Africa needs more emergency care specialists to prevent unnecessary deaths due to a lack of capacity and training.
Africa needs more emergency care specialists to prevent unnecessary deaths due to a lack of capacity and training. (Gallo Images)

The Eastern Cape health department has accused nurses and doctors at Holy Cross Hospital near Flagstaff of “deliberately misleading” a task team sent by health minister Aaron Motsoaledi in September to investigate mismanagement and unnecessary deaths at the hospital.

“During a meeting with health MEC Sicelo Gqobana this week it was revealed that some of the equipment the minister’s team found to be lacking at the hospital was, in fact, not missing, but locked in unopened boxes since January this year in a storeroom at the hospital,” said Eastern Cape health spokesperson Sizwe Kupelo. “None of the health workers interviewed told the minister’s team about this. It is serious sabotage.”

Kupelo claimed that health professionals also “hid away” new linen shortly before Motsoaledi’s team arrived and replaced it with “old, dirty linen with holes”, to create a “bad impression”.

Motsoaledi suspended the hospital’s chief executive and nursing manager in September and used money from the national health department budget to buy essential equipment for Holy Cross, including blood pressure machines, fetoscopes (used to listen to infants’ heart beats) and paediatric ambubags (used to aid babies’ breathing). He ordered the same equipment for all hospitals in the Oliver Tambo health district in the former Transkei after his task team found several facilities in the region to be missing essential items.

According to the District Health Barometer, OR Tambo has the third-highest infant mortality (babies dying before the age of one) rate in the country and is one of the government’s 11 pilot districts for its planned National Health Insurance scheme.

Waste if time
Motsoaledi told the Mail & Guardian: “I’m not going to get involved in a debate about who sabotaged whom and who is lying to whom. That’s a waste of time. My duty is to restore function when things go wrong in a province, regardless of who was responsible for the problems, which is why I bought the equipment.”

In August a baby at Holy Cross died after the hospital ran out of oxygen, according to Dr Dingeman Rijken, who treated the child. He said: “Disposables and equipment needed for his resuscitation were lacking, and an emergency ambulance was not available for more than 10 hours. Just a few weeks earlier I had to run through the whole hospital with a child in my arms that was no longer breathing because the only paediatric ambubag in casualty was missing.”

Kupelo provided the M&G with a list of equipment the provincial health department bought for OR Tambo hospitals in January. Other than glucometers and suction machines, none of the equipment correlated with the equipment Motsoaledi bought.

Rijken maintained that no one at Holy Cross was “hiding” equipment. “The insinuations of the department are absurd. If officials would acknowledge and address problems, instead of being in denial and attacking the messengers, we could easily improve the standards of care rendered to our communities,” he said.

The advocacy organisation Section27’s director, Mark Heywood, said: “How does ‘finding equipment’ absolve the provincial health department of anything? If the equipment is not in the hospital wards where it’s needed, it’s as good as not being there. I find Kupelo’s story hard to believe.”

Section27 and health group Treatment Action Campaign (TAC)released a damning report on the Eastern Cape’s “collapsing” health services in September and gave Gqobana until October 11 to respond to a set of demands — a deadline he missed.

Department's rescue plan "poor"
According to Heywood, Section27 and the pressure group, Eastern Cape Health Crisis Action Coalition, instead received a “very poor” and “badly drafted” five-page “rescue plan” from the Eastern Cape health department’s new director general, Thobile Mbengashe, last week. “While we’re pleased that there is at least something we can now use to engage in with the department and help them to improve, the plan is severely lacking in specifics and has no time frames,” he said.

Mbengashe was appointed by Motsoaledi in September to improve management in the provincial department shortly after the release of the Section27 and TAC report. “We’ve noticed growing tensions between Motsoaledi and the health MEC, as the health minister constantly needs to intervene in the province,” said Heywood. “Motsoaledi’s intervention is evidence of the failure of the MEC to provide sufficient services, and such people should be removed from their positions.”

Motsoaledi recently told the M&G: “We have not yet arrived at Section 100 [the national health department taking over the administration of the provincial department]. We are still working together to see if we can improve things in the Eastern Cape.”

Kupelo insisted that the province’s failure to provide quality services is “not political”, but should be ascribed to “corruption and looting on the ground … A new MEC won’t help”.

Heywood responded: “That’s a stupid statement to make. The MEC is clearly responsible for putting systems in place to prevent corruption and to report it. If those systems aren’t working or not in place, he’s failing in his job.”

_____________________________________________________________________________________

Department staff collared for corruption

According to the Eastern Cape health department spokesperson, Sizwe Kupelo, the following corruption activities were uncovered over the past four months:

• In July a driver was suspended for using a health department ambulance for an overnight visit to his girlfriend in Mthatha. The driver was caught when his girlfriend’s neighbours called the police to remove the ambulance as it was blocking their driveway.

• In September a driver was caught using a health department ambulance to drive from Flagstaff to Durban for personal business. He attempted to falsify documents to make it appear as if he was fetching patients.

• In October the department discovered that 80% of the annual food budget for the current financial year at Victoria Hospital in Alice had already been spent. An investigation revealed that hospital workers had been stealing “copious amounts” of food. Among their claims was that 50 patients consumed 16 bags of sugar, each weighing 12.5kg, every month.

• In September, an investigation revealed that ambulance drivers were removing the engines and gearboxes of new ambulances and selling them to taxi drivers. They replaced them with cheap, second-hand parts, resulting in ambulances regularly breaking down.