There’s no money for Panado or tenders for condoms, and yet there’re thousands of rands for skinny jeans, says fiery nurse activist Fikile Dikolomela-Lengene, who says she has had a front-row seat to corruption unfolding in Gauteng’s public health sector and is not afraid to speak out, writes Biénne Huisman for Spotlight.
“I don’t know how they’re going to get rid of corruption in health in Gauteng. You have to ask, who authorises codes for jeans, skinny jeans, in a hospital? It’s like somebody’s mocking the governance,” she says.
Dikolomela-Lengene grew up in the corridors of Chris Hani Baragwanath Academic Hospital in Soweto: the youngest of nine siblings and the only daughter, her father died when she was three-years-old. After this, her mother, a nurse at Baragwanath Hospital, would take her to work.
“She worked in the same surgery theatre at Bara for 40 years,” says Dikolomela-Lengene. “I would actually sleep on stretchers or accompany her to fetch patients. This was a single mom with a little girl and nobody to look after her and she needed to work.”
The young Dikolomela-Lengene grew inspired to become a nurse, while cultivating her first inkling of justice. “I saw what was happening, and I thought, this is something I would like to do,” she says. “It came with a lot of context of the profession. I mean, I saw my mom and how the profession didn’t upskill her, how she suffered because of having a child, the shifts, and so on. And I think it’s where the love for professional activism came in. To say, if I go into this profession, I wanted to be able to influence change.”
Nurse activist
Today, with a string of qualifications including a Bachelor’s degree in nursing from North West University and a Mandela Washington Fellowship for Young African Leaders, Dikolomela-Lengene (36) describes herself as a “nurse activist” and calls herself ‘Sr Fikx’ because she is passionate about influencing change in the public health sector.
Based at the Stretford Community Health Centre – serving the township of Orange Farm in Johannesburg south – she is passionate about HIV care and heads several public health campaigns at community level.
Commenting on the report findings of the Stop Stockouts Project launched in August, she laments the shortfall of contraceptives, particularly injectable contraceptives and condoms.
“What is interesting is the non-acquiring of condoms, in an era when HIV is so rife,” she says. “We ran out of (government-issued) condoms in May. And they actually don’t even have a new tender yet. This shocked me. We should plan, right?”
She points out the ripple effects of this shortfall, like an increase in required abortions. “Since there are none of these types of contraceptives, how has it affected our TOP (termination of pregnancy) services? Especially in clinics where these services are burdened already.”
'Rot of corruption'
Dikolomela-Lengene told Spotlight “the rot” of corruption in Gauteng’s health sector runs deep.
In 2015, she was a founding member of The Young Nurses Indaba Trade Union (YNITU), which represented more than 10 000 workers, who pay R70 per month for membership.
She said the union’s leadership was “hijacked” at a congress in October last year and that millions of rands from the union’s coffers disappeared. In the midst of the clash, the union’s FNB business account was frozen in November 2021.
However, membership fees are allegedly still being paid into private accounts. AmaBhungane reported on the alleged hijacking of the trade union in September. The new leadership rejected claims of wrong-doing.
In February, Dikolomela-Lengene and fellow former union leaders put the allegations before the Department of Labour. “We told them we need assistance because the union is hijacked and is being used for activities that currently… we actually don’t even know what is happening,” she says.
The union had been given notice to deregister on 28 September, she adds. She will continue having meetings the Department of Labour. “Let me just say it’s been a hassle,” she adds.
Last year in August, Gauteng health official Babita Deokaran was assassinated shortly after flagging up to R850m in suspicious payments authorised at Tembisa Hospital in Johannesburg.
One of the people accused of capturing the YNITU – Lerato Mthunzi – is the wife of embattled Tembisa Hospital chief executive officer (CEO) Ashley Mthunzi, who was suspended on 26 August over allegations of widespread corruption, including R498 000 of the hospital budget spent on 200 pairs of skinny jeans.
After his suspension, one of Mthunzi’s notable supporters had been the nursing union, now headed by his wife. Mthunzi (Lerato) has denied any wrongdoing.
‘Defending and defending’
“I’m laughing, you know, because it’s so sad,” says Dikolomela-Lengene. “People are defending and defending, but there’s a family here that lost somebody. There are kids who don’t have a mother because there are people in positions who don’t want to do their job.
“I don’t know how they’re going to get rid of corruption in the department. Those ridiculous payments for things….
“How many processes are there before payment is actually made? So all those processes were flawed, or were people in those processes flawed themselves? And then, you have condoms not being on tender. How are people able to get money for jeans, but there’s no money for a tender for condoms?”
Looted
She says the province’s health budget is being looted. “We’re not going anywhere unless they actually bring a lot of people to account,” she says. “R850m, imagine! I’m looking at my clinic. Our budget is around R20m. How many clinics could have been revamped for R850m? How many hospitals could have been looking A-class, private style, with that money? It is possible to revamp our clinics. It is possible to revamp our hospitals. There is money. There is money, but there is no political will.”
‘Into the lion’s den’
On Gauteng’s new Health MEC Nomantu Nkomo-Ralehoko, Dikolomela-Lengene says: “The past two MECs disappointed us and they were both health professionals. (Nkomo-Ralehoko is not a healthcare professional by training).”
Nkomo-Ralehoko has vowed to act on recommendations by a Special Investigating Unit currently conducting a forensic investigation into transactions at Tembisa Hospital.
“At this moment, I’m not going to be judgmental,” Dikolomela-Lengene says. “We just want to see change. I mean, having to fight with a patient because you don’t have a Panado. A simple thing like that. And as a nurse, you have to take the brunt of it. She’s (Nkomo-Ralehoko) going into a lion’s den. She will need a thick skin.”
Earlier this year, Dikolomela-Lengene was one of 700 young African leaders who studied in the US for six weeks as Mandela Washington Fellows. She was placed at Howard University, which counts former US President Barack Obama among its alumni.
As part of her training, she got to shadow and even debate with high-ranking American government officials. “I learned a lot of skills, but what stood out was the ‘huddle system’. This is a programme where we have meetings more frequently so that changes can be made more frequently. I think in South Africa, we stick with things that are wrong for too long. If a policy isn’t working, we wait for five years. If a system isn’t working, we wait for five years. So with the huddle approach, you continuously monitor and make changes when things are not working.”
Downgrade in nurse training
Another issue keeping Dikolomela-Lengene awake at night is South Africa’s nurse training curriculum. In 2019, she served on the ministerial task team that oversaw amendments brought to the country’s nurse training strategy, as chronicled in The National Strategic Direction for Nursing Education and Practice: A Road Map for Strengthening Nursing and Midwifery in South Africa (2020/21−2025/26).
She is highly critical of this new strategy, calling it a “big mistake”, and effectively a “downgrade” in nurse training.
“I’ve got a four-year diploma. I’ve got a one-year post-graduate, (and) I’ve got a three-year degree. I’m not even going to talk about the side courses I’ve done. There are more than 10. Can I tell you that I cannot access a university in South Africa? Our qualifications have been downgraded. I’ve got more than nine years of formal study and I can’t do my Masters (degree) because my accreditation has been brought two to one level lower,” she says.
“You’ve got academia and professors making a curriculum for nurses – not nurses. It’s shocking… So there is a big fight between the National Department of Health, the South African Nursing Council, and the Department of Higher Education.”
She says her salary could triple if she moved from the public sector into private, but that she wouldn’t dream of such a step. “The passion I have for what I do is what fuels me,” she says. “And it’s effortless, you know? I love what I do. Whatever time they call me, I’m ready. I just show up – always.”
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