Rural versus Urban health care: Complacency cripples rural health care!

Some of the health care disparities include access to medical care, demographic and socioeconomic characteristics and health risk factors. According to literature access is one of the most prevalent disadvantage in rural areas, patients have to travel long distances to health care facilities, and sometimes they lack means of travelling due to a low income status. These issues are real issues in our country which contribute to mortality and morbidity in rural areas.  Inequitable distribution of health care workers between rural and urban health care is another factor. Rural areas lack some health disciplines and if there are health professionals they are less than the demand. Inequity in rural and urban health care is said to be inevitable (Spasojevic, Vasilj, Hrabac & Celik, 2015).

Besides all the above mention inequalities between rural and urban health care I want to comment on “complacency” which I have observed to be a factor that cripples health care in the rural areas. The Oxford definition of complacency: “too satisfied with yourself or with a situation, so that you do not feel that any change is necessary”.  It’s unfortunate some of the departments in the rural hospitals are too comfortable with their level of incompetent work because they mostly deal with illiterate patients who don’t even know their rights and also there is lack of resources.

Out of my own interest during school holidays I usually go to a hospital close to home to shadow physiotherapists and assist where I can. What I observed is a high level of complacency where qualified Physiotherapists would see far less patients a day than what we as students see in clinical practise not because there are no patients to see but there is lack of structure in operations and people generally just do not care. People come in any time to work and leave anytime. They will tell you, “Here you can work as much as you want but these places will never improve you just have to do as much as you can”. In rural areas mostly patients don’t know what physiotherapy is they go because they are referred by the doctor ,because they are so desperate for health they do what they are told to do even though they don’t fully understand somethings. Patients queue for hours in waiting areas while physiotherapists are in their tea room for an unreasonable amount of time discussing personal matters during working time. My grandmother had a stroke she went to the nearby hospital and was referred for physiotherapy. She went for physiotherapy she needed maximal assistance to function and her cognitive aspect was affected. On arrival at the physiotherapy department she was told to wait for on a chair outside after hours of waiting the physiotherapist attending her was not patient enough with her as she could not clearly follow instructions, as a result she was told to come some other without being treated. My mother was with her, she was disappointed by the waiting for hours and finally when get to be attended told to come some other time with no specific appointment time. I later contacted the HOD of the department to enquire about my mother’s concern, she asked for my grandmothers details and the response she could give was that I should have called prior they would have attended her had they known she was my grandmother. This response chattered me so much because health care services are for patients in need not for people who are known, by that time my mother had resolved that she will never go to physiotherapy or take anyone to a physio for help because they don’t have the heart to help.

Sometimes the issue is not just resources but rather the attitude, because people are in rural areas they make lack of resources as an excuse yet their attitude also plays a significant role in the level of health care in rural areas.

Cherrie Moraga — “Complacency is a far more dangerous attitude than outrage”

After this incident I realised the importance of self-reflection and self-assessment. According McMillan & Hearn (2008) Self-assessment is can promote intrinsic motivation and internally controlled effort and more meaningful learning. I don’t want at any point to get to a level of satisfaction and open no room for improvement or learning in my practise, even as a student I realised that self-reflection helps to identify your strengths and weaknesses and helps you to set meaningful goals.




Eberhardt, M. S., & Pamuk, E. R. (2004). The importance of place of residence: examining health in rural and nonrural areas. American Journal of Public Health94(10), 16


Spasojevic, N, Vasilj,I, Hrabac, B & Celik, D. (2015)Rural-urban differences in health care quality assessment. Mater sociomed, 27(6):409-411


McMillan, J. H., & Hearn, J. (2008). Student self-assessment: The key to stronger student motivation and higher achievement. Educational Horizons87(1), 40-49.complacency

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