Already bogged down by loadshedding, operations at various health facilities in Gauteng and some other provinces have also been disrupted due to cable theft, creating another layer of risk for patients and healthcare workers.
This is despite millions being paid for security at these health facilities. Spotlight previously reported on security contracts for health facilities in Gauteng here.
Among facilities in Gauteng where healthcare workers say cable theft have been reported and impacted some hospital operations in the last six months or so are the Lenasia South District Hospital, Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), and Chris Hani Baragwanath Academic Hospital (CHBAH). Elsewhere, in the Eastern Cape there were reports at Cecilia Makiwane Hospital as well as at Bongani Hospital in the Lejweleputswa District in the Free State.
Often these thefts include cable and copper pipes, among others - all part of vital life-saving equipment for patients, particularly those who require extra oxygen.
"non-existing security"
A specialist gastroenterologist at CMJAH, Professor Adam Mahomed tells Spotlight there have been several theft incidents at the hospital in recent months. This include people stealing cables and copper piping from the floors, he says.
"The bulk of these things need a big vehicle to take them out. This means security will have to be involved since this bulk will have to exit through the gate where there is security. One of the security managers of the hospital was part of the system, and he was being used as the driver to take out stuff with his vehicle," Mahomed says, referring to an incident in December.
This, he says, happened after a new security company was appointed after a fire at the hospital in March 2021.
In January he says they had theft of piping in block three that affected oxygen and water. He says they also had water pipes and cabling stolen from above ward 586 and some oxygen piping from a section above the transplant ward in area 561. According to him, there is security and cameras in this area.
"The problem with these thefts is that an emergency plan must be made for the work to continue and that itself takes a lot of money, paperwork, and time delays," he says.
Not only is the ongoing theft ignored by health authorities, according to him, but security is paid for what he calls "non-existent security" and security's "abuse of nurses and doctors like searching bags for small things while millions are being stolen".
Security contracts
Concerns over theft in health facilities are triggering questions about how security contracts are awarded and how these companies are held accountable. Mahomed says these are big contracts and since they go through the Gauteng Department of Health hospital management is not involved.
What worries him, he says, is that no one is being held accountable for failing security in health facilities. "All we're doing is playing musical chairs on a sinking ship. There's no one that's being held accountable. There are no court cases and no one's going to jail."
Mahomed suggests that if something is stolen while the hospital has a security contract with a security company, that company should pay for the losses. "Money must come off your payment every month. So if you have R5 million stolen from the hospital, you'll get R5 million less on your contract."
Substantial losses
Motaletale Modiba, Gauteng Health spokesperson, says the provincial health department has lost over R4.5 million in copper pipes and R917 297 in copper cables/wires, bringing the total loss due to copper cable theft in Gauteng health facilities to about R5.4 million. He says these losses were due to theft and fire incidents that happened in the two financial years 2021/22 and 2022/23.
Responding to the concerns about security tenders, Modiba says the security tender was advertised on two occasions, namely, 2016 and 2020 and subsequently cancelled due to tender irregularities.
To ensure continued security at all health institutions, he says the security contracts are extended on a month-to-month basis until the new contract is in place. "The department is in the process of re-advertising the tender to ensure competitive bidding and, eventually, a regular contract is in place," he says.
Despite several follow-up requests by Spotlight since 16 March for a date when the tender will be re-advertised, Modiba couldn't provide a date or a reason for why it is taking so long.
"scandalous and indefensible"
This week on 28 March during a question and answer session in the Gauteng Legislature, DA MPP and spokesperson for health in the province, Jack Bloom asked Gauteng Health MEC Nomantu Nkomo-Ralehoko about the security contracts and costs.
Bloom said the last time the security contracts were awarded was in 2014 and they were supposed to expire in November 2016. "So, every year for more than six years now, the Auditor-General has been scathing about the irregular rolling over of these contracts month-by-month. I think it's scandalous and the fact of the matter is that hospitals are not getting good security and these contracts should have been awarded long ago," he said.
Agreeing with Bloom, Nkomo-Ralehoko said, "I have to speak up. I can't defend something that I know was not supposed to be like that." She said, however, that it was good that auditors picked up the irregularities and cancelled the tender. "I do appreciate [this] because it's a lot of money that is involved with those tenders. So we need to follow all the proper processes." The MEC vowed to follow up on the progress of the new tender. "And we will ensure that probity auditors make sure they scrutinise each and every contract before we can award it. So, I agree with you. We can't have month-to-month contracts for so many years. That's irregular and it's not making us look good."
She said the department is currently spending R59 million on the month-to-month contracts and because there is no fixed-term contract in place, only service-level agreements are used to manage these contracts. "The department is in the process of advertising a new tender, which is anticipated to be awarded early in the new financial year of 2023/2024," she said, also failing to provide an exact date.
Concerns over staff and patient safety
The theft of copper pipes that are supplying oxygen to critical areas like ICU and theatre, says Yandisa Zungula, a member of trade union Denosa and a nurse at CHBAH, not only causes disruption but requires more planning and extra hands. He says copper piping was stolen at the hospital in December.
"As a nurse who is directly rendering services to the patients, when there is theft that affects certain departments, it means I need more hands than I would ordinarily need. When removing a critically ill patient out of ICU to another department, I need a team of nurses and doctors who will escort one patient."
