Dozens of patients whose lives are at risk as various medicines on the North West Province’s essential drugs list are not available, according to Spotlight. Physicians at Klerksdorp/Tshepong and Rustenburg hospitals believe that the province only has about 40% to 50% of the items on the essential drugs list.
One doctor at Rustenburg Hospital says it should never drop below 75%: “It means I know I can’t do the best for my patients. It’s very demoralising for the staff.”
Spotlight reports that drug shortages include painkillers, vitamin B12, calcium tablets, iron tablets, the flu vaccine, urine test sticks, antibiotics and drugs to treat hypertension, diabetes, epilepsy, psychiatric conditions, cryptococcal meningitis, epilepsy and pneumonia. Drugs used for sedating and paralysing patients for intubation in intensive care are also not available.
Doctors have flagged these problems for at least two years and say the shortages have occurred intermittently for the past few years. In 2018, the province’s medicines depot in Mahikeng was at the centre of a go-slow that severely compromised healthcare services that year.
Since then, the report says , the depot has run sub-optimally. There have been problems with staff being suspended, staff shortages, and alleged incompetence and maladministration. Suppliers have gone unpaid, leading to terminated service agreements.
Some companies that won tenders could not meet their obligations, but have not been penalised or forced to pay back money. An accrual system now means new budgets are used to pay old debts, inevitably leading to shortfalls towards the end of each financial year.
The four doctors who spoke to Spotlight say they “cannot in good conscience remain silent”. They have followed all the official channels to raise their concerns.
A doctor at Klerksdorp/Tshepong Hospital relates how they delay discharging patients so they can receive life-saving drugs intravenously. “Administering drugs intravenously comes with hospital stays of about R2 700 a day instead of sending people home with medicines. It’s a case of being penny wise and pound foolish,” the doctor says.
“I also have no doubt that we will see HIV patients returning to hospital with meningitis because we are not able to give them fluconazole, which is an antifungal treatment that fights opportunistic diseases in HIV-positive people,” the doctor says. “It’s the same with urine testing – because there are no urine test strips, doctors have to order expensive blood tests instead. It comes with high costs and delays, so there are infections that are not getting picked up early.”
Another doctor says that, for some conditions, there just are no alternative medicines, and switching one medicine for another often means having to restabilise patients on a new drug regimen.
Some pharmacists are already resorting to dispensing smaller quantities of drugs to patients and asking them to return more frequently in the hope that stocks will be replenished by their next visit.
Spotlight reports that before South Africa’s COVID-19 coronavirus lockdown, patients from Rustenburg Hospital often turned to sourcing medicines at public facilities in Pretoria or Johannesburg. That avenue has been cut off because travel across provincial borders is restricted.
Reporting on the government’s response, Spotlight quotes Polaki Mokatsane, the deputy director-general for health in North West, as saying that there are long-standing systemic problems, but he believes that they are getting things back on track.
Mokatsane says that, with the new financial year having started last month, he expects all debts to suppliers to be settled by the end of this month so contracts and supplies can resume. However, he confirms a huge backlog in the processing of individual invoices.
[link url="https://www.spotlightnsp.co.za/2020/05/22/doctors-blow-whistle-on-medicines-crisis-in-north-west/"]Full Spotlight report[/link]