system run by community health workers," offered Ortynsky. "This enables them to actually get into the rural areas and ensure people are taken care of, regardless of transportation or income issues. Health care in South Africa is also two-tiered in that there are private and public systems. The work I did was always to improve the public system.
"From a personal standpoint I did however come in contact with the private system and found it interesting that my visit and diagnosis had to be put on a TD Visa credit card. What they deal with here in terms of disease burden is much different from Canada. Our major hurdle is chronic diseases with Canada's demographics changing to that of a majority aging population. South Africa contends with not only non-communicable diseases such as diabetes and cancer but also infectious diseases such as HIV/AIDS and TB. The South African government is working on putting into place full health care coverage for basic essential services, but it will probably take about 10 to 15 years and billions of rand before it comes to fruition. Regardless these are exciting times to be a part of."
The situation Ortynsky experienced has changed her perspective of things in Canada.
"Coming from Canada a place where it was not always an easy journey to implement full coverage for the whole population with Doctors' strikes, funding problems and such, in the end you can only look back at the place of your birth and be very proud to come from a country where our integral value of taking care of one another, regardless of background or financial situation, has enabled and promoted the establishment of many successful public institutions that are looked to around the world as examples," she said.
Among the many experiences, Ortynsky said some will stick with her most.
"Visits to some of the public sector hospitals in the Townships of Gugulethu, Khayelitsha and Browns Farm with University of Cape Town (UCT) medical students and colleagues from work will always stick with me," she said. "First of all before even entering the facility you have to go through a security check which involves a metal detector and bag search. You then come into the waiting room crowded with people who are all sitting in chairs facing the front and waiting to be admitted. Some of them will wait for a day before being admitted to see a student or physician."
Ortynsky will be sharing more of her experiences in Yorkton next Tuesday (Feb. 26).
'Health and Development in South Africa; is the topic she will be addressing for the Canadian Federation of University Women at the Parkland College at 7 p.m..
"Early on in my internship I was in contact with Bilkies McKen, the President of CFUW Yorkton Club, about doing an outreach activity," said Ortynsky. "A component of our internship involves public outreach while we are away and once we return to Canada. Having been involved with the International Affairs group with the CFUW Saskatoon Club, I was well aware of the respectable work they do in the community, nationally and internationally, especially when it comes to women and child rights.
"The main objective of the talk will be to shed some light on healthcare in South Africa while comparing it to Canada.
"Discussing life in South Africa will also take up a large portion of the presentation as living in the Southern hemisphere has really taught me a lot and changed my perceptions about how I initially saw it and how they see North American countries. There is a lot to be learnt from others' approaches to life."
Ortynsky said she now looks forward to working closer to home.
"Having been exposed and gained experience in a research foundation aimed at improving health systems in South Africa, I am looking forward to doing more such research with an organization in Saskatchewan," she said. "Since my undergraduate years at the U of S, I have wanted to work for the Health Quality Council as the organization's main objective involves improving healthcare for everyone in this province."
