'As doctors, we've advised each other to discharge stable patients and explain to there is nothing we can do.'
The National Health, Education and Allied Workers' Union (Nehawu) has threatened to make its strike in North West a national issue if Premier Supra Mahumapelo does not resign.
Some hospitals and clinics in the province remain closed as the strike enters its third month.
The provincial hospital in Taung, about 230km west of Klerksdorp, has almost 300 beds; on Saturday all but 19 of them were empty.
The remaining patients were the sickest of the sick, left behind after the few health workers still manning the facility discharged who they could over the weekend, Doctors Without Borders (MSF) nurse Anna Celliers says.
The international humanitarian organisation runs projects in Rustenburg.
The hospital doesn't even have enough health workers left to be able to say it's running on a skeleton staff and it is no longer admitting patients, Celliers says.
The nearest hospital has become the Klerksdorp Tshepong Hospital Complex. The major state hospital is operating with few staff members.
Meanwhile, the gates of the Lehurutshe-Zeerust Hospital Complex have been locked since early April and the hospitals' doctors have been ordered to report to the Mafikeng Provincial Hospital, about 70km away, says Desmond Kegakilwe, a public sector doctor who is an executive member of the Rural Doctors' Association of South Africa.
What's happening at other health facilities is anyone's guess, say healthcare workers in the embattled province.
"All over the province, hospitals and clinics have been opening and closing. It's a very fragile and unstable situation," Kegakilwe says.
"We don't know what is going to happen. As doctors, we have advised each other to discharge patients that are stable and explain to them that there is nothing we can do," he says.
Provincial health department spokesperson Tebogo Lekgethwane has confirmed that many North West patients have sought care at some health facilities only to find them barricaded.
The strike by Nehawu and its affiliates has brought health services in the province to its knees and the situation could play out across the country if the union follows through with the threats it made this week.
According to Nehawu national spokesperson, Khaya Xaba, union members will go on a nationwide strike if their demands are not met. These include not just Mahumapelo's resignation but also investigations into corruption in the health system.
President Cyril Ramaphosa put the province under the administration of the government in late April. This week, an interministerial task team appointed by him briefed the media on the findings of a preliminary investigation, although its statement was short on detail. Its report has not been made public.
The delivery of chronic medication, including those for HIV and hypertension, seems to have been resumed but some patients may not have been able to collect their drugs from the clinics, Celliers says.
Major pharmaceutical companies on tender to supply drugs have now begun delivering medicines directly to hospitals, bypassing the provincial medical depot. A Nehawu go-slow crippled the province's major medicine warehouse until the South African Military Health Service was called in to staff not only the depot but also the Mafikeng Provincial Hospital following violent protests.
Celliers says: "[Some] patients have been without their medication for two months because the clinics are closed and the [nearest] hospital is too far.
"If patients don't have access to healthcare for a prolonged period, this could become a public health crisis, and there is no prediction about when things will be more stable."
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