MHM Magazine

systems accountable for patient outcomes when the workforce itself is in psychological crisis? A study of 208 community service doctors found 89% had emotional exhaustion and 94% suffered depersonalisation. A survey at Charlotte Maxeke Johannesburg Academic hospital found that of the healthcare respondents, 46% screened positive for burnout while 54% for depression. Factors associated with mental health challenges include age, race, position, the disciplines of emergency medicine and having prior psychiatric diagnoses. The Health Professions Council of South Africa (HPCSA) mandates that young medical doctors work no more than 40 hours per week, with a maximum of 20 hours overtime, and rest periods, including a 12-hour break, between weekend shifts. In SA’s overstretched public health facilities these regulations are frequently disregarded, and in overburdened facilities, young medical doctors routinely work between 80 and 120 hours per week. This is not an unavoidable consequence of resource constraints; it is a management choice that prioritises operational convenience over human dignity and regulatory compliance. The South African Medical Association (SAMA) has documented extreme exhaustion and mental health consequences faced by young medical doctors, including instances leading to suicide yet the medical professions stigma around mental health prevents help seeking behaviour. The Health and Allied Workers Indaba Trade Union (HAITU) said: “It is a common occurrence for managers to deny leave or even recall leave to ‘patch up the shortage of staff’. HAITU has received numerous grievances related to gross violations of this basic right.” This represents a fundamental failure of workforce planning and demonstrates how senior leadership shifts operational failures onto the most vulnerable members of the healthcare team. Medical graduates in training are meant to be guided, mentored and supervised, instead, they are treated as expendable resources, carrying operational burdens that should be distributed across more experienced staff. This represents a profound breach of educational and professional responsibility. Youth month is a time not only to honour past sacrifices but also to be mindful of how far we have come. The struggle for justice, dignity and humane working conditions continues and this time it is existing in hospitals, clinics and community health centres in SA. Leveraging technology for support Addressing these challenges requires comprehensive leadership commitment across multiple domains such as: Anonymous communication platforms: implementing secure, anonymous chatbots allows young medical doctors to report issues without fear, facilitating early intervention. Leadership training programs: equipping senior staff with the skills to recognise and address mental health challenges fosters a more supportive environment. Data analytics and insights: regular surveys and data analysis help identify systemic issues, enabling targeted strategies to improve workplace culture. Matched Media offers a suite of services designed to enhance communication and support within healthcare institutions. These tools not only address immediate concerns but also contribute to a long-term cultural shift within healthcare institutions. Ultimately, as Dr. Kubheka-Chauke powerfully puts it, “a system that exploits its healers cannot heal, just as a system that ignores the dignity of its workers cannot provide dignified care.” The legacy of Dr. Mazwi must compel us to rethink the very ethics of our medical institutions, where ensuring rest, mental wellness, and humane conditions becomes not a luxury, but a moral and professional obligation. Upholding the principles of beneficence (do good) and non- maleficence (do no harm) means promoting the well-being of patients and healthcare workers and, also actively preventing harm caused by unsafe conditions, understaffing, and lack of resources. Just as the youth once fought for our freedom, we must now advocate for a health system that truly serves and protects all. EDITORIAL 2 | MENTAL HEALTH MATTERS | 2025 | Issue 3 MHM