How Bhekisisa exposed Benny Malakoane

Bhekisisa’s investigations for the Mail & Guardian into the Free State’s health system under MEC Benny Malakoane’s watch.

‘How a dying woman’s bed was taken by an ANC official’

Doctors at the Pekholong Hospital in Bethlehem in the Eastern Free State claimed that, late one night, in July 2014, Benny Malakoane and the head of the provincial health department walked unannounced into the hospital where an ANC branch secretary was being treated. The Treatment Action Campaign (TAC) later established that the patient was a cousin of Mineral Resources Minister Mosebenzi Zwane, who was the Free State MEC for agriculture at the time.

Malakoane and his colleague wanted the patient to be admitted to the intensive care unit (ICU). Pekholong, a district hospital, had no ICU, so the two officials ordered that he be transferred to the Dihlabeng Regional Hospital, also in Bethlehem.

The ICU consultant on duty assessed the patient and found that, in line with national clinical protocols, he did not qualify to be admitted to the ICU unit; he was in the final stages of a chronic condition and highly unlikely to recover. “No other ICU in the country would admit a patient like that, especially over other patients we could more likely save,” a senior doctor at Dihlabeng told Bhekisisa.

Because of cost-cutting measures, Dihlabeng had only three ICU beds, all of which were taken, so the ANCaligned patient was admitted to a secondary-level medical ward in the hospital. Two other critical patients, one with a mild heart attack and another a burns victim, had already been turned away from the ICU because of space constraints.

Doctors said an instruction from Malakoane was delivered the next morning to the clinical manager on duty by one of the MEC’s staff members: an ICU bed was to be opened “because the MEC had promised family members the patient would go to ICU”.

Later that week, another two critical patients deserving of an ICU bed lay in ordinary medical wards while Malakoane’s patient remained in ICU, with no improvement to his condition. He died a few days later. So did an elderly woman, with a promising prognosis, who couldn’t get an ICU bed.

Malakoane denied these allegations in a later interview with Bhekisisa: “That’s another allegation which was grossly uninformed,” he said. “Do those doctors know what I look like?”

‘It’s the Free State hospital that killed my husband, Frik’

In 2011, the Free State government named the Dihlabeng Regional Hospital the best regional hospital in the province. In March 2015, two years after Malakoane became health MEC, the hospital was in such disarray that the hospital’s doctors turned to Health Minister Aaron Motsoaledi in desperation to save the facility’s services from collapsing.

The hospital was operating with less than a quarter of the number of doctors and specialists required, resulting in medical interns (who have completed their studies but are not yet registered doctors) giving anaesthesia unsupervised or being left to run casualty wards without supervision, doctors said.

The doctors had first tried to approach the provincial health department’s chief operating officer, Balekile Mzangwa, for “some guidance as to the way forward”.

But, said the doctors, “he could not be reached because he had joined [Free State] Premier [Ace] Magashule on a trip to Cuba … We have found out the Cuba trip included an entourage of 72 people at a cost of about R21-million. The head of department, David Motau, was in Germany for some reason and could also not be reached. Malakoane himself was not available because he was appearing in court on corruption charges.”

In a press release, the Free State government confirmed the delegation’s Cuba visit but refused to reveal the cost of the 15-day trip. It claimed criticism of the visit was “politically motivated” because the Democratic Alliance had initiated an inquiry into it. Health delegates were included in the trip as it was the provincial government’s duty to “motivate” and “encourage” 197 Free State students studying medicine in Cuba to ensure their return “to the Free State province upon completion of their studies to ensure that we continue to derive benefit from this investment”.

A Dihlabeng doctor asked: “How can you run a department like that? According to the DA’s statement, the cost of the trip worked out to about R300 000 per person.

“That is R20 000 per person per day. How is it possible to have the money for such a trip for several health department people but not for doctors’ or nurses’ salaries, or for patients’ medication?”

Martisa Balanco, whose husband, Frik, died at Dihlabeng during that period, said doctors acknowledged to her his death was because the hospital was out of stock of the correct antibiotics and lack of staff.

“Politics,” she said, “does not matter to me. I don’t understand much of it at all. But what I do understand is that it killed my husband.” —