I had the joy of spending three weeks on Kangaroo Island in January 2025, an experience that deepened my understanding of rural healthcare.
Kangaroo Island, part of South Australia, is the country’s third-largest island, home to around 4,500 residents. The population can swell to 10,000 daily as tourists come and go. With an aging population and an economy rooted in agriculture, the island has a distinctive character—Kingscote, the main town where I stayed, feels like a Karoo dorp by the sea. The locals are kind, authentic, and prone to supermarket small talk.
The island’s healthcare system is closely integrated with its lone 15-bed hospital. A privately owned GP practice in Kingscote is contracted by the South Australian Rural Health Authority (SARHA) to provide at least one GP around the clock. However, nurses primarily manage the hospital, consulting the GP or specialists via telehealth when needed.
With its breathtaking ocean view, the hospital offers emergency, inpatient, outpatient, and long-term nursing home care—the latter situated right next door. Patients requiring advanced care are flown to Adelaide by helicopter or plane, depending on urgency.
What struck me most was the high standard of care provided to this remote, elderly population.
South Africa has many rural communities struggling with healthcare access. We frequently hear tragic stories of ambulances failing to reach clinics in time. SARHA’s model offers valuable insights into improving rural healthcare.
Telehealth & Digital Solutions: SARHA has embraced telehealth for remote consultations, specialist access, and mental health support. South Africa, despite recognising its potential, has yet to fully harness it.
Integrated Health Services: SARHA ensures continuity of care by coordinating primary, emergency, and specialist services. South Africa could benefit from a similarly integrated approach—reducing the divide between public and private healthcare and implementing a unified system to track patients across levels of care.
Attracting & Retaining Rural Health Workers: SARHA incentivises rural healthcare with scholarships, housing support, and career development. While South Africa offers a basic rural health allowance, it falls short of ensuring long-term doctor retention. Greater support is needed.
Data-Driven Decision-Making: SARHA uses analytics to allocate resources effectively. South Africa must enhance its use of data to inform rural healthcare planning. Even in a fiscally constrained environment, we should better leverage administrative and survey data. The uncertainty around South Africa’s Demographic and Health Survey, set to begin this year, must be resolved. Hopefully, other funders step in to fill the vacuum left by USAID’s withdrawal.
South Africa has the tools and knowledge to improve rural healthcare. We know what to do—what’s needed now is the will to implement solutions in a gradual, systemic way.
Photo credit: Anja Smith, Kangaroo Island Hospital
