sama boss QUITS in HEALTH for all quest

There's no acrimony in his departure from the South African Medical Association (Sama), says Dr Kgosi Letlape, who has just ended his eight-year stay at the helm of the doctors' body.

He thinks, quite simply, that he'd overstayed his welcome and it was about time he moved on to other challenges.

He was going to leave in August. When he took up the second of his three-year terms, he'd already told the suits at Sama he was not going to be available for election.

"If it had happened nicely." he says, probably about his resignation, but trails off. What he chooses to say, and finish, is that "things happen for a reason".

"What I've learned in my life is to actualise the fact that every [dark] cloud has a silver lining. Sometimes what might be perceived as bad happens to keep you on a good path."

Once things happen, one has to either wake up to a new era - "God saying you've done your part" - or start fighting.

At the heart of his discontent with Sama is the Medical Schemes Act No 131 of 1981.

The thing with Letlape is that he's not only eloquent but knows what he's talking about.

The self-interest of the inner circle in Sama, he says, was at odds with what he believed in regarding the medical aid act. "Their interests elsewhere were clashing with what I stood for."

The act speaks of universal access to health, says the good doctor, but this is a fallacy as all it has done is divide the nation into the haves and have-nots.

He moves from the technical to simple layman language, his voice pregnant with emotion, explaining how, while it is true that the government spends 10percent of the Gross Domestic Product on healthcare, this money is disproportionately shared between those on medical aid and those without.

The disparities we see and the challenges we face, he says, can be traced back to the Medical Schemes Act.

There's an eight-fold difference on per capita spending for those on medical aid and those not on any, says Letlape, who has since given up his own medical aid.

He quit because he feels strongly that his position as chair of Sama precludes him from fighting to cement his views.

He reiterates: "Given the issues at stake, and where I stand with these, it was important not to be chair. When these divisions come, and you hold a strong view - and the strong view is a minority view, and you want to fight for it, you can't be chair. Democracy is allowing the majority view to prevail.

His leadership of Sama was in pursuit of an ideal he believes in: "An organisation needs to be united to succeed."

Says Letlape: "When your own values threaten unity, you either put them aside, pursue the values of the majority or you step down."

He remains a member of Sama as the body's outlook "is not different from my position".

But free from the shackles of chairmanship, he can always come back to argue his position, he says.

This freedom also allows Letlape, president of the World Medical Association in 2006, time for his duties as chairman of the Africa Medical Association. His term of office ends next year.

In between all these, the self-styled health activist will continue in his crusade - the quest for health for all.

He is adamant the irksome act needs to be dismantled so that the money collected "must be used for all of us".

An ophthalmologist - the first African - whose entry into this area of medicine is a story on its own, Letlape believes that over and above giving the gift of vision to patients, the greater ophthalmic surgery he's destined to perform is "to open the eyes of society to the ills among us".

The surgical disciplines have always appealed to him. The general surgeon, he says, arms flailing in gesticulation, is a macho field - treating gunshot wounds, saving lives there and then. But when he found this denied him time, he knew frontline surgery was not for him.

He got married in December 1983 and the following month he had to start work as senior house officer in cardiothoracic surgery at Chris Hani-Baragwanath Hospital.

A gifted ball juggler who played with the likes of John "Shoes" Moshoeu at Alexandra Blackpool and former Orlando Pirates players Ronnie Zondi and Alfred "Shakes" Gwabeni at Michelangelo, he gave up football because of the scalpel.

Ophthalmology allows him space, even for a round of golf, he says: "I wouldn't give it up for anything."

A call comes through. It is the UK. As you read this he'll be in London presenting a paper on how the lack of proper hygiene has led to challenges like cholera.

Basic hygiene is the key to good health, he contends. To this end, he features in a TV advert promoting the washing of hands.

He quotes a lot from the Good Book and peppers his language with "God this, God that". He mentions JF Kennedy's inaugural speech that referred to "the hand of God, not the generosity of man". He will not stop his pilgrimage as he's guided by Psalm 27.

He returns to the parable of Jesus feeding the masses from five loaves of bread and two fish and tells the story of how one young pastor explained the symbolism of the parable. Collectivism, the pastor said.

He applies it to the healthcare system: "If we pool the resources together, there'd be enough for everyone."

As in the parable, there'll even be leftovers, he chuckles.

Letlape has four children.