Letter of concern: Ongoing Health Crisis in the North-West Province
Currently there is a crisis in the provision of health care in the North-West Province. This is a result of action taken by various groups who were angered by chronically unresolved issues which resulted in violence and closure of health care facilities. The crisis that began in the health sector has rapidly spread including calls for the resignation of the Premier. Some of the violence has led to opportunistic attacks on innocent individuals and private businesses particularly foreign owned. These issues have gone beyond health care matters:
Issues that have ignited the crisis include
- 1 Corruption
- 2 Freezing of posts despite resignations/retirements.
- 3 Shortages of skilled personnel and support staff within the sector.
- 4 PMDS challenges that have remained unresolved.
- 5 Non-payment of service providers resulting in shortages of medications, surgical
sundries, interruption of health care facility telephones with no or poor internet
- 6 Demanding resignation of HOD who has been implicated in corrupt activities.
- 7 Outsourcing of services by the North-West Department of Health.
Actions taken by striking employees include:
- 1) Main medical store closure, where health institutions were unable to procure medication and surgical sundries, resulting in shortages of medications and surgical sundries resulting in the compromise of patient care.
- 2) Closure of clinics / hospitals particularly Lehurutshe, Zeerust, Mahikeng and surrounding areas. These communities cannot access preventative, obstetric, both acute and chronic surgical or medical care. Ironically these actions are committed by individuals, some of whom are likely to have access to private health care via medical aids and are thus unlikely to be personally affected by their actions.
- 3) Intimidation by striking individuals of health care worker, who threatened and intimidated with physical violence and forced to leave patients unattended.
- 4) Issues beyond health care which include demands for the resignation of the Premier of the NWP which complicates the resolution of the crisis in health.
These actions lead to the compromise of all aspects of health provision and patient care with associated increases in illness profile and death of patients …
- 1) Suboptimal management of pregnancies resulting in poor outcomes.
- 2) Surgical emergencies not timeously attended to, particularly trauma, burns and
motor vehicle accidents.
- 3) Risks for TB and development of MDR -TB thus risking the community at large.
- 4) Risks for HIV and MDR HIV making treatment more complicated and this is costly.
- 5) Chronic diseases not appropriately treated causing complications like strokes, heart
failure and diabetic emergencies leading to poor outcomes including death.
- 6) Many psychiatric patients not treated, which may make Life Esidimeni numbers look
Who is affected?
- 1) Poor/ homeless
- 2) Disadvantaged
- 3) Disabled/vulnerable
- 4) Those with lack of access to private care
- 5) Those with chronic illnesses that include HIV, TB, Hypertensives, diabetic, psychiatric
As care givers, we have been silent for too long. We have taken an oath to “do no harm” and in our silence, we have contributed to harm. This cannot go on as we are concerned about methods used which include closure of health care facilities that affect the health of our society. Of note provision of health care is an entrenched Constitutional right in South Africa.
The grievances of the striking employees are valid and supported, however the modus operandi is condemned, particularly the shutting down of health service provision.
We urge the following
- 1) The immediate reopening of health care facilities including main medical stores.
- 2) Government, all political parties, labour movements, civil society groupings, faith
based organisations, health care worker movements and the community in general need to become more vocal, rejecting corruption and denouncing the current methods used by striking workers.
- 3) National Department of Health to guarantee both patients’ and Health care workers’ safety when receiving and delivering services.
- 4) That immediate and urgent negotiations be held on issues that precipitated this crisis. That measures be taken to ensure adequate service delivery, including the unfreezing of posts, employing adequate number of qualified staff, resolution of PMDS, payment of outstanding bills to food suppliers, Telkom, NHLS, Pharmaceutical companies, and that all matters be resolved.
- 5) Currently and in the future action taken by striking employees should not affect communities already dispossessed and disadvantaged. Government together with employees and communities should actively prevent closure of health services during any strike action.
- 6) Medical equipment together with diagnostic services including radiological, laboratory and specialist services be made available to appropriate levels of care.
- 7) Insourcing of core services be addressed and actioned.
- 8) Should such crises recur, immediate action be taken by the Department of Health to address concerns and proactively avoid such harmful situations developing in the future.
This document is a result of our commitment to serving patients and their communities, noting that the denial of health care is unconstitutional. Hopefully the issues that precipitated this crisis are resolved immediately without further harm to our patients.
Doctors who support this letter and request urgent action be taken include:
1)D Leburu, 2) E Variava, 3) M Dikhing , 4) B Luke, 5) A Calver, 6) A Daude, 7) A Mallier, 8) T Makotsvana, 9) C Das, 10) O Mekgoe, 11) S Gerber, 12) A Thaivalappil, 13) E Verster, 14) C Chiwara, 15) I Sebogodi, 16) T Rangaka, 17) NC Ngene, 18) S Nair, 19) M Dikgang, 20) M Nong, 21) T Ledibane, 22) GD Kegakilwe, 23) S De Villiers, 24) H Ferreira, 25) P Naran, 26) D J Lamptrecht, 27) N Sabet, 28) W Urban, 29) S Mosam, 30)N Mfuta, 31)P Sharma, 32) SP Dlamini, 33) P Kyei, 34) H Van Niekerk, 35) S Makhate, 36) I Motala, 37) P Mentoro, 38) PM Ntila, 39) KN Masuku , 40) OS Leburu, 41) R Minty, 42) JK Mentor, 43) LF Keogotsitse, 44) S Masala, 45) SLK PItso, 46) KC Tsele, 47) O Mahloko, 48) M Mokhajoa, 49) TS Bogatsu, 50) Z Esterhuizen, 51) IO Kingsley, 52) KN Holonga, 53) NS Maitin, 54) JMM Shakung, 55) LC Nthutang, 56) R Moorad, 57) N Mphothulo, 58) BP Moncho, 59) I Wana, 60) V Titus, 61)D Sauer, 62) L Khatle, 63) H Huan, 64) ZS Lubiki, 65)T Swiel, 66) L Marapo, 67) C Lion-Cachet, 68) P Juggernath, 69) Manwana, 70) D Masudubele, 71) K Pillay 72) C Wu 73) TNC April