Barriers to progress: The Dihlabeng Regional Hospital has suffered from a lack of leadership and equipment shortages. (Fredrik Lerneryd)

Has anything changed at Dihlabeng Hospital in Bethlehem?

Mia Malan
Exposé spurs flurry of activity, but problems remain.

On March 20 the Mail & Guardian published the heartbreaking story of Maritsa Balanco, whose last memory of her husband, Frik, was how four men carried his body down the staircase of the Dihlabeng Regional Hospital in Bethlehem in the Free State amid the “stench of rotten, wet bodily fluids”.

There was no other way to remove Frik’s body after he died of pneumonia – the hospital’s elevators had been out of order for more than a year.

Balanco believes drug stock-outs and a shortage of doctors were responsible for her husband’s death. She says Dihlabeng didn’t have the type of antibiotics he needed and was also out of stock of an intravenous feeding solution that could have helped to keep him alive.

At the time Dihlabeng had almost no permanent leadership – almost all managers were in acting positions, including the chief executive, nursing manager, head of administration and clinical manager. The hospital also had less than half the medical officers it required. In January Dihlabeng’s doctors wrote a letter to Health Minister Aaron Motsoaledi, asking him to intervene after Free State health MEC Benny Malakoane had not responded to any of their appeals.

After the publication of the M&G article, Motsoaledi intervened. Doctors at the hospital say four different teams visited Dihlabeng within two weeks: a national health department team, a presidential team and an Office of Health Standards Compliance team, and Free State Premier Ace Magashule and his team met the hospital’s executive committee. But Malakoane was nowhere to be seen.

Politics
These developments, however, were overshadowed by politics. Health activists and doctors argue that Malakoane and Magashule are “higher up in the ANC ranks than Motsoaledi” and that Motsoaledi is therefore cautious about criticising them publicly.

Motsoaledi’s spokesperson, Joe Maila, said: “We have done a number of things to intervene, but I can’t reveal the details. I can’t talk about it. ”

But the Office of Health Standards Compliance, a statutory body that monitors compliance with norms and standards for healthcare delivery, is transparent about its findings. The executive manager for compliance inspection, Bafana Msibi, says Dihlabeng was awarded a rating of 61% in April – down from 75% in 2012. An 80% rating is considered compliant with healthcare standards; 60% is compliant, but “with concerns”.

Msibi said his team was concerned about the lack of leadership and shortage of doctors at Dihlabeng and therefore instructed the Free State government to fast-track recruitment for the positions.

“The provincial government responded to this quickly. All the posts have been advertised and chief executive candidates were interviewed last week. The clinical manager and nursing manager interviews will happen within the next two weeks,” he said.

An engineering company has also been appointed to fix the elevators and address other infrastructure problems.

Little has changed
Msibi’s team will pay Dihlabeng another “unexpected” visit before mid-June, the deadline his office has set for the Free State government to tackle the problems his office identified.

But, Dihlabeng’s doctors say, although they’re aware of the advertised positions and the engineering company that is on site, little has changed regarding the drug and equipment stock-outs they regularly experience.

“As soon as it comes down to something that’s dependent on the Free State health department’s logistical ability, things dismally fail,” one said.

A report released by Stop Stock-outs on Thursday found that almost one in three Free State health facilities experienced drug stock shortages in 2014.

But Balanco believes neither Malakoane nor Motsoaledi cares. She has been trying to get her husband’s hospital file for six months to open a case of medical negligence. “I have got so many questions about Frik’s death. If the health minister or MEC cared, they would have contacted me and asked how they could help to answer those questions for me.”

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Free StateNational Health DepartmentAaron Motsoaledi