South Africa's health system consists of a large public sector and a smaller but fast-growing private sector. Health care varies from the most basic primary health care, offered free by the state, to highly specialised hi-tech health services available in the private sector for those who can afford it. Specialist services are also available at state hospitals, but waiting lists are often very long, depending on the problem or medical procedure needed. If you have medical aid cover it may be easier to go to a private hospital. Private hospitals and clinics can be found in most urban areas. The public sector is under-resourced and over-used, while the mushrooming private sector, run largely on commercial lines, caters to middle- and high-income earners who tend to be members of medical schemes (18% of the population), and to foreigners looking for top-quality surgical procedures at relatively affordable prices. The private sector also attracts most of the country's health professionals.

Although the state contributes about 40% of all expenditure on health, the public health sector is under pressure to deliver services to about 80% of the population.

The cost for treatment at a state hospital depends on how much you earn and on how many dependants you have, according to the hospital rating scale. At the low end of the scale - that is, if you are unemployed - you will be expected to pay R39 as an outpatient. This will cover your consultation, medication and possible blood or other tests. A pensioner will pay only R13 for the same service. If you are unemployed and are admitted to hospital, you will pay R194 for up to 30 days. The maximum a state hospital will charge, if you're at the top end of the income scale, is R55 for a consultation. However, you will be charged additional amounts for medication and tests. For a stay in hospital, a top-end patient (including those on medical aid) will pay R484.90 per day, excluding medicine and theatre costs.The government is trying to guide patients away from hospitals to its public clinics and community health care centres, where free primary health care services are available. However, patients on medical aids are charged. 

Doctor, GP

All medical practitioners must register with the Health Professions Council of South Africa, and the organisation has a comprehensive database. The organisation also deals with reports of malpractice. Phone: (012) 338-9300. One means of finding a local GP is to go to the MEDpages website which lists online directory of healthcare professionals and organisations. The site offers a free search containing selective information aimed at the general public. MEDpages also publishes its authoritative directories of healthcare professionals and organisations by region. Phone: (021) 441 9700.

Pharmacists may only prescribe up to Schedule 3 drugs, which do not include antibiotics. They may issue oral contraceptives, insulin, thyroid and heart medications and some pain killers, for example. Pharmacists are also trained to give basic medical advice to cut down on unnecessary visits to the doctor. However, a pharmacist should advise clients of when a visit to the doctor is necessary.

Scores of alternative health practitioners can be found in South Africa - from homeopaths, to acupuncturists, polarity therapists, sound healers, iridologists ... the list is endless. Health shops usually supply information on health practitioners in your area. Go to the Natural Health Network for a wide variety, if not a comprehensive list, of alternative health practitioners. Health Pharm also offers information on natural healing, focusing mainly on homeopathy and nutrition.

Many people visit South Africa's 2,000 traditional healers, and there is a growing recognition of their value to society. Traditional healers, or sangomas, use a combination of plant and animal products for their medicinal potions, known as muti. They also incorporate a spiritual element into the healing process and perform a variety of functions for those who visit them, including doctor, counsellor, priest and psychiatrist.

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