Dr E Bowen Jones, Sr Lynette Thomas, Dr Philip Erasmus
The South African Red Cross has one aeroplane in KwaZulu Natal which takes specialist care to rural hospitals. Government specialist services are concentrated in the teaching hospitals in Durban with smaller concentration in Pietermaritzburg, 90km inland and Empangeni in the North. There are no other specialists in the 38 rural hospitals, many at the end of dirt roads many hours away.
A full time co-ordinator recruits specialist doctors and ancillary staff to visit hospitals on a regular basis by the aeroplane. Visits are organise on a monthly roster with military precision to obtain maximum cost effectiveness. During the day, the plane doubles as an air ambulance and transfers specialists to a second hospital, returning volunteers by evening.
In the year 2000, 5731 consultations were done by specialist doctors and 14770 by ancillary staff. The most widely used specialists were orthopaedics (2370 consultations), general medicine (1107), paediatrics (823), and ENT (558). 211 operations were performed, mainly by orthopaedics and plastic surgeons. Anaesthetists were brought to teach local doctors and G.P's came to relieve local doctors to be with visitors. The most widely used ancillary consultations were optometrists, (6348), dentist (4057), orthotist (1652) and physiotherapist (1052). 2118 pairs of spectacles were dispensed and 3762 dental procedures done.
Conclusions:
We have learned that for cost effective service delivery :