The scarcity of ambulances in rural areas continues to compromise patient care, particularly those with TB, reports IOL, with the Rural Health Advocacy Project (RHAP) urging improved policies and strategies to tackle the issue that it says is compounded by inaccessible roads, among other problems.
The project’s latest policy brief on TB in rural regions revealed that while patients in the Eastern Cape face significant barriers to reaching clinics because of the bad roads, the problem is worsened by the scarcity of suitable ambulances.
The Eastern Cape has a shortage of 32% of ambulances, while other provinces, like North West, face an even greater shortage of 85%.
While the national standard for ambulance availability is one per 10 000 people, in the Eastern Cape, the ratio is just 0.68 per 10 000.
The report said while resources are unequally distributed across provinces, favouring urban areas and the private sector, this leaves rural populations underserved, where so many people rely on primary healthcare clinics and face added barriers like low income, lack of medical insurance, and poor education.
“The impact of TB is much higher in rural areas … which are generally impoverished, impacting the quality of healthcare they receive. Evidence is notable in that only 80% of the people here who have TB receive a diagnosis, and just 53% successfully complete treatment,” according to the report.
National Health spokesperson Foster Mohale said the department was working with provinces to find a solution to this challenge, which “cannot be eradicated overnight since some ambulances get involved in accidents while others require regular maintenance to remain roadworthy”.
“Though the department acknowledges contributing factors affecting healthcare delivery, which differs from one area to another, road infrastructure is one of them, partly affecting the timely arrival of ambulances at the scene or at health facilities.”
He added that the department had previously acknowledged a shortage of ambulances, and that some provinces have agreements with private Emergency Medical Services (EMS) to relieve pressures.
The report stated that although the National Strategic Plan (NSP) aims to eliminate TB, rural communities continue to face massive challenges because of systemic inequities and resource shortages.
“Policies must focus on expanding mobile health services, improving the supply chain for TB medications, and providing comprehensive social and financial support for affected households. Swift and co-ordinated action from government, healthcare providers, and community leaders is essential to address these disparities, ensuring that rural populations receive equitable access to TB care and support,” it said.
In rural areas – like the Eastern Cape – the financial burden of TB further devastates families already grappling with poverty and socio-economic instability.
“The province records the highest TB-related mortality rates at 8.3%, followed by Mpumalanga at 8.1%. The economic strain from TB-related illness deepens this poverty cycle, creating ‘poverty-disease traps’ where individuals cannot afford treatment, leading to worsened health and economic hardship,” the report noted.
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