Provincial focus
How the North West Department of Health is working hard to improve health access and services in the province
Rural healthcare in the North West Province requires more development and Health MEC Magome Masike is on a mission to improve access to medical services there.
The economy of the province is dominated by agriculture and is rural in nature while areas suffer from underdevelopment but the MEC believes this should not be an excuse for residents to receive below par healthcare.
In an interview with PSM he said he would not rest until all clinics and hospitals in the province meet the standards residents deserve.
“Residents in villages, townships, and small towns deserve the same standard of services as enjoyed by those living in big cities, especially with regard to basic services and human rights,” he said.
“The only time I will be happy with the state of healthcare services in my province is when everybody has access to healthcare on their doorstep, have access to medication and an ambulance can get to them quicker than before,” MEC Masike said.
Revitalisation programme
He said the department is rolling out the revitalisation programme for local clinics and hospitals to ensure they are upgraded and service delivery is improved.
There are around 400 healthcare facilities in the province, including clinics and hospitals.
“Our core business is to prevent, diagnose, treat and control diseases. Clinics are about prevention most of the time and that is why we regard everything in clinics as vital,” added the MEC.
As part of the revitalisation programme in the 2016/17 financial year the Klerksdorp Hospital received a new boiler, Witrand Hospital was upgraded and Bophelong Psychiatric Hospital Phase II A (state patient wards) was completed.
Construction also started on the new Madikwe Clinic, new Jouberton Community Health Centre (CHC) and on the upgrading of the Excelsius Nursing College.
Projects expected to be completed in 2017/18 include the new Mmakaunyana, Weltevrede and Madikwe Clinics, refurbishment of JST Hospital Ward 10, new Mathibistad CHC. Others include the installation of a new boiler at Mahikeng Provincial Hospital, replacement of lifts at Potchefstroom and Witrand Hospitals, upgrading of Boitekong CHC, new Sekhing CHC and the replacement of water supply network at Itsoseng CHC.
Ideal clinics
The MEC said that about 25 percent of the province’s 314 public clinics are in a good state and actually meet the ‘Ideal Clinic’ standards.
“We are looking at increasing this percentage because clinics are the first line of defence to diseases,” he added.
According to the standards set by the national Department of Health, an Ideal Clinic is defined as:
• A clinic with good infrastructure in terms of physical condition and spaces, essential equipment, and information and communication tools.
• One with adequate staff, sufficient medicines and supplies, good administrative processes and adequate bulk supplies.
• A clinic that uses applicable clinical policies, protocols and guidelines, as well as partner
“The HIV positive rate for the age group 15 to 49 years has decreased from 9.3 percent in 2015/16 to 6.8 percent in 2016/17.”
and stakeholder support, to ensure the provision of quality health services to the community.
The department was allocated a budget of about R10.4 billion in the 2017/18 financial year but the MEC said in order to improve services in 2018, the department will need about R15 billion in the coming year.
Doctors and nurses needed
However, there are more to the challenges facing the province than just funding, there is also a shortage of healthcare professionals.
“We need more staff. We do not have enough doctors and nurses,” pointed out the MEC.
Health Minister Aaron Motsoaledi is on record saying that young doctors and other health professionals do not want to work in hospitals and clinics in rural towns.This is not because they have an issue with the health facilities themselves but because the towns are underdeveloped and do not offer much to complement their lifestyles.
MEC Masike echoed this sentiment, saying it is a challenge in the North West also.
“You must remember that the development of a town includes many things like roads, shopping malls, better schools, international airports and other things. We don’t have that yet. Most young people want to live in Gauteng because the province has a lot to offer that matches their lifestyles,” he said.
“But we appeal to their consciences to say the sick in the rural areas also need their help. They have taken the profession oath and some of them do listen and come to work in rural areas,” added the MEC.
Fighting HIV and AIDS
Despite all the challenges it faces, the department is making progress in fighting against HIV and AIDS.
It is estimated that about 474 768 people are HIV-positive in the
North West, and 5.6 percent are children below the age of 15 years.
The MEC said of those who are HIV-positive, 234 454 are on lifelong antiretroviral treatment and are receiving treatment at public health facilities.
“The HIV positive rate for the age group 15 to 49 years has decreased from 9.3 percent in 2015/16 to 6.8 percent in 2016/17. This is a great achievement, however, the most vulnerable groups and key populations still remain hard to reach,” he added.
With regard to TB, about 83 percent of TB patients in the province are also HIV-positive.
“So we are conscious about the co-mobility of these two diseases,” said the MEC.
The province prides itself on being the first in the country to successfully treat a patient with extreme drugresistant TB at Tshepong Hospital. The province has since continued to establish multiple-drug resistant centres throughout its districts so that patients are no longer referred to just a hospital for treatment.
One of the challenges that hampers the progress in fighting TB, HIV and AIDS is the language barrier.
The department makes use of Community Development Workers to cascade information and continue to raise awareness about diseases, but sometimes the message gets lost along the way as some residents are foreign to the heritage language.
“In mining areas in the North West, many South Africans do not want to do manual work so they leave the work for people who come from outside South Africa, and because most of them do not understand Setswana, the message that we are trying to communicate does not get across,” he said.
He said hospitals in the province do not only provide services to South African patients but to foreign nationals as well and this means having to spend more money to meet people’s needs.
Partnerships yield results
To address some of the challenges it faces, the department has established partnerships with the private sector and communities.
Through a public-private partnership, the department has opened a new Chemotherapy Unit within the Radiation Oncology Unit at Tshepong Hospital Complex in Klerksdorp.
MEC Masike said the construction of the unit came about as a result of a donation by the Muslim community.
“Previously, patients had to be transported to Gauteng to treat cancer but now they can be treated close to their homes. We are trying by all means to ensure that our people do not have to leave the province to get services,” he said.
Another success story from the partnerships is a maternity ward worth R6 million that was opened in May 2016 in Botshabelo CHC at Khuma Township in Stilfontein. According to the MEC, 446 healthy babies were born at the ward since it opened.
Mining company Lonmin also donated 18 ambulances to the department, as well as two patient transport and a school health vehicle.