Medical student’s plea reaches finance minister’s ears

Medical student Sarah Stein was shocked to hear that Finance Minister Enoch Godongwana named her and had quoted an article she wrote that illustrated the terrible conditions and lack of resources in public hospitals in his third Budget speech delivered on 21 May. The minister maintained that this article validated his commitment to the country’s increased healthcare budget and a focus on assisting frontline service providers.

However, Stein had made no contact with the minister, nor had she tried to connect with him in the run-up to his speech. She simply wrote an article about the emotional toll these unacceptable conditions and lack of resources in government medical services took on medical students, and how unprepared they were for it. She had submitted the article to Bhekisisa, a health journalism publication, in the hope it would be published.

It was, and then republished in Mail & Guardian, Daily Maverick, and in News24. Not only was she surprised when it was republished in the mainstream media, but she said that never in her wildest dreams would she have considered her outpouring of frustration would make headway in government.

Her article not only exposed what many don’t know about the life of a medical student, but clearly greatly moved the minister.

Stein, who is in her fifth year of medicine at the University of Cape Town (UCT), matriculated from Herzlia High School in 2020. She grew up in a family of medical professionals. Her father, Professor Dan Stein, is the chairperson of the department of psychiatry at UCT. Her mother, Professor Heather Zar, is the head of the department of paediatrics and child health at UCT.

Stein is completing rotations in public hospitals, including at Red Cross War Memorial Children’s Hospital, Groote Schuur, Mitchells Plain, and some of the small clinics around Cape Town. Her article recounts the tragedy and suffering medical students face in hospitals every day. She makes the point that the degree doesn’t teach young people to handle the trauma and grief she has experienced while working with patients and doctors in the wards.

In her article, Stein wrote that in her degree, “We deal with death as an academic topic. Our palliative-care lectures teach us about prescribing morphine in the terminal stages of cancer, and we learn what happens when body tissue dies. But we never deal with how it feels to spend every day in the face of death amid a failing system.”

Stein told the SA Jewish Report, “My article was a criticism of med school as a whole, largely focused on the effect that death has on you when you’re still a student and learning the ropes of the system. But it was also a broader criticism of the healthcare system and its cracks.

“I feel overcome with gratitude that my article has made it so far,” Stein said as she described how “surreal” it was to hear her name on national television during the 2025 Budget speech in the National Assembly plenary sitting.

Godongwana quoted Stein in his opening remarks of the public-services section of the Budget speech in order to give an authentic account of the harsh realities experienced in the frontline of public hospitals. Quoting her, he said, “Working in a public hospital with way too few resources punches you in the gut every day. It’s not just the trauma of seeing your patient die, it’s having no gloves in a delivery room; no alcohol swabs to clean wounds; and knowing that nurses stop at the shop on their way to work to buy their own gloves and masks because the clinic has run out. Where waiting times for a scan are months long and surgery delays needlessly let disease progress to the point of being inoperable. It’s the limited beds in high care that mean doctors are regularly forced to decide whose life is worth saving more because there’s only space for one.”

Godongwana went on to say, “It’s for this reason the Budget maintains the expenditure trajectory presented in the March 12th Budget, addressing the persistent spending pressure to restore critical frontline services, and investing in infrastructure that is critical to improving basic access to services and lifting economic prosperity.”

Stein said she often talked to friends, family, and her peers about her experience of studying medicine. “I have a lot of criticism of medicine, of the medical degree, and the healthcare system in South Africa,” she said. “I talk about it openly as I want people to engage with me.”

The past four years have clearly taken their toll on Stein, who is reconsidering her future as a doctor. She said she is investigating a medical-adjacent career aligning with her values of helping others.

She said her intention in sharing her experience in the article was to allow other students deciding whether medicine is the correct career path for them to comprehend what they were signing up for.

“A little part of me kind of feels scammed that I was told to do this degree by family and societal pressure, and I didn’t really know what I was getting myself into. I wrote this for people to know what they’re getting themselves into and ask themselves if they are the kind of person that would be interested in doing medicine,” Stein said.

Stein said the response to her article has been “heartwarming” and she was grateful.

“People who are part of the healthcare system and people who are not part of the healthcare system have reached out to me,” she said. “After the Budget speech, another wave of people started contacting me. Now people who are politically engaged took interest in what I had to say. So many people have written to me to say that they empathise with me and agree with my thoughts, as well as to thank me for saying what I said and for articulating what they feel as well.

“A lot of people have reached out to me to write more, and put out podcasts about this. It’s exciting that I’ve unlocked a whole new network of people who can make change in different ways to people in medicine,” Stein said.

“Initially, I felt excited and empowered to hear my words be read in front of the National Assembly and the public. I felt he was making a change to the Budget, and I was at the forefront of his mind in doing it. I felt incredibly powerful,” said Stein. But her excitement was cut short when a few days later, she found out from healthcare workers that some clinics were about to experience budget cuts.

Though Stein said it was a privilege to witness moments of humanity in the hospital and have the ability to help and save people, she said, “I don’t know what comes next or what the future holds for me and where I want to be.

“I just know I don’t want to be part of this broken system. Not because I don’t want to help people. My priority is always to find a way to help others. But I don’t think I’m strong enough to witness the horrors of medicine for the rest of my life.”

But through her article, Stein has effectively started a conversation about the sacrifices it takes to be a doctor in South Africa that will potentially continue to influence the government to bring about change in the healthcare system.