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A civil society commission has accused the Free State Department of Health of failing to take action to mitigate alleged shortages of medicine, health professionals and ambulances. The Free State Department of Health has fired back, accusing the Treatment Action Campaign of a politically motivated attempt at "co-governing the department".
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A new civil society report released on Tuesday has accused the national and Free State provincial governments of failing to protect access to health services for patients in the Free State. According to the report, written and verbal evidence presented before a two-day people’s commission of inquiry have shown that the province continues to suffer from shortages of medicine, medical supplies, health professionals and ambulances.
The Free State Department of Health has denied many of the allegations and criticised the inquiry, which Aids lobby group the Treatment Action Campaign initiated in May.
Overseen by three independent panellists, the commission heard and read the testimonies of dozens of Free State citizens and health workers regarding the state of provincial health services. The inquiry was chaired by former Johannesburg Central Methodist Church head Bishop Paul Verryn, former Democratic Nursing Organisation of South Africa General Secretary Thembeka Gwagwa as well as Alternative Information Development Centre Co-Director Thokozile Madonko chaired the inquiry.
James Johnson lives in Bethlehem, about 200 kms east of Welkom, and has been a patient of his local Mphohadi Clinic for 12 years. The stroke survivor testified drug shortages forced him to pay R60 monthly to buy his hypertension medication earlier this year.
“I am forced to pay for these (medications) from my pension money, which is only R1 400 per month,” said Johnson in a written testimony submitted to the commission.
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“I therefore have to sacrifice food and the money budgeted to transport my 21-year-old daughter Monica to college,” he added.
The report describes shortages of not only drugs but also medical supplies in the province as “chronic”, however Free State Department of Health Spokesperson Mondli Mvambi has denied allegations of drug shortages.
“The inflammatory statements by the report are reliant on old false information that was not procedurally acquired and thus devoid of the truth and the context,” he said. “We know of false claims of dry stock outs that were based on eye observation of the shelves in some of our facilities.”
Under administration
In 2013/14, the province suffered stock outs due to non-payment of suppliers. The province remains under financial administration and Mvambi said the province is doing everything in its “power to prior prioritise the payment of suppliers within 30 days.”
“Our medical depot is reconsidering alternative suppliers where there has been non-adherence to contractual obligations,” he added.
He also added that the province was working to replace large numbers of doctors it has lost in the last year according to recent Health Systems Trust research. Released in October, the research showed that the province had lost nearly a quarter of its doctors in the last year.
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“Doctors are forever seeking better opportunities,” he said. “Our province is rural and sometimes (doctors) require that we pay doctors more than we can afford to retain them.”
“We have been replacing these doctors, however with session doctors and recruiting in the country and outside in countries like Cuba,” said Mvambi who added that the province was working to improve retention strategies. “Last week…MEC of Health Dr. Malakoane encouraged CEOs of hospitals to identify doctors wherever they may be and facilitate the process of hiring them.”
In the report, Free State health professionals who asked to remain anonymous testified that one hospital had lost nearly all its kidney specialists after 20 specialists had resigned.
According to the Health Systems Trust, the province as lost about nine percent of its medical specialists in the last year. The report notes about a 19 percent vacancy rate in the province’s district and emergency medical services departments. This rate skyrockets to more than half among individual health facilities’ management.
In March, Mojalefa Sefali said his mother suffered a vicious asthma attack but emergency medical services refused to take his mother to hospital, meaning the family spent about 10 percent of its monthly income to rush the woman to Botshabelo District Hospital about 60 kms east of Bloemfontein.
An ambulance crisis
“The dispatcher operator told me that ambulances do not pick patients up from their homes,” he testified. “We therefore had to pay our neighbours to take her to Botshabelo hospital. Upon arrival, we waited a long time before being helped because there is a shortage of doctors and nurses.”
Mvambi did not deny allegations that province has had less than half of the ambulances required to meet national norms as highlighted in a Rural Health Advocacy Project (RHAP) analysis included in the report. RHAP also notes that this is despite R200 million in unspent funds in the 2014/15 financial year.
He said that the province is working towards meeting national norms of one ambulance for every 10 000 people and that 55 ambulances were recently added to the provincial fleet. He did not specify if these were replacement vehicles or new additions.
Ambulance shortages have also been reported in the Eastern Cape, Limpopo, Mpumalanga and Gauteng in the last year.
Addressing the crowd at the report’s Bloemfontein launch, TAC Secretary General Anele Yawa re-iterated calls for Malakoane to be replaced.
The commission has called on the province to make public its community health care worker policy and re-hire dozens of community health workers suddenly fired last year. It has also called on the National Department of Health to establish a task team to investigate the findings of its report.
Yawa has promised to deliver copies of the commission’s 35-page report to Health Minister Dr Aaron Motsoaledi, and Deputy President Cyril Ramaphosa at the South African National Aids Council’s next plenary meeting.
Yawa added that he would also send a copy to African National Congress Secretary General Gwede Mantashe.
A call to action
Verryn said that the report should be seen as a call to action by both government and civil society.
“We are failing to protect access for health care services in the province,” he said. “If we are gong to survive as a nation, we have to ensure that the most vulnerable in this country have access to proper health care.”
“As much as we need to point out what is wrong, we do so in an action seeking – pleading – that we try to put hands together to solve the problem,” he added. “The responsibility for the solution is all of our responsibility.”
Mvambi added that the department does plan to release a statement in response to the report but lambasted TAC’s actions as being politically motivated
“It is regrettable that the TAC is not following decent forms of engagement and theirs is not a commitment to resolve matters but a political intention to embarrass the department,” he said. If this was not the case, a decent platform of engagement – not a demand of co-governing the department – could have been found and we would have scheduled a briefing platform on the progress we are making since the MEC launched a turn-around strategy in May 2013.” – Health-e News.
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