The Swaziland Government has not paid medical bills running into millions of dollars in neighbouring South Africa and as a result sick Swazis are being denied treatment.
South African health institutions stopped giving medical assistance under the Phalala Fund on 19 March 2018, according to a report in the Swazi Observer newspaper on Friday (4 May 2018). More than 100 people have been denied treatment, the newspaper reported.
The objective of the Phalala Fund is to assist deserving Swazi citizens who would otherwise not have access to specialist medical care to get it either, within Swaziland or 'in special circumstances' outside the kingdom.
Somntongo Member of Parliament Sandile Nxumalo the chair of the parliament select committee set up in 2017 to investigate the administration of the Phalala Fund said people would die if government did not attend to the situation as a matter of urgency.
The suspension of services is nothing new. The Phalala Fund has been riddled with corruption and inefficiencies for years.
In October 2017, the Times of Swaziland reported at least three people had died because they could not get treatment after services were suspended because bills had not been paid.
At the time the Swazi Government owed E170 million (US$12 million).
Many times in the past South Africa stopped taking patients because of unpaid bills. For example, in 2014 a Ministry of Health's Senate Portfolio Committee Report said E40 million (less than a quarter of the 2017 debt) was unpaid and patients were being refused treatment.
In November 2014, the Accountant General Phestecia Nxumalo reported that the Phalala Fund had been defrauded of E9 million because single bills had been paid multiple times.
As long ago as 2006 a report published by the World Bank recommended sweeping reforms of the scheme, but these have not taken place.
The report said 'only a tiny segment' of the Swazi population benefitted from the large medical subsidy the government paid. It said there were no cost-effective guidelines so the fund could be used on patients who were too sick to benefit from treatment.
Also, fees and other prices were not negotiated before treatment and were 'completely supplier-determined'.
The report concluded, the fund provided a 'blank cheque' for South African doctors and hospitals: whatever amount they asked is paid for by Government, since it had no choice but to pay up.
Meanwhile, within Swaziland itself a health crisis continues because the government has not paid bills for medicines and supplies.
Early in January 2018 health facilities were reported to have run out of vaccines against polio and tuberculosis and new-born babies were being put a risk.
In June 2017, Senator Prince Kekela told parliament that at least five people had died as a result of the drug shortages. About US$18 million was reportedly owed to drug companies in May 2017.
As ordinary people died the Prime Minister Barnabas Dlamini revealed that King Mswati and the Queen Mother paid for him to travel to Taiwan for his own medical treatment. Dlamini was not elected PM by the people of Swaziland. He was personally appointed by the King, as were all other government ministers and top judges in the kingdom. None of Swaziland's senators are elected by the people.
Dlamini celebrated his 75th birthday in 2017. The Swazi Observer, a newspaper in effect owned by King Mswati, reported (5 June 2017), 'The Prime Minister said he was grateful that when Their Majesties were informed about his ailment in April, they responded hastily and ordered that he be taken to the best doctors in Taiwan, Taipei.
'"Their Majesties gave orders that I go to the best and well experienced doctors in Taiwan. I am now looking forward to turning 76 years and I thank God for keeping me safe," he said.'
The nature of his illness has not been publicly revealed.