Health advocacy organisations are up in arms over the deteriorating state of the Eastern Cape's public health system. The Eastern Cape Health Crisis Action Coalition, which includes groups such as Section27, the Treatment Action Campaign and the Rural Doctors Association of South Africa, will deliver a memorandum of grievances to the province's health MEC Sicelo Gqobana as part of their "right to health" campaign, which was launched in Johannesburg and East London on Wednesday.
Vuyokazi Matiso of the Treatment Action Campaign in the province said access to health is "being made to look like a privilege" because many people don't get the medical care they need.
"Patients are being turned away from health facilities without essential drugs and there have been cases of people going to test for HIV and being told that there are no test kits available," she said. "This is a crisis and it has been going on for some time now."
The coalition first investigated essential drug stock-outs in the province's Mthatha depot between September 2012 and January 2013. The investigation found that over half of the facilities served by the depot had run out of HIV and tuberculosis medication.
The investigation resulted in a report that included suggestions of how these problems could be solved being delivered to Eastern Cape health authorities. A follow-up investigation released at the National Aids Conference in June this year showed that not much had changed. The report noted that "continued staff shortages and lack of management" at the depot contributed to the stock-outs of essential medicines.
Numerous attempts to meet with the MEC by the coalition have been met with disinterest, the coalition said, so Matiso said she hopes a "march for health" scheduled for Friday will pressure the department into action. "We have no other platforms to share the challenges of the community. Even now we don't know if he will be there to accept our memorandum on Friday," she said.
Sizwe Kupelo, spokesperson for the department, said that Gqobana is scheduled to attend the opening of a new hospital in Port Elizabeth on Friday – an engagement arranged many weeks before the march was announced. "I'm not saying he won't be available but he might be forced to not be there [due to previous commitments]. But the MEC is not a lone person in the department – there will be someone to accept the coalition's memorandum on Friday," he said.
Around 2 000 healthcare workers, civil society and community members are expected to march the 2km from Bisho Stadium to the provincial legislature.
The provincial health department has been plagued by staff and equipment shortages as well as doctor strikes. The coalition previously called on the health minister to place the department under administration.
Matiso said both patients and health professionals are "suffering" because of a lack of leadership on the part of the MEC. The march and its call to action are a result of a special Section27 and Treatment Action Campaign investigative report into the "collapsing health system in the Eastern Cape".
The group said the report "aims to show our government the devastating human consequences of mismanagement, corruption and political indifference".
'We don't want to fight'
Kupelo said the department is "already responding to the challenges in the report. We don't want to fight. We are more than willing to engage with civil society, as we have done in the past, to address these challenges".
According to Kupelo, the Eastern Cape faces challenges similar to those of other rural provinces. They include retaining trained healthcare workers who often move to urban areas as soon as they qualify. "We spend millions of rand on doctors and nurses but despite our investment they leave the province."
He said that richer provinces like Gauteng and the Western Cape get bigger budgets, while the Eastern Cape's budget has been cut over the years.
The problem is exacerbated by endemic corruption in the system. "Yes, there is corruption, and we are doing our best to deal with it," he said.
Matiso said Gqobana is in denial about the problems his department is facing and that his "lack of accountability and leadership is cause for concern". The MEC, she said, is "out of touch with the situation on the ground".
"He does not see the pain [when a patient is] told to go home without their HIV treatment," said Matiso.
"This is no longer only a health-related issue, the economy is being affected. People are not going to work because they are sick."