The departure of Dr Sibongiseni Dhlomo, KwaZulu-Natal Health MEC has been widely welcomed by opposition parties, while his promotion to the National Assembly has been met with disdain. According to a Sunday Tribune report, opposition leaders in the province said they had watched Dhlomo move from one crisis to another during his decade-long tenure.
Dhlomo acknowledged the many challenges. But he was also proud of the positive outcomes he had achieved, especially with HIV/Aids. “In KZN, about 1.3m people of the 4.5m countrywide are on antiretroviral (ARV) drugs. The life expectancy for women affected by HIV has risen from 47 to over 60 and for men from 47 to over 55,” he said. He added that prevention of mother-to-child transmission rates had been drastically lowered in recent years.
“If an HIV positive mother accepted our treatment within the first three months of pregnancy, we could almost guarantee that the child would be born HIV negative. We have seen a drop from 20% to 0.7% in mother-to-child transmission to date.”
He said in the report that male circumcision as a means to combat the disease had also yielded positive results. About 2m were circumcised with no fatalities.
Dhlomo is also proud of the Make Me Look Like A Hospital (MMLLH) project. The aim was to ensure hospitals were well managed. “The project allows for those who work and visit hospitals to have a voice and suggest ways to improve the hospital but, ultimately, it falls on the hospital leadership to implement these suggestions,” he said.
With regard to treatment for cancer patients, Dhlomo is quoted in the report as saying: “We admit that we had challenges with oncology, but we adapted and outfitted Grey’s and Addington hospitals with machinery and specialists to provide treatment for oncology patients. Addington was never meant to cater to this issue, but we took the initiative to get things up and running. The report that we have tabled before the Human Rights Commission on the progress that has been made was accepted,” said Dhlomo.
Ncamisile Nkwanyana, the Inkata Freedom Party’s spokesperson on health in KZN, held Dhlomo accountable for the deterioration of health care in the province. “We are glad that he is leaving. People have been dropping like flies and the blame falls on the leadership,” she said in the report.
Nkwanyana said she had been left “disgusted” and “appalled” by the conditions at hospitals she visited. “They were filthy and didn’t have basics like linen, clean stretchers or gloves for staff. They don’t have enough life-saving medical supplies. If you want someone to die then take them to a government hospital. They are no longer places of healing. They’ve become morgues. I visited a ward in RK Khan which had about 50 patients being tended to by only three nurses. It is just unacceptable,” she said.
The report says Dhlomo conceded there had been challenges with staffing, attributing it to the more than R9bn the department had lost over the past three years in cutbacks. “We have employed nurses, doctors and cleaners but, honestly, not in the numbers that we would want. Funding is our core issue. I have advocated assistance from the provincial and national treasuries. If you don’t have enough staff, you run the risk of having higher rates of medico-legal claims as there are too many people to treat and this leaves room for mistakes. But what do you cut – food, linen, salaries? We are constantly juggling with our limited resources,” he said.
The Democratic Alliance (DA) spokesperson on health, Dr Imran Keeka, said in the report that he was aware of the challenges but welcomed Dhlomo’s departure. He said it was disappointing that instead of being held accountable for his alleged failings, he was being promoted to Parliament. “We have repeatedly called for Dhlomo to be removed because under his leadership the province had to deal with more bad than good. We just hope the new MEC will step up,” he said.
Keeka described Dhlomo’s legacy as that of “poor political leadership” and “poor budgeting”. “The province had to deal with the oncology crisis which led to the death of hundreds of people as well as shortages of medical supplies,” he said.
The report says earlier in the year, Keeka conducted an oversight visit at Murchison Hospital in Port Shepstone, on the KZN south coast. The hospital pharmacy did not have 117 different items. “They didn’t have critical drugs such as adrenalin and furosemide which are critical for the resuscitation of patients in intensive care units. We also established that there was a massive shortage of certain dosage forms of ARV drugs and antibiotics,” said Keeka.
Dhlomo cited the Centralised Chronic Medicines Dispensing and Distribution initiative as a means to allow for the patients to collect medication on a tri-monthly basis. “This initiative supports 1.1m patients across KZN and ensures they don’t visit hospitals and clinics every month. This saves travel costs and lost working hours. You can even have a family member take your documents and collect the medication,” he said.
Dhlomo said the department had never intended to fail the people but errors were always a possibility. “We are not in any ways undermining certain challenges but, if you are given a cake and you are told to share it, yes, you would want a bigger cake to make everyone happy but, realistically, that’s not the case,” he said. He acknowledged that there was still room for improvement but argued that he was pleased with the foundations that he had put in place. “Leadership and management will need to be more prudent, hands-on and learn from our mistakes to ensure that they are never repeated,” he said.
Health director-general Precious Matsotso is quoted in the report as saying that Dhlomo had left an invaluable mark on KZN with his innovative and progressive solutions for the province’s hardships. “HIV/Aids has always been a key concern for the country and the work he has done to address the concern has had national implications. You are seeing more people come forward for treatment. Studies from the Centre for the Aids Programme of Research in South Africa detail the strides he has made in the field,” she said.Sunday Tribune report