Distressed and disillusioned doctors in the North West Province are calling the province’s current crisis in healthcare a silent killer, says a City Press report. Last week, the strike action that has affected the province’s hospitals and clinics reached fever pitch as protesters stormed into the Klerksdorp Tshepong Hospital Complex’s theatre, forcing staff out. The theatre had to be shut down, despite there being three cases listed for operations. The kitchen was closed down and clinical managers had to scramble to find a way to feed patients in the wards.
The report says in Taung District Hospital, doctors reported that there were no staff to help feed the patients, while Zeerust Hospital was completely shut down this week due to the volatility. Doctors at Dr Ruth Segomotsi Mompati District Hospital said that while it had been relatively quiet there, they were unable to refer patients in need of higher-level emergency care to Tshepong Hospital because of the protests.
On Friday, all work at Potchefstroom Hospital ground to a halt after protesters burned tyres at the entrance, threatening to burn the doctors as well. “It is horrendous … Innocent people are being denied their basic right to (heathcare). People are being killed,” said Dr Ebrahim Variava, a Wits professor and internal medicine specialist at Tshepong hospital. Variava, who has worked in the province for 17 years, said patients’ lives were in danger and many more could die.
For two months, some patients haven’t been able to access their chronic medication for illnesses including diabetes, which could lead to complications in their conditions. “It’s really got out of hand. No one is saying their reasons for protest action aren’t valid, but this is affecting the poorest of the poor. Chronic patients who need their medication were taken out of hospital. In a few weeks when the strikers have reached a settlement, who will be left to deal with the complications?” Variava asked. “Some people may die during this time and it would be recorded as a natural death because of the illness, yet something could have been done sooner, but we couldn’t because they can’t access care.”
The report says the inter-ministerial task team assigned to resolve the crisis, which has lasted more than two months, arrived in the province on Friday. Led by Health Minister Aaron Motsoaledi, it also included ministers Nhlanhla Nene (finance), Zweli Mkhize (cooperative governance and traditional affairs) and Nkosazana Dlamini-Zuma (planning, monitoring and evaluation). The task team also includes the justice, crime prevention and security cluster. The team arrived following a Cabinet decision to place the provincial department under administration.
Dr Desmond Kegakilwe, the chair of the Rural Doctors Association of Southern Africa and the district manager in Vryburg, said in the report: “The ministers got a briefing by the district managers at the Mahikeng Provincial Hospital, which is fully functional now. Some facilities remain closed around the province.
“We don’t know what will happen next or if they are going to visit other hospitals.”
Meanwhile, the National Education, Health and Allied Workers' Union (Nehawu) maintains that it isn’t its fault that things escalated to this point, and that blame should lie squarely with the provincial government. The union’s deputy secretary, December Mavuso, said they would be meeting with the task team.
Veriava is monitoring the effect of the protests on his colleagues and the hospitals serving poor and disadvantaged patients, reports Business Day. One doctor took a video of burning tyres outside the hospital. Another doctor sent Veriava pictures of strikers who were removing doctors from wards of Klerksdorp Hospital. Klerksdorp is a referral hospital treating the sickest patients from across the province but is now short-staffed‚ he explained.
This comes as the South African National Defence Force said its involvement in the crisis had rendered the situation back to normal.
The report says Nehawu has been on a go-slow in the province since February‚ disrupting medicine supply at the main medicine warehouse, and is now keeping nurses from work. The union is tired of corruption in the health sector and a shortage of medical staff in hospitals. The number of available posts for doctors and nurses has apparently dropped by more than 1,000 in the past three years‚ according to the Rural Health Advocacy Project.
Veriava was one of the authors who wrote a letter last week on behalf 70 doctors, calling for an intervention in the province‚ saying the continued delayed access to healthcare meant patients could not be treated timeously. The report says the letter also said TB patients were not taking medicines on time due to medicine stock outs and that that could cause drug-resistant TB in patients‚ which could spread. It added that pregnant women were not being managed well due to the disruptions‚ which could have bad – or even deadly – consequences for the baby or the mother.
The letter was a desperate plea for intervention to stop the Nehawu strikers disrupting hospitals. The report says the doctors from the Rural Health Advocacy Project have asked in a second letter that civil society be included in the task team. The doctors have also asked that they task team deal with the fact that hospital security is not able to stop mobs of people storming hospitals.
Public interest law centre Section27 on Friday condemned the growing crisis in the North West province, caused by the disruption of all levels of healthcare services. Polity reports that the human rights organisation was concerned that the violence and disruption of healthcare services was resulting in loss of life as patients are denied entry to health facilities and doctors and other health care professionals are prevented from providing care.
