Death threats and intimidation drove one man to leave the country after exposing crumbling conditions within the province’s health system.
When a former health department employee and activist revealed the shocking state of healthcare in the Free State under Ace Magashule’s former health MEC, he claimed he almost paid with his life.
In 2013, Sello Mokhalipi worked with civil society to lay bare medicine shortages in the Free State. At the time, Mokhalipi was the provincial chairperson of the Aids lobby group the Treatment Action Campaign (TAC) and had been seconded to the health department’s of Health’s provincial AIDS council.
Mokhalipi later told Bhekisisa that thugs attempted to force his car off the road twice. Fearing for his life, he fled the province with his family and some activists say he may have even attempted to seek refugee in Swaziland or Lesotho.
The Free State health department has consistently denied allegations that it attempted to intimidate the activist, who eventually returned to the province and formed his own association for people living with HIV.
But the executive director of the public litigation organisation Section27 Mark Heywood says the problems in the province go far beyond intimation.
“There’s just the issue of the complete destruction of large parts of the Free State health system under Magashule and Malakoane. The Free State has lost about 25% of its public sector doctors in recent years. It’s very, very difficult to recover from something like that,” explains Heywood.
And as doctors fled, the province’s maternal mortality rose by almost 50%, revealed the 2014/2015 District Health Barometer report by research organisation the Health Systems Trust.
Section27 also helped represent almost 100 community health workers in a prolonged, nearly two-year battle. They had been arrested for staging a silent, non-violent protest outside the health department after Malakoane reportedly fired them without warning.
Magashule’s recent appointment as ANC secretary-general at the party’s elective conference at Nasrec south of Johannesburg leaves Heywood and others disappointed to say the least.
“I think there was an initial feeling of great relief when the victory of Cyril Ramaphosa was announced but it was followed rapidly by a feeling of deflation, and I must say for myself almost despair. The presence of Ace Magashule in particular, with DD Mabuza not far behind, can only make you think that Cyril Ramaphosa would not be able to clean up the government in the way that he has said he would while campaigning,” he says.
“We’re better than we were yesterday or the day before but it’s certainly not the place we wanted to be in,” Heywood adds.
But dentist and rural health activist Bulela Vava took to Twitter last night to say health advocates were livid with the election of both Magashule and Mabuza, who as deputy ANC president could stand a good chance of becoming the country’s next deputy president after the election in 2019.
Unlikely to be happy? That’s sugar coating it, activists are livid.
— Bulela Vava (@ruraldentistSA) December 18, 2017
Heywood says that in both provinces, crucial hospital CEO positions are still be allocated based on political connections rather than merit. Soon after taking office in 2009, health minister Aaron Motsoaledi attempted to deal with unqualified CEOs by forcing some to reapply for their jobs.
Mabuza’s Mpumalanga health system has also hobbled along in recent years. In March, parliament’s Portfolio Committee on Public Service and Administration/Monitoring and Evaluation issued a statement saying there was a crisis in public healthcare. The body’s declaration followed an oversight visit during which it unearthed serious problems in financial management, including more than 12 000 unpaid invoices.
Mpumalanga racked up nearly R2-billion in irregular expenditure in its health department alone in 2014-15, according to the auditor general’s report.
“The public health system is very broken in Mpumalanga, [and this] may be part of the financial expenditure problems,” says TAC provincial chairperson Nqobile Tshabalala.
He explained: “The infrastructure is very bad and there’s a shortage of skilled staff. Some of the clinics don’t even have toilets.”
While Tshabalala congratulated Mabuza on his appointment, he says Mabuza will have a lot to learn about the HIV should he ever become deputy president of South Africa – a position required by legislation to chair the national Aids council. Mabuza has been a somewhat absentee chair of his own provincial Aids council, a position that he and all premiers are required to fill. Under the new national HIV plan, these provincial bodies have assumed increasing responsibility for leading the country’s Aids response.
Laura Lopez Gonzalez is a freelance health journalist and editor. She was Bhekisisa's news editor then deputy editor between 2016 and 2020. Follow her on Twitter @LLopezGonzalez