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HomeFocusThe fragile state of South Africa’s health system

The fragile state of South Africa’s health system

[b]Mpumalanga’s[/b] public hospitals have come under fire as being possibly the most haphazard and hazardous in [b]SA[/b]. [s]The Times[/s] reports that authorities have admitted the province's state hospitals were woefully equipped, lacking even basic life-saving equipment. The CEOs of the province’s 33 public hospitals engaged in a five-hour long deliberation with Premier David Mabuza, revealing the many woesexperienced by staff and patients alike. Mabuza’s administration has decided to place the entire provincial health system under curatorship until a turnaround becomes evident.

Unpaid health workers in the [b]Free State[/b] staged a night vigil and sit-in at the offices of the premier and MEC for health, as the province’s health system continues to spiral – and the [b]Free State Department of Health[/b] remains largely silent, say activists. [s]Health-e[/s] quotes the [b]Treatment Action Campaign’s[/b] Mary-Jane Matsolo as saying that workers say they have not been paid their monthly stipends of R1,500 for two months after MEC of Health Benny Malakoane terminated their contracts, claiming they were ghost workers. Following this, the head of department sent a second circular stating that their services should not be stopped,’ the TAC said. The report says the protest is the latest symptom of a provincial health system that the TAC and public interest group [b]Section 27[/b] say is collapsing.

Despite [b]Free State[/b] health workers being owed R77m in outstanding payments and bonuses, a [s]Sunday Times[/s] report says the [b]Health Department[/b] is blowing millions on refurbishing Malakoane’s office and conferences at a luxury lodge.

The details of the cash-strapped department’s spending spree have emerged amid daily complaints by doctors and nurses about the severe shortage of medical consumables, drugs and equipment, and long delays for patients needing surgery. [b]Health Minister[/b] Aaron Motsoaledi is studying a report of a high-powered team that recently spent almost two weeks investigating problems in the department.

The [b]Gauteng Department of Health[/b] has promised to fix electrical wiring at [b]Dobsonville’s Itireleng Community Health Centre[/b] following a public outcry over a baby’s death, but the [b]Democratic Nursing Organisation of South Africa (Denosa)[/b] says there are larger issues. According to a [s]Health-e[/s], the baby girl’s 30 May death sparked a public war of words between Gauteng Health and Denosa, which had released a statement prior to the child’s death warning that on-going power cuts dating back to 2011 were endangering Itireleng patients. Although nurses say the faulty incubators to blame for the baby’s death have been fixed, Denosa says it will take much more than working machines to restore quality health services at the centre. Gauteng Health denies that equipment was at fault.

[s]The Times[/s] reports, meanwhile, that doctors studying to be heart surgeons can no longer be trained at [b]Charlotte Maxeke Johannesburg Academic Hospital[/b] because it has lost its accreditation to train registrars in cardiothoracic surgery. This means that the [b]Steve Biko Academic Hospital[/b] in [b]Pretoria[/b] is the only hospital in [b]Gauteng[/b] that can train cardiac surgeons. Private hospitals, with better equipment, are barred by law from training registrars. An insider said broken equipment, a shortage of hi-tech equipment and a lack of ICU beds for patients had affected how much training was on offer, the report says.

SA[/b], like many developing countries, faces severe shortages in doctors. Amanda Jitsing and Fouche Venter from [b]DNA Economics[/b] write in [s]Polity[/s] that in 2010, the country had only 55 physicians per 100,000 people, against the 180 average of similar middle-income countries. When compared to its [b]Bric[/b] counterparts, SA also fares poorly. [b]Russia[/b] proportionately has almost eight times more physicians than SA. They say this statistic is worrying in a country confronted with a quadruple burden of disease – HIV/Aids and TB, maternal and child mortality, non-communicable diseases, and violence and injuries. It becomes even more concerning given that many of these physicians work exclusively in the private sector.

SA’s[/b] health system is collapsing with lifestyle diseases infiltrating every strata of black society. [s]Destiny Connect[/s] quotes Dr Vash Mungal-Singh, CEO of the [b]South African Heart and Stroke Foundation[/b], as saying that 20 years ago the white Afrikaner male was most at risk of heart disease in this country, but that situation has changed dramatically. Since the transition to democracy, more and more black South Africans have adopted the sedentary [b]Western[/b] lifestyle and diet, and are paying a devastating price.

[link url=http://www.timeslive.co.za/thetimes/2014/06/26/mpumalanga-hospitals-placed-in-intensive-care]Full report in The Times[/link]
[link url=http://www.health-e.org.za/2014/06/30/free-state-health-crisis-continues-unabated]Full Health-e report[/link]
[link url=https://secure.newspaperdirect.com/epaper/accountingloginse2.aspx?returnurl=%2fepaper%2fpageview.aspx%3fissue%3d11072014062900000000001001%26page%3d4%26articleid%3d7d71f8ee-4f3b-42e1-b16b-dcdbd9e04456%26articlekey%3dSyFY9ktgpB698svfGDeWUw%253d%253d%26previewmode%3d2]Full Sunday Times report (subscription needed)[/link]
[link url=http://www.health-e.org.za/2014/06/26/babys-death-reveals-lack-planning-denosa]Full Health-e report[/link]
[link url=http://www.denosa.org.za/Media_View.php?id=34936]Denosa statement[/link]
[link url=http://www.timeslive.co.za/thetimes/2014/06/27/help-gone-in-a-heartbeat]Full report in The Times[/link]
[link url=http://www.polity.org.za/article/on-call-bolstering-the-supply-of-doctors-2014-06-30]Full Polity report[/link]
[link url=http://www.destinyconnect.com/2014/06/24/whats-killing-black-men]Full Destiny Connect report[/link]

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