Is this the price of Supra’s defiance?
North West clinics and hospitals are shuttered as medicine runs dry and protests drag on
Trade union protests have brought North West province to its knees, closing health facilities and forcing hospitals to discharge even the sickest of bedridden patients. And only Premier Supra Mahumapelo’s resignation will bring an end to the crisis, say labour leaders.
“If the premier steps down, even now, then we can go back to the negotiation table and proceed, and advise our employees,” says Motlalepule Ramafoko, the acting provincial secretary for the Democratic Nursing Organisation of South Africa (Denosa).
The nursing union and the National Education, Health and Allied Workers’ Union (Nehawu) embarked on a go-slow in the province more than a month ago that has crippled healthcare.
The protest action has now turned into a stayaway for many nurses after violent demonstrations by residents erupted in Mahikeng this week, and Denosa says it now fears for its members’ safety.
“The security of our employees is compromised,” Ramafoko says.
“We never made any total shutdown. We were working with a skeleton staff until yesterday when the community decided to take over our strike. Now the communities are the ones striking.”
Calls to oust Mahumapelo follow allegations that the province awarded R180-million in illegal tenders to the Gupta-linked company Mediosa for mobile clinics. Of this, R30-million was paid out to the medical technology firm before the vehicles were delivered.
As of Thursday morning, health workers at Mafikeng Provincial Hospital were phoning family members to collect patients from the hospital wards and were forced to discharge some patients without medication.
Healthcare workers reported that cars attempting to enter or leave the hospital were being stoned, forcing them to shut down the emergency room.
Doctors were being warned not to report for duty, and those who had were advised to leave for their safety. About 4km away, protesters had also blocked the entry to Victoria Private Hospital.
Residents in Mahikeng’s Lonely Park neighbourhood say they have been lining up daily in the hope that the local clinic will reopen after it closed its doors earlier this week.
At the time of going to print, North West health department spokesperson Tebogo Lekgethwane said the department remained in talks with the South African Military Health Service about their potential deployment to affected health facilities.
Neither the national health department nor the South African Defence Force could confirm that military personnel had been activated for deployment.
This comes hard on the heels of reports by the Treatment Action Campaign and public interest law organisation Section27 that 95% of medicines in the province are out of stock, according to Vuyokazi Gonyela, who is the national strategic plan advocacy officer at Section27.
Almost 400 clinics and hospitals are estimated to have no medicine or are running on dangerously low stock levels, medication monitoring consortium the Stop Stockouts Project warns.
Ndiviwe Mphothulo is a doctor in rural Taung, about 231km south of Mahikeng. He says that 80% of his patients on chronic medication for illnesses such as HIV, hypertension or diabetes have been spared treatment interruptions because they collect their medication at private pharmacies as part of the national health department’s centralised chronic medicines dispensing and distribution programme.
This public-private partnership allows long-term chronic patients to collect their drugs at pharmacies to help decongest overburdened clinics.
But the programme doesn’t cover mental health patients, Mphothulo warns.
“Our problem is mental health treatment. [The mental health patients] are the ones who have to go to the hospital for their treatment and spend their last money,” he says.
“Taung is a vast and largely undeveloped area. A taxi to the hospital costs R160 there and back, which is a catastrophic cost for most patients. [Mental health patients] have to choose between food or going to Taung hospital,” Mphothulo adds.
He says that pharmacists at the district hospital have been putting in long hours trying to match each medication with its supplier and then place orders.
The national health department has instructed suppliers to deliver medicines directly to health facilities. But it will cost the province, which already has to pay off almost a billion rand that it overspent in last year’s budget.
This includes an unexplained tripling of drug costs in one district, says Russell Rensburg, health systems and policy manager at the Rural Health Advocacy Project (RHAP).
“There was no medical emergency, an outbreak of malaria [for instance] … There wasn’t a 300% increase in communicable diseases or people that they put on treatment, yet they spent three times more. We can’t say that the medicines actually reached clinics,” Rensburg says.
But what the RHAP can say is that certain budget lines in the province are being underspent.
“Budgets allocated to specific line items such as human resources are often underspent and instead reallocated to provincial priorities or goods and services budgets that are used to procure services and buy medicines,” Rensburg told Bhekisisa this week.
“In this goods and services budget, there is greater opportunity for directing the funds to service providers such as the Gupta-linked medical technology company Mediosa.”
Nehawu and Denosa are also calling for an end to corruption and to the outsourcing of work.
“Today, patients and health workers in North West will continue to scramble to access life-saving medication.
“The health emergency in North West provides an opportunity for bold leadership that can begin to address a legacy of failure that has arisen over the past nine years,” Rensburg says.
“Failure to act can be seen as tacit approval for the ongoing plundering of the state.” —