As the Rahima Moosa Mother and Child Hospital turned its focus on whistle-blower doctor Tim de Maayer this week – instead of addressing the very damning issues he raised publicly – the saga has now been catapulted to the Human Rights Commission (HRC), notes MedicalBrief.
De Maayer, paediatric gastroenterologist at the hospital, was suspended following his open letter to the Gauteng Department of Health (GDoH) – published on 22 May in the Daily Maverick – describing the “horrendous conditions” at the institution. The letter blew wide open the troubles afflicting not just Rahima Moosa, but most government hospitals in SA.
In his letter, De Maayer had written: “I wish you could come to our unit and see doctors trying to intubate children and administer cardiopulmonary resuscitation by their mobile phone’s torch as the power has failed again. Or the cold neonate whose incubator went off with the loss of power [from load-shedding].
“I wish you could come and explain to parents that their child needs an urgent computerised tomography scan of the brain, but he’s going to have to wait since our scanner has been broken for nearly three months, Chris Hani Baragwanath is overflowing, and Charlotte Maxeke has had crucial parts of its scanner stolen.”
He wrote: “This letter is not a political statement. Instead, it is a plea. This hospital, with its current staff but without its infrastructural and supply issues, could be the envy of private hospitals. Our children deserve it.”
The letter raised huge public concern about the state of Gauteng hospitals as well as strong support from fellow doctors and the public for De Maayer’s willingness to speak out. Even the Presidency is believed to have asked the GDoH and the hospital for an explanation.
Last Thursday, De Maayer was placed on precautionary suspension “with immediate effect”. A letter sent that night by an anxious doctor to Daily Maverick stated: “We found out this evening that he has been suspended by the CEO. As the only paediatric gastroenterologist, with phenomenal patient care, it will be the patients who suffer. The suspension is an unacceptable response to the unveiling of the truth regarding the unacceptable conditions we work with daily.”
In response to a request to confirm he had been suspended and whether the MEC for Health, Dr Nomathemba Mokgethi, had known about it or authorised it, Kwara Kekana, spokesperson for the Health MEC, said she would “check with the facility”.
In a statement released later in the evening, Kekana said the MEC had been made aware of the suspension.
A Withdraw the Suspension petition was launched at 8pm last Thursday and attracted 1,500 signatures in the first hour, reported Daily Maverick, and by noon on Friday, more than 23,500 signatures.
Wits University and Section27 also joined public support for De Maayer, with Wits pleading with the GDoH for the suspension to be rescinded, joining calls by civil society for government not to “punish the messenger”.
De Maayer is a joint appointee by the department and Wits.
“This is a ludicrous situation – instead of resolving the issues raised by the doctor at the coalface, the department has chosen to shoot the messenger,” said Professor Shabir Madhi, dean of the faculty of health sciences at Wits.
TimesLIVE reported that the Progressive Health Forum, urging medical colleagues to demonstrate their support for De Maayer, said as the only paediatric gastroenterologist at Rahima Moosa Hospital, with his suspension, his units were effectively shut down, to the detriment of patients.
Daily Maverick added that what was surprising about the suspension was that although the GDoH had reacted defensively to De Maayer’s letter, issuing a statement on 24 May denying the situation at Rahima Moosa hospital was as bad as he had depicted, it had not criticised him directly.
Earlier in the week, Premier David Makhura, at the launch of Gauteng’s anti-corruption report, had said he had read De Maayer’s letter and told officials the provincial government needed to address the issues raised, rather than attack the messenger
As outrage grew from the shocked medical profession and others, Makhura intervened, telling Maverick Citizen: “I will never approve any act of intimidation or victimisation of professionals and workers who speak out where things are going wrong. We need more such people in the public service.”
Although De Maayer was reinstated on Friday after Mokgethi met hospital CEO Dr Nozuko Mkabayi, the head of the department of paediatrics and child health Professor Ashraf Coovadia and De Maayer, the issue has forced authorities to scrutinise the institutions servicing the majority of the population.
On Monday, the HRC stepped in and, after a visit to the regional hospital, called for it to be reclassified as a tertiary hospital. This, said the commission, would allow for a bigger budget and help alleviate some of the issues, as the current budget was completely inadequate for the facility.
The commission's Gauteng head Buang Jones said this might help solve its problems, reports TimesLIVE. He and human rights officer Sithembiso Mdlalose held a meeting with senior staff and hospital CEO Mkabayi, and also visited the neonatal intensive care unit (NICU).
NICU doctors told the commission that staff were overstretched and patient space limited.
Jones said the commission’s concern was the plight of patients, and he commended De Maayer for speaking out.
“But (it is important) to also call for the reclassification of this hospital from regional to a tertiary hospital so that they are allocated enough budget. At the moment their budget is inadequate to address the challenges.”
The hospital will be providing the commission with a report.
“We will look at the report. We also intend to establish a monitoring mechanism through which the commission will receive regular updates from the hospital and other role-players such as Joburg Water, City Power and the department of infrastructure development,” said Jones.
“Equipment is still a challenge; backup generators and issues of water outages. We are going to engage the new head of the health department to attend to some of the issues.”
The CEO had attempted to address some of the challenges after joining the hospital in 2021, some of which dated from before her time, Jones added, calling the meeting a “painful” one.
“She was dismissive, didn’t understand our process is meant to enhance accountability to ensure responsiveness on the hospital’s part to provide quality healthcare.”
The commission would continue to monitor the hospital regularly to ensure that the promised remedial action was taken.
Meanwhile, Dr Aayesha Soni, writing in Daily Maverick, said she had worked in the same department as De Maayer at Rahima Moosa Mother and Child Hospital during her training as an intern.
“What is happening at Rahima Moosa isn’t isolated to that hospital — it is a problem that has metastasised throughout South Africa’s healthcare system.
“When people like Dr de Maayer …. come bravely forward to point out the glaring deficiencies in one of the basic building blocks of our society, their pleas should be heard with earnestness. Suspensions… reflect an ugly disposition of those in charge to shift the blame from the true (albeit harsh) reality. Petitions, outpourings of support and objections should not be needed to reverse suspensions — they shouldn’t happen in the first place.”
De Maayer's letter, she added, was “a desperate plea for reform and represents what most doctors in SA feel — De Maayer reiterates our frustrations, our anger at not being able to efficiently serve, our burnout and emotional distress and most importantly our dedication to the people who need it the most”.
Kekana confirmed that De Maayer had returned to work and that the management team of the hospital had agreed to “work together to address the issues” raised in the letter.
“The department remains committed to tackling challenges within the Gauteng health system, while continuing to render services to millions of patients annually,” Mokgethi said.
TimesLIVE article – Reclassify Rahima Moosa Mother and Child Hospital: SAHRC (Open access)
See more from MedicalBrief archives:
Doctors back paediatrician’s account of Rahima Moosa collapse
Viral video leads to investigations at Rahima Moosa Hospital
Maverick investigation: Mother and Child Hospital’s CEO denies any crisis
Floundering Rahima Moosa Hospital ‘needs to admit it has a crisis’