The Good Shepherd Hospital, Siteki, Swaziland
Hospital Medical Officer
The Kingdom of Swaziland is a small, fertile land-locked country surrounded mostly by South Africa but also sharing a small eastern border with Mozambique. The entire country is only about 18,000sqkm!! The population is just under 1 million people, of which 97% are Swazis. The capital of Swaziland is Mbabane and the business capital Manzini. Swaziland became independent from Britain in 1968 and is currently ruled by King Mswati III.
The Good Shepherd Hospital is a 125 bed rural hospital located on the eastern border of Swaziland in a small town called Siteki (pronounced 'Steggie'). It runs in partnership with the Catholic Diocese and the Swazi government. The government pays the hospital wages but the operational costs of the hospital are covered by the Catholic Church. There are male and female medical units, paediatrics, obstetrics and surgical units. There is a very busy outpatients facility plus a TB clinic attached to the hospital. There is a pharmacy (partially stocked by overseas donations), pathology department (VERY basic) and x-ray facilities (only when the radiographer is around). There is Internet available but the connection is unreliable.
The Good Shepherd hospital services the entire Lubombo region and is one of only 6 hospitals in Swaziland. Given that there is no medical school in Swaziland, all doctors are foreign trained and very few are of Swazi origin. There is an average of one doctor per 30,000 people. At the Good Shepherd hospital, the director is of Indian background but has been at the hospital more than 25 years. Other staff come from Ethiopia, England, the Congo and the USA. Dr Ned Wallace is a retired American physician who lives part-time in Swaziland and facilitates American HMOs to work short terms at the hospital. All other placements are organised via Dr David Wakely or Dr Aby Philip. Some of the nurses have formal training in South Africa but the majority are training on-the-job and are qualified to work only in Swaziland.
I worked on the male medical wards. The major presentations were HIV associated diseases and TB. The rate of HIV in the hospital population is thought to be as high as 50%. Otherwise malaria, cholera, schistosomiasis, sexually transmitted diseases were frequent. There are also many obstetric emergencies that are often dealt with by C-section. Treatment regimes were quite different from what I was used to but the permanent staff have complied a document to get you through. The Zimbabwe medical handbook is also invaluable. Your work is basically tailored to your experience ... which you are sure to gain quickly. The nurses are fantastic at helping you to understand traditional beliefs and family structure (polygamy is practised in Swaziland) and the medical staff will provide adequate back-up where required.
Working hours are 8am-5pm daily but you may be called upon at any hour in extenuating circumstances. Lunch is between 1-2pm and almost everything stops for lunch hour. The hospital chef will provide your lunch and dinner that is structured around your working hours. You can hire someone to do most of your domestic duties - this is great as it provides employment for a local person and leaves you free to concentrate on your hospital duties. Weekends are basically free to travel unless you have organised otherwise.
The official languages are SiSwati and English. In the cities, you will have no problems with English. But in the more rural areas, SiSwati predominates and it is valuable to learn a few phrases $hellip; even if it just to show the locals that you are trying! In the Good Shepherd Hospital, the nurses act as translators. The reliability of the translation is sometimes questionable. And to make things more difficult, whilst some of the patients know English, they will not speak it.
Siteki is a moderate sized town but unfortunately the hospital is located at least a few kilometres from the town centre. Outside the hospital are roadside stalls selling fruit. If you head into town you will find all the basics - grocery store, post-office etc etc. For all other needs, the capital is not too far away and it is probably worth the trip. If you don't hire a car, a bus travels between Siteki and the capital. But be warned, there is no upper limit to the number of passengers picked up and the speed limits are not obeyed by the drivers.
Swaziland is only small but don't bypass it for travel options. The roads are fantastic and it is relatively safe to travel by car. Try to track down a copy of the "Jumbo Guide to Swaziland". There are fantastic day hikes in the Lubombo Mountains and the local markets should not be missed. And if you make the right connections, a visit to a local Sangoma (witch-doctor) can be organised. In South Africa, a trip to Johannesburg is amazing if you are interested in African history. Also, within travelling distance are Zimbabwe, Mozambique and if you are ambitious and have a bit more time Namibia is fantastic.
Dr Aby Philip OR Dr David Wakely
Good Shepherd Hospital