From the narrow streets of bicycle-riding Amsterdam to the wide and worn pothole-riddled roads of Flagstaff, two Dutch doctors have chosen to settle where even few locals would want to.
Doctors Stephan Bontekoe and Quirine Huijgen – 32 and 31 respectively – have forsaken lives of luxury in the Netherlands to serve people in rural Eastern Cape instead.
As a young child, Huijgen had aspirations of being a bartender but, after being inspired by Médecins Sans Frontières (Doctors without Borders) when she was 15 years old, she elected to tend to the sick and vulnerable instead.
Bontekoe was initially undecided about his career but knew that he wanted to work with people.
Africa became “attractive” for these young doctors when they were in medical school.
Now based at Holy Cross Hospital in Flagstaff, they say they are living their dream.
“We read books and we watch television so we were not surprised to find no wild animals roaming South African streets. But on a serious note, I was pleasantly surprised by the infrastructure of this hospital on arrival because I had spent time in Malawi [prior to arriving in SA] and South Africa is better developed, even though it is a rural hospital,” Bontekoe said.
Bontekoe did a portion of his internship in Malawi while Huijgen did some of her internship in Tanzania.
Holy Cross Hospital is a 180-bed district hospital built by missionaries in 1923.
When comparing the hospital they work in now to the ones back home in Amsterdam, the couple cite several contrasts.
According to them, hospitals in the Netherlands have an average of 300 to 350 beds and there are over 100 doctors employed at each of these. The hospitals have state-of-the-art equipment and in-house specialists.
Holy Cross Hospital with its 180 beds has only four permanent doctors, although there are sessional doctors that work part-time at the hospital.
Of the four permanent doctors, only one is South African – two are Dutch and the third is Cuban.
While South African clinics are nurse-led, Dutch clinics are doctor- led.
“In that regard, South African clinics are ahead of our clinics back home, it is only now that things are beginning to change. Both countries’ healthcare systems have strong primary healthcare and referral systems,” Huijgen said.
Huijgen works mainly in the paediatric ward while Bontekoe works in the maternity and labour wards. They rotate duties in casualty.
Language is a barrier for them because they need to ask someone to translate what their patients are saying. They have learnt Xhosa, Zulu and colloquial words to help them communicate with their patients, to some extent. These include the following:
l molweni: hello
l suku khathazeka: do not worry
l ewe: yes
l akhonto: there is nothing
l uyahambhisa?: do you have diarrhoea?
l uyaphalaza?: are you vomiting?
l umntana uyadlala?: does the child play
l ufuna ugoduka?: do you want to go home?
l pipi: penis
l gusha: vagina
They both want to be general practitioners when they return home and Huijgen said the experience they are getting at Holy Cross will help them.
“There is a lot of work that needs to be done because there so few of us. Also, there are no X-ray facilities available on weekends and we just have to make do without them as best as we can. We have to rely on our clinical skills here. The skills and expertise we acquire here will improve the kind of doctors we are,” Huijgen said.
“Back home, there are so few HIV cases that they are only dealt with by specialists. But here, the burden of HIV and TB is present everyday in that a third of the patients we see are HIV-positive. That means whenever we are dealing with whatever ailment they have, the HIV is compromising their immune systems,” she explained.
Huijgen has been in South Africa since March 2016 and was joined by Bontekoe in January 2017. What they miss the most from home are Dutch cheese, peanut butter and cookies.
“The South African ones just do not taste the same,” Bontekoe joked.
The couple are unable to go on typical dates like they did when they were back home. Because of their new home, they cannot go for coffee at the local cafe or go to the movies because Flagstaff does not boast such luxuries.
But Huijgen insisted that Flagstaff offered a different kind of luxury for them.
“Our weekends are much cooler and fun here. We can go on safari, we explore places like Mkambati Nature Reserve. Otherwise at home we would simply walk to the park,” she added.
The pair are in South Africa through the efforts of Africa Health Placements (AHP) which focuses on the remote and the most rural parts of South Africa and finds doctors who are then contracted by the national Department of Health.
Both Huijgen and Bontekoe are on three-year contracts.
Through the network of doctors brought into the country by AHP, Bontekoe and Huijgen have friends at Isilimela Hospital in Port St Johns, Zithulele Hospital in Mqanduli and in hospitals in KwaZulu-Natal.
On living and working in an area which even locals would like to escape from, Bontekoe and Huijgen said they felt that the people of Flagstaff deserved great healthcare.
“This community deserves more that what they are getting. They deserve a much fuller team of professionals that want to do more in order to improve their lives,,” Huijgen said.
Bontekoe said: “The living conditions are good. We have access to phones and the internet and we are able to talk to our families every week”.
Holy Cross Hospital has running water and electricity.
To the couple, the South African winter feels like summer back in the Netherlands. They are enthralled by the African sun. The beauty of rolling hills of the green Eastern Cape landscape and wide blue skies consistently persuade them to call Flagstaff home.