Since the start of the COVID-19 pandemic, the Gauteng government has spent a staggering R1.238bn of much-needed COVID-19 funds on the construction of four new “field intensive care” hospitals. The money was spent in 2020, but two are still not open. The other two are only partially open and are being repurposed for other aspects of healthcare. The Alternative Build Technology (ABT) units were controversially commissioned in March 2020 to provide extra bed capacity for the first wave of the pandemic.
Last week, Kwara Kekana, spokesperson for the Gauteng Department of Health (GDoH), told Maverick Citizen that the three senior health officials suspended in February were the head and deputy head of infrastructure and the clinical manager of Helen Joseph Hospital. Kekana declined to provide their names on the advice of the legal and labour relations units of the department.
However, Maverick Citizen has established that the head of infrastructure is Dr Sifiso Goodhope Maseko and the clinical manager Dr Medupe Modisane. Maseko had previously been the acting head of Chris Hani Baragwanath Academic Hospital (CHBAH) but was then already caught up in allegations of corruption and maladministration, leading to his dismissal. According to sources, shortly afterwards, he was appointed as the head of infrastructure by former Gauteng Health MEC Bandile Masuku, despite having no qualifications or experience for the job. According to a source, this “put him in complete control of the infrastructure budget and projects”.
Last Thursday night (24 March), Maverick Citizen spoke to Tasneem Motara, the MEC for Infrastructure Development. Motara confirmed that the head of the Gauteng Department of Infrastructure Development Supply Chain Management and (then) Acting CFO, Trevor Tabane, had been suspended. In addition, she said, five officials in the health directorate had been suspended, listing them as the Deputy Director General, Chief Director, Deputy Director, Chief Professional and Project Manager. She did not provide their names.
The identification of all of the people who have been suspended (previously the Gauteng government declined to provide this information) joins the dots with information provided by Kaizer Kganyago, spokesperson for the Special Investigating Unit (SIU).
Kganyago revealed that the five hospitals in Gauteng which are the subject of an ongoing investigation by the SIU “as part of its COVID investigations under Proclamation 23 of 2020” are Kopanong Hospital, George Mukhari Academic Hospital, Chris Hani Baragwanath Academic Hospital, Tshwane District Hospital and Jubilee Hospital.
Four (out of five) of these hospitals were the sites for controversial ABT field intensive care units, controversially commissioned in March 2020 to provide extra bed capacity for the first wave of the COVID-19 pandemic.
Last Thursday, Sagren Reddy, acting head of the SIU in Gauteng, confirmed that it was the hospital “extensions” (ie, the ABT facilities) that are the subject of the SIU investigation. MEC Motara, however, said she had no knowledge of this latest SIU investigation.
Reddy said that the latest investigation involved the same persons of interest and modus that the SIU had uncovered in the AngloGold Ashanti Western Deep Levels Hospital, which has cost the department more than R700m. Reddy said the investigation was “at an advanced stage, just tying up loose ends and would be complete by the end of April”.
Questions about irregularities in the tendering and construction of these hospitals were first reported exclusively by Maverick Citizen in September 2020. But they were always denied by the Gauteng Department of Health and the GDID. At the time we reported how, by the third quarter of 2020, their expenditure topped well over R1bn. Unfortunately, this expenditure became impossible to track further when the Gauteng government stopped publishing its monthly COVID-19 Expenditure Disclosure reports in January 2021.
Thabo Masebe, acting director-general in the Gauteng premierʼs office, claimed this was because of concerns about the Protection of Personal Information Act. But he did not substantiate how reporting company names and amounts of publicly awarded tenders could violate this act.
Similarly, although Gauteng Premier David Makhura has on several occasions promised to resolve the issue around abruptly ending publication of the reports, they remain missing.
Maverick Citizen sent a set of questions about the state of readiness of the ABT hospitals to the Gauteng Department of Healthʼs Kekana. We established that as the fifth wave of COVID-19 approaches, two of these new ABT hospitals are yet to open, and two are in the process of being repurposed.
Kekanaʼs answers are below.
Abandoned: Kopanong Hospital
Project cost: R208,250,000 (According to Kekana this figure may not represent all expenditure to date as the GDID has not provided updated information.)
Of the four ABT ICU hospitals, Kopanong is the one shrouded in the most controversy and has generated the largest amount of wasteful expenditure. No part is open and it is nowhere near completion. In fact, it appears to be abandoned.
Kekana tried to sugarcoat the carcass of the stillborn hospital by saying that a contractor had been appointed to complete the hospital and that “GDoH is considering the possibility of repurposing the facility”. But, she added, “Two challenges must be addressed: the lack of build quality by [the] previous contractor; the structure size/number of beds if completed is above the norms of a District Hospital, and presents an operational funding dilemma.”
In addition, said Kekana, “The building contractor had sued the department, and the department had a counterclaim which the adjudicator found to be premature. No funds have been recovered at this stage.” Kekana was unwilling to name either the old or new contractors, as was the GDID. However, from correspondence in October 2020 with Jonathan Peel, the CEO of Sanjo Fabtech Sterling Building Technologies, Maverick Citizen learnt that a company called Condocor is the main contractor and that it had “contracted with SSP, one of Sanjo Fabtech Sterlingʼs licensees for proprietary walling system and the roof”.
