Read the grim findings of the South African Human Rights Commission’s Hearing into access to emergency medical services in the Eastern Cape. RHAP’s Prinitha Pillay served the committee as external panelist.
National inquiry to be launched into emergency medical services
The South African Human Rights Commission will launch a national investigation into the state of emergency medical services (EMS) after finding just 200 of about 416 Eastern Cape public ambulances are functional in the province of 6.5 million people.
Even if the province was able to ensure all 416 ambulances in its fleet were functional, staffed and on the road, the province would still be more than 200 emergency vehicles short of national targets, according to a new roughly 100-page report released yesterday by the commission.
Those scarce ambulances running the gauntlet of the province’s rural roads face tough conditions after chronic neglect that may take decades to rectify, according to Human Rights Commission deputy chairperson Pregs Govender.
The province has the third worst network of paved roads in the country, according to Eastern Cape Department of Roads and Transport’s Craig McLachlan, who presented at a March two-day South African Human Rights Commission hearing into the state of EMS in the province.
The hearings – and the new report – are the culmination of almost two years of investigations by the commission.
In its new report, the commission found that a shortage of vehicles and staff, as well as poor roads and budgeting mean that some in the Eastern Cape have never seen an ambulance in their lives. For others, it has meant having to watch family members die before their eyes as some, like Xolisile Sam, report waiting as much as five days for an ambulance.
Sam’s sister Tumeka had been on tuberculosis treatment when her health deteriorated and she began having seizures.
“We called ambulance but it didn’t pitch that day,” he said recently from his home in Isilatsha village outside East London. “We waited on the second day and it didn’t pitch.”
Sam alleges emergency call centre operators repeatedly told him that his sister was not sick enough to merit an ambulance. Tumeka was taken to a health facility by ambulance five days after Sam made the call. She died days later. The pile of bricks she bought with dreams of expanding the family homestead still stand in the yard.
“Of course (when) the ambulance didn’t arrive in the first instance, it played a crucial role in her death,” he told Health-e News.
Better staffed and trained emergency call centres are just one of the commission’s recommendations for the Eastern Cape alongside better and more consistent reporting of its EMS department outcomes, such as response times.
Although a recent Health-e News investigation found that about 90 percent of Eastern Cape ambulances were operational as of late June, the commission has given the provincial department of health six months to respond to the report – and provide the commission with a detailed rescue plan. The commission will also launch a national investigation into the state of EMS in late October or early September.
Both Gauteng and Mpumalanga departments of health have also recently admitted to ambulances shortages.
The Eastern Cape Department of Health has already committed to purchasing more ambulances and employing more EMS staff, according to Govender.
The Rural Health Advocacy Project’s Dr Prinitha Pillay took part in the hearing and urged the commission and communities to remain vigilant.
“The Human Rights Commission and the state have a responsibility to monitor progress and more importantly to act where there is no progress,” she said.
The commission’s investigation was prompted by a 2013 complaint from the rural community of Xhora Mouth outside Mthatha. The report is expected to be officially launched in Xhora Mouth today. – Health-e News
Port Elizabeth – The Eastern Cape health department has committed to fixing a number of problems cited by the SA Human Rights Commission (SAHRC) regarding the delivery of emergency medical services, especially to rural areas.
This emerged in the findings of a report produced by the SAHRC on emergency medical service delivery in the Eastern Cape presented to media in Johannesburg.
Deputy chair Pregs Govender, speaking at the briefing, said some of the recommendations included increasing the number of ambulances, “especially the number of ambulances specifically designed to navigate the rough terrain, adapted in terms of 4×4 capacity”.
This was after the commission found the department only had 200 operational ambulances, out of a fleet of 416, while national standards stated the province needed 656 ambulances.
Govender said among their recommendations was that all ambulances have proper equipment, that there was a particular need for trained staff in rural areas, and that call centre operators required training on prioritisation for dispatch.
Further, roads needed to be improved as it made it extremely difficult, if not impossible, for standard ambulances to reach rural areas.
“The commitment [from the health department] was that the budget for EMS would be increased. There was a clear commitment that they would purchase more ambulances,” Govender said.
“More 4×4 ambulances would be purchased… They committed that ambulances will be fitted with tracking devices, the number of vehicles to transfer people between health services and facilities will be increased so the service will be more reliable.”
No person would wait longer than four hours for an ambulance, though the aim was for ambulances to arrive much sooner than that.
If an ambulance has not arrived as expected, the relevant district mangers could be contacted. The department handed the relevant cellphone numbers to the commission to share with communities in the case of delayed response.
The provincial transport department, which had also participated at the public meeting, pledged to improve certain roads leading to hospitals and rural roads.
However, in their submission to the commission, it was emphasised that improving all the province’s roads would take many years.
Dr Prinitha Pillay, programme manager for human resources for health and policy implementation at the Rural Health Advocacy Project, told media that it was clear there had been multiple violations of citizens’ rights.
“What we witnessed was an extreme amount of physical and mental anguish for these communities and their resulting bereavement… certainly needs to be a priority going forward,” she said.
This was because rural communities tended to be neglected, and since they were rural, suffered from an out-of-sight, out-of-mind attitude.
“The SAHRC and the state have a responsibility to monitor progress and more importantly whether there is not progress,” she said.