2 November 2012

South Africa: Strike Paralyses Eastern Cape Health Services

A large number of clinics and hospitals in the Eastern Cape are experiencing critical medicine shortages and stock outs while surgery and other procedures have virtually grind to a halt due to a wildcat strike by staff at the Mthatha Health Complex (MHC).

The strike is affecting over 100 rural clinics and a number of hospitals, with some using their own vehicles to drive to Mthatha in the hope of getting drugs from the medicines depot. Regional hospitals have also reported that referrals for anything from x-rays to surgery has virtually stopped.

About four-million people rely on the health services affected with large parts falling within the OR Tambo health district, one of the National Health Insurance pilot sites.

An urgent notice from the provincial health deparment, leaked to Health-e, orders the MHC heads of department, nursing managers and ward departments to find alternative hospitals to refer critically ill patients to or send them home. The notice states that only emergency cases will be attended to at the Nelson Mandela Academic and Mthatha Hospitals that form part of the MHC.

The Nelson Mandela Academic Hospital is one of the poorest performing hospitals in the country. It has been dubbed “the mortuary” by locals who say that people who go there are likely to die.

“It’s obscene. The strikers are holding the sick and poor at ransom in order to get a pay raise,” said Dr Karl le Roux from the Rural Doctors’ Association for South Africa (RuDASA). According to Le Roux, who works at Zithulele Hospital, the strike has wreaked havoc in the health services in the district.

The medical depot at MHC supplies about a dozen district hospitals and more than 100 rural clinics with essential medicine and medical supplies. Since the end of September, this depot has been staffed by just one department manager and one pharmacist processing and dispensing orders from facilities covering nearly half of the province.

The dispensing and delivery of medication was also affected by the transport workers’ strike which meant no drugs were delivered to district hospitals and rural clinics for weeks. Although transport workers have returned to work, the strike created a huge backlog.

The delivery of medicines is further delayed by recent flood damage to roads in the region, according to Sizwe Kupelo, spokesperson for the Eastern Cape Department of Health (ECDOH).

The leaked urgent notice from the Head of Clinical Governance at Mthatha Hospital Complex, Dr Theodore Madiba, instructs staff to only attend to emergency cases that present at the hospital, and to discharge or transfer all patients with non-life threatening conditions.

A source at the MHC confirmed to Health-e that clinics were running out of essential medicines including ARVs, anti-hypertension medicine and antibiotics.

“The repercussions are disastrous. Without medicine, patients default on their treatment, and that can be life-threatening,” the source said

Some medical services at the hospital complex have also come to a halt since the strike began.

Le Roux said in an earlier interview that the in-theatre x-ray machine at the Bedford Orthopaedic Hospital has been broken for several weeks, and there hasn’t been any administrative staff on duty to arrange the repairs. Without the x-ray machine, about 50 percent of critical orthopaedic surgeries requiring in-theatre x-rays have not been performed during the past few weeks.

“This strike is causing a lot of suffering and even unnecessary deaths. In the public service health service where your first responsibility is to your patients – not to yourself,” a distressed Le Roux said

While some hospitals in the region are making contingency plans to collect drugs from Mthatha, dysfunctional district hospitals like Madwaleni, which has one doctor, are reportedly not receiving any essential drugs.

Madwaleni has no functioning x-ray machine. As an interim measure all patients requiring x-rays and other referrals have been transported to Mthatha once a week. Since the Mthatha-based drivers, who transport patients are also on strike, this service has stopped.

Many rural clinics in the region have also reported stock-outs and shortages of antibiotics, antiretrovirals (ARVs), cholesterol-lowering medication and paracetamol. For the last three weeks, patients collecting their monthly supply of ARVs at Goso Forest Clinic in Lusikisiki have only been receiving enough medication for two weeks.

According to Le Roux, the depot in Mthatha supplies medicine and medical equipment to a very large region in the Eastern Cape which provides health-care services to around four million people in some of the poorest communities in the country.

Kupelo says the only reports they have received about medicine shortages are the ones in the media, and the ECDOH is still working to verify the claims.

Administrative staff at the MHC went on strike about a month ago because they were excluded from a Performance Management and Development Systems (PMDS) bonus, a performance-based promotion accompanied by a salary increase.

According to Kupelo, everyone who applies for the bonus does not automatically qualify to receive it, butt hat the workers will be “paid what is owed to them.”

Kupelo says that the department is also taking legal action against the striking workers, because it is an illegal strike. “We are taking decisive action against the striking workers and we are getting an interdict at the labour court in Port Elizabeth today (Wednesday),” says Kupelo.

“We have a list with the names of the striking staff members and will be taking disciplinary action. We will be deducting money from those who haven’t been working – no work, no pay,” he says.

According to Kupelo, they are also investigating reports of intimidation against nurses who wanted to return to work, but were forced to stay away by the strikers.

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