In response to questions about “the process by which Sanjo was contracted as part of the consortium at Kopanong Hospital and the relationship to Condocor Construction; whether there was a direct tender from the GDID” and a request to “shed light on the decision made by GDID to use ABT before going out to tender”, Peel said: “We are not privy to the tender process or the decision-making on ABT and therefore cannot assist you with those answers.”
Soon after that time, it appears construction halted.
Recently, Jack Bloom, the DAʼs Gauteng Shadow MEC for Health, issued a statement lamenting how “grass is growing around the incomplete new wards that were meant to be for COVID-19 patients”.
In addition, said Bloom, “Medical staff are concerned by the lack of security and the decay of the old hospital. Ceilings are broken and the floors also need urgent repair.”
Bloom undertook to raise these issues in the Gauteng Provincial Legislature as the Kopanong Hospital “needs to be upgraded to provide decent care to sick people in the Vaal area”.
Repurposed: Chris Hani Baragwanath Academic Hospital
Spending to date: R528,277,993.30
Kekana said the new 500-bed facility “was operationalised during the third wave of COVID-19”.
“The facility is used to accommodate COVID-19 patients who are stepped down from COVID-19 designated wards in the main hospital. Some wards in the facility are used to step down non-COVID patients from the medical wards. This decision was taken to decongest the medical wards and create space to accommodate newly admitted patients with a high acuity level.”
Kekana said that 200 of the 500 beds “have been allocated to Wits Oral Health to accommodate dental services” and that “post the COVID-19 pandemic, the ABT facility will be repurposed to accommodate multidisciplinary oncology services”.
Doctors we spoke to have confirmed these plans, although they point out that substantial further costs will be incurred in the repurposing. There is also growing alarm about the lack of progress with the new dental hospital, with the current one continuing to operate in unsuitable and unsanitary conditions at Charlotte Maxeke.
According to Professor Shabir Madhi, Dean of the Faculty of Health Sciences at Wits University: “The decision to relocate the dental hospital to CHBAH was made last September and agreed on by the premierʼs office. The planned date to move was the end of March 2022. To date, no plans have been finalised for adapting the ABT at Bara to make it fit for purpose.
“This was meant to be done by DID, who have largely been missing in action and obstructive to providing even the basic plans of the facility to start the planning process. It is now being handed over to DBSA [Development Bank of Southern Africa] as part of the Charlotte Maxeke [CMJAH] work package. Once they start working in Block 2 at CMJAH, the dental hospital will need to be closed. At this stage, no one really knows when that will happen.
“What needs to be done is final planning to reconfigure the ABT (one-third of it) as a dental hospital, securing the budget once costing has been done, starting and completing the renovation. If not done, it will result in people in Johannesburg again being denied dental care, and poses a risk to the training of oral health science students.”
Unfinished: George Mukhari Academic Hospital (GMAH)
Spending to date: R229,208,121.70
Kekana admitted that the “GMAH ABT facility has not yet [been] handed over to the hospital pending awarding of the Certificate of Occupation by Tshwane Metro”. She said the delay was due to the following outstanding matters: Finalisation of the ICT infrastructure; commissioning of the heating, ventilation and air conditioning (HVAC) system, and awaiting the smoke extraction completion certificate.”
According to Kekana, “114 beds [out of 300] are at 98% completion, 36 beds due, delayed delivery of the HVAC and the recently approved CEs (Smoke vents, palisade fence around plants and dirty utility). Commissioning of HVAC, signage, snagging and commissioning for phase 2 is ongoing, interrupted by the strike”.
Based on the above it would seem George Mukhari too is a long way from opening. In the words of senior health worker there: “ABT still a white elephant.”
Repurposed: Jubilee Hospital
Spending to date: R272,821,530.84
Kekana reported that: Jubilee ABT was handed over on 27 November 2020. “The ABT is a 300-bed structure, currently we use 226 beds.”
Presumably forwarding information she received from the hospital itself Kekana said: “The use of the ABT wards has changed depending on the COVID-19 infection rate; at one stage we used six wards for COVID-19 related patients but… due to the decline in the infection rate and infrastructural challenges in the hospital, the ABT is currently being used for COVID cases and persons under investigation as well as one ward as an overflow ward for medical patients; one ward was used for paediatric patients; one ward was also used for the neonatal unit.”
Kekana also attempted in 2020 to explain the decision to use ABT, ironically claiming it would speed up matters: “In the case of ICU units to accommodate COVID-19 patients, the use of light steel frame construction allowed for [a] significant reduction in time for construction, in comparison to the conventional building technologies.
“The prefabricated nature of the light steel frame building systems also allows for the reduction of on-site building operations and vehicular traffic, which improves overall safety and security for existing facilities in the area. The light steel cladded frame interiors also allow for adaptability and flexibility with future reuse, allowing for a legacy of the infrastructure beyond the COVID-19 pandemic.”
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