“We are receiving desperate phone calls from anxious and alarmed hospital doctors reporting on the consequences of the disruption of services caused by the protests and strikes led by Nehawu and other trade union organisations,” stated Section27.
The organisation said some of the reports it received included protestors invading theatres, threats to the lives of doctors, doctors being forcefully removed from hospital wards and entrances to hospitals being blocked off, resulting in no supplies or drugs being delivered to hospitals.
Section27 added that it fully supported responsibly conducted protest action against the now ex-North West Premier Supra Mahumapelo and “his corrupt Zupta clique”. The organisation stated that it was in solidarity with most of the demands of healthcare workers who are Nehawu members for decent and safe working conditions and living wages. However, it condemned violent protests and stated that it was grossly irresponsible and morally reprehensible.
Section27 stated that it supported the right to protest and had been involved in extensive litigation to affirm this right. However, the organisation could not support protests which denied vulnerable and poor people access to healthcare and life-giving services.
“This causes great pain, suffering and loss of life for the most vulnerable. It also alienates patients from health workers when what we need is a united front for patient and workers’ rights,” said Section27.
The Democratic Alliance (DA) has released a statement calling on Motsoaledi to ensure proper health services in North West takes place amidst the chaos here.
The statement read: “We welcome the North West Executive Cabinet’s decision to place the provincial Health Department under administration, as the Health Department does not have the capacity to execute its constitutional functions of delivering critical health care services. But in the meanwhile, our communities are suffering. Urgent intervention is needed here to prevent unnecessary deaths and suffering.
“The DA has confirmed a shortage of essential medicines such as ARVs, chronic medication, and immunisation vaccines. In the entire North West, only the Bojanala District is currently not that greatly affected by this shortage.
“Non-striking workers in Tshepong Hospital in Matlosana and workers in Mafikeng are not allowed to go to work, and it seems that this situation has also escalated to the Potchefstroom hospitals. Meanwhile, some clinics are locked as they cannot serve their communities.
“Yesterday, 3 May 2018, we met with a father whose daughter tried to commit suicide. The father rushed to the scene but they couldn’t get an ambulance and they were told that the emergency staff members of ambulances were scared to work as they feared for their safety due to the strikes and protest at the hospitals.
“The collapse in the delivery of health services in hospitals and clinics is a direct result of a complete lack of governance by the ANC North West Provincial Government (NWPG). After placing the Health Department under the administration of the Provincial Treasury it became clear that this was not done to improve the performance of the department but this was a ploy to subject it to state capture. Shortly after placing the department under administration two major contracts worth at least half a billion; Buthelezi Ambulances and Gupta-linked Mediosa, were approved without following proper tender procedures.
“The beneficiaries of the contracts are known associates of the embattled Premier Supra Mahumapelo and the contracts have now become subjects of criminal investigations by the Hawks.
“The lack of accountability and transparency in the management of affairs within the department is also the cause of the collapse of the department. The suspended Head of the Department of Health, Dr Thabo Lekalakala, made an advance payment of R30 million to the Gupta linked Mediosa company without being accountable to the executive authority of the North West Health Department.
“The DA applauds Dr George Mothibi and his team at Mahikeng Provincial Hospital who went beyond the call of duty to help women who were in labor to deliver the babies.
The DA wishes to convey its condolences to the families and friends of the people who at the height of the crises that collapsed the delivery of health services lost their lives in hospitals and clinics across the province.
“We urge the people of North West to work with administrators from the national government to restore the normal provision of health services in the province, especially to poor and vulnerable people.
“The people of North West need Total Change that only a DA government can bring, not the ANC who are crippled by factional battles and failing to resolve this ongoing crisis.”
The University of the Witwatersrand has released a statement registering “its deep concern following the major disruption of healthcare services caused by industrial action in the public healthcare sector in recent weeks, which has resulted in patients being denied access to basic and critical healthcare services.
“Recent protest action in both Gauteng and the North West Province has resulted in striking workers disrupting medical services, damaging public property, and closing clinics and hospitals, which resulted in many patients being turned away despite the need for urgent healthcare services. This has resulted in the most vulnerable members of our community being deprived of healthcare services – a basic human right.
“The impact of the industrial action has also had far-reaching consequences for the University’s staff members, academics and students who undertake clinical duties in public hospitals and clinics. In some instances, teaching and learning activities were disrupted, staff members were threatened and denied access to facilities, and property was damaged.
“The University finds these actions reprehensible and calls on all stakeholders to work together to urgently resolve the crisis in the healthcare sector as soon as possible. “City Press Business Day report Polity report DA statement on the Polity site