Looking at the size of CHBAH, Zungula says a theatre needs to be functional. "Anything that disturbs the starting time of the theatre means a lot of problems for the hospital because that means patients will suffer," he says.
He says that a control room where pipes were cut off in December is a locked place that not even the hospital staff have access to. It is only the maintenance people who have access, he says.
"But if someone can have access and can cut vital pipes and cables, it raises the question of how secure are we as the staff and patients in the institution because people have access to a restricted area and so far no one knows what happened. Then you can imagine what would hinder those people from accessing the patient area and injure the staff as well as the patients."
Zungula also questions how security companies are appointed, especially when contracts are renewed on a monthly basis. "There are people who are benefiting from this chaos. This is done deliberately for someone to profit and continue to benefit from a contract that is not advertised," he says.
Thefts denied
When Spotlight asked CMJAH's spokesperson Tabudi Madisha about the theft incidents Mahomed refers to, he denied that there have been any cable thefts in recent years that have affected the hospital's operations. According to him, the Gauteng Department of Health is responsible for ensuring the security of all facilities. "The Gauteng Department of Health has undertaken a review of security measures across all facilities with the view to strengthen the state of security, which include the deployment of integrated measures such as the use of technology," Madisha says.
He says their employees' safety is a top priority, "which is why we have security on site 24/7 and have increased the number of cameras in high-risk areas. Whenever any of our staff members feel unsafe walking to any section of the hospital or even outside the hospital, our security personnel are always available to accompany them."
Gauteng Health's Modiba, also tells Spotlight that neither CHBAH nor CMJAH had recently had cable theft incidents that affected operations.
"The cable theft at Charlotte Maxeke Academic Hospital took place during the fire incident," according to him. "After assessments of the incident, necessary corrective measures were taken, including termination of the contract of the then security company," Modiba says. The fire occurred in March 2021.
Modiba says the security company has since been replaced by Mafoko Security Patrols, which is responsible for security at both hospitals. However, the company is not responsible for all health facilities in Gauteng.
Despite the spokespersons denying incidents of theft, the SAPS has confirmed to Spotlight that two cases of theft had been opened relating to incidents at CMJAH in December and January. Sergeant Mduduzi Zondo says that there was one arrest in the one case but both cases are currently under investigation.
Lebo Nare, Director of Mafoko Security Patrols, also confirmed to Spotlight that there was an incident of theft at CMJAH in January. "The theft was done by an individual who had authorised access to certain areas in the hospital. It was discovered that the suspect was in the employ of a contractor doing some work for the hospital who had intricate knowledge of locating critical infrastructure and its value," he says.
Nare says a comprehensive report was submitted to hospital management for action with recommendations and a case was opened with SAPS.
Regarding CHBAH, Colonel Mavela Masondo confirmed to Spotlight that a case of theft and attempted murder was opened at Diepkloof police station, however, no arrests were made and the case is still under investigation.
Nare also confirmed that there was a case of attempted theft at CHBAH in December, although we haven't been able to confirm whether it is the same case referred to by Masondo.
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Spotlight's attempts to get further clarification from the Gauteng Department of Health and an explanation for the contradictory information about these thefts was unsuccessful.
Feeling the impact
Meanwhile, the South African Medical Association (SAMA) has also expressed concern over the incidents of theft.
"Our doctors are in an untenable situation of having to juggle providing quality care to patients and managing infrastructure problems caused by loadshedding and cable theft," says Dr Mvuyisi Mzukwa, chairperson of SAMA. He says delivery of most healthcare services relies on power. This includes the neonatal intensive care unit (NICU), dialysis machines, refrigeration of medicines, and HVAC in theatres, among others. Without electricity (either through loadshedding or cable theft) patient lives are at risk. These theft incidents also interrupt workflow as the planned surgeries will be rescheduled. "SAMA is gravely concerned that people's lives are at stake when cable theft disrupts oxygen supply, such as at Chris Hani Baragwanath Hospital in 2022," he says.
According to Dr Edward Ngwenya, SAMA's vice chairperson, SAMA members pledge to save lives as part of their oath to first do no harm, but their members want to be allowed to work in an environment that can deliver quality health outcomes.
"When they have to work in a sub-optimal environment, this does not augur well for their safety and security as they get attacked and abused by patients and loved ones who are frustrated by the health system," he says. "It is reported that our doctors find themselves administering intravenous lines (drips) in the dark, operating using cellphone lights as a result of unexpected power failures and lack of backup power supply. This is not the way to work and administer professional healthcare."
Ngwenya says that non-functional healthcare equipment and infrastructure make it impossible to provide quality care. This situation, he says, is getting worse year on year. "Hospital management is not doing enough to address issues facing not only doctors but all services provided in a public hospital environment," he says.
Mzukwa says SAMA has engaged the national and provincial health departments on safety and security issues at hospitals. "The association supports calls for safety and security and is concerned that major hospitals' security contracts are running on a month-to-month basis. These contracts need to be finalised," Mvuyisi says.
Denosa has similar concerns. Bongani Mazibuko, Gauteng secretory of Denosa tells Spotlight they are concerned about acts of vandalism and theft at health facilities and the safety impact it has on their members. "As Denosa in Gauteng, we have long called for consequence management and for as long as no one is held accountable for these things, we won't see an end to them."
