Health activists ululated when the Free State’s controversial health MEC, Benny Malakoane, was removed from his position in a provincial Cabinet reshuffle.
He now heads the economic and small business development, tourism and environmental affairs portfolio.
HIV lobby group the Treatment Action Campaign (TAC) has, for the past two years, been running an intensive #FireBenny campaign. But the ANC says Malakoane has “done an excellent job” and denied his removal has anything to do with the activists.
Here are three things Bhekisisa exposed about the Free State health system and Malakoane during his three-and- a-half year reign as health MEC.
1. How a dying woman’s bed was taken by an ANC official
Doctors at Phekholong Hospital in Bethlehem in the eastern Free State claimed that, late one night in July 2014, Benny Malakoane and the head of the provincial health department walked unannounced into the hospital, where an ANC branch secretary was being treated. The TAC later established that the patient was a cousin of Mineral Resources Minister Mosebenzi Zwane, who was the Free State MEC for agriculture at the time.
Malakoane and his colleague wanted the patient to be admitted to the intensive care unit (ICU). Phekholong, a district hospital, had no ICU, so the two officials ordered that he be transferred to Dihlabeng Regional Hospital, also in Bethlehem.
The ICU consultant on duty assessed the patient and found that, in line with national clinical protocols, he did not qualify to be admitted to the ICU as he was in the final stages of a chronic condition and highly unlikely to recover. “No other ICU in the country would admit a patient like that, especially over other patients we could more likely save,” a senior doctor at Dihlabeng told Bhekisisa.
Because of cost-cutting measures, Dihlabeng had only three ICU beds. All three beds had been taken, so the patient was admitted to a second-level medical ward in the hospital.
Two other critical patients, one with a mild heart attack and another a burns victim, had already been turned away from the ICU because of space constraints.
The next morning, doctors said an instruction from Malakoane was delivered to the clinical manager on duty by one of his staff members: an ICU bed was to be made available “because the MEC had promised family members the patient would go to ICU”.
Later that week, another two critical patients deserving of an ICU bed lay in ordinary medical wards while Malakoane’s patient remained in ICU – with no improvement in his condition. He died a few days later. So did an elderly woman, with a promising prognosis, who couldn’t get an ICU bed.
Malakoane denied these allegations in a later interview with Bhekisisa: “That’s another allegation which was grossly uninformed,” he said. “Do those doctors know what I look like?”
2. ‘It’s the Free State hospital that killed my husband, Frik’
In 2011, the Free State government gave Dihlabeng Regional Hospital an award for being the best regional hospital in the province. In March 2015, two years after Malakoane had become health MEC, Dihlabeng was in such a state of disarray that doctors turned to Health Minister Aaron Motsoaledi in desperation to save the facility’s services from “collapsing”.
The hospital was operating with less than a quarter of the number of doctors and specialists required, resulting in medical interns (who have completed their studies but are not yet registered doctors) administering anaesthesia and running casualty wards without supervision, doctors said.
The doctors tried to approach the provincial health department’s chief operating officer, Balekile Mzangwa, for “some guidance as to the way forward”.
“But he could not be reached because he had joined Premier [Ace] Magashule on a trip to Cuba … We have found out the Cuba trip included an entourage of 72 people at a cost of about R21 million. The head of department, David Motau, was in Germany for some reason and could also not be reached. Malakoane himself was not available because he was appearing in court on corruption charges,” doctors said.
The Free State government confirmed the delegation’s Cuba visit but refused to reveal the cost of the 15-day trip. It claimed criticism of the visit was “politically motivated” after the Democratic Alliance launched an inquiry into it. Health delegates were included in the trip as it was the provincial government’s duty to “motivate” and “encourage” 197 Free State students studying medicine in Cuba, so that they would return “to the Free State province upon completion of their studies to ensure that we continue to derive benefit from this investment”.
A Dihlabeng doctor asked: “How can you run a department like that? According to the DA’s statement, the cost of the trip worked out to about R300 000 per person. That is R20 000 per person per day. How is it possible to have the money for such a trip for several health department people but not for doctors’ or nurses’ salaries, or for patients’ medication?”
Maritsa Balanco, whose husband Frik died at Dihlabeng during that period, said doctors told her it was because the hospital was out of stock of the correct antibiotics and a staff shortage.
“Politics,” she said, “does not matter to me. I don’t understand much of it at all. But what I do understand is that it killed my husband.”
3. Malakoane believes people wearing ‘HIV positive’ T-shirts are all HIV positive
Malakoane came prepared for the August 2014 interview he granted to Bhekisisa: an official with a video camera recorded the conversation for “legal recourse” in case he got misquoted. “The media can make or break you,” Malakoane said. “It can be an instrument of destruction of individuals. It’s exactly what happened to me. The media have tarnished my integrity.”
The MEC claimed the ongoing corruption case against him was a case of conspiracy. “The police have been infiltrated. There are certain connections, there are inappropriate attachments. Before I got arrested, I knew in the media that I was going to get arrested … maybe people in the media have access to certain things and plans,” he said.
“I don’t believe it’s government taking me to court, even though we’re prosecuted by the state. The detail of that I would not want to get into.”
He branded the TAC’s #FireBenny campaign ignorant. “[The TAC members] are largely people who are unguided and misinformed about what’s going on … They call me a killer when I know I’m a saviour of life. Because that’s me; that’s my profession.
“On the other hand, [the TAC’s actions] epitomise the success of [the provincial health department’s] HIV treatment campaigns. If those are self-confessed HIV-positive individuals [and they can still demonstrate], it means our treatment is so accessible and available to them that they are able to hit the streets in the manner that they do. They have energy, they have vitality, which is music to me. I see health outcomes alive.”
But the people with the HIV positive T-shirts are not necessarily HIV positive – they’re just activists fighting for access to health services, Bhekisisa explained. Malakoane responded: “No, they are,” and slid his hand across his chest. “They write here: HIV positive.”