SA’s healthcare system is broken, and neglecting its workers

Covid-19 has exposed our healthcare system as being as broken as industry bodies have always claimed, while an Oxfam report has found the sector is plagued by unfair labour practices and poor treatment of workers


The country’s healthcare system could be ill-prepared to deal with the coming influx of coronavirus cases, as the sector is plagued by unfair labour practices and poor treatment of workers.

A report by Oxfam South Africa found that nurses, who are the backbone of South Africa’s national health system, as they make up 77% of the sector, were underpaid for the work and hours put in.  Some nurses can work up to 24 hours without a break. The sector also had a shortage of professional nurses, as only half the number were employed between 2012 and 2016 as compared to the period of 2006 and 2012.

The healthcare system saw a further strain due to the continuous budget decline of the national health department.

“The nature of the way the work time is organised has an impact … critical understaffing of healthcare workers in the healthcare system is one way to further exploit [them] through loopholes of not protecting the working hours.

“This leads to stress, burnout, and cancer. Exhaustion compromises our healthcare system,” said Dr Basani Baloyi, inequality programme head at Oxfam SA.

According to a report by the World Health Organisation, to meet the current and future health needs, countries should impose an 8% increase in the number of nursing graduates each year until 2030.

To compound matters, there continued to be a shortage of medical supplies and personal protective equipment (PPE), despite the government imposing a lockdown to prepare for the peak of the pandemic, which meant patients would not have access to quality healthcare, said chairperson of organisation Treatment Action Campaign, Sibongile Tshabalala.

She used Livingstone Hospital in the Eastern Cape as an example. She said it was understaffed and had a shortage of PPE. An internal audit report into the hospital commissioned by the Eastern Cape health department also found that screening protocols were not followed and common areas were not disinfected.

READ MORE: Secrecy and poor planning putting healthcare professionals and patients at risk 

The Eastern Cape has the second highest number of coronavirus deaths in the country.

“We have seen a lot of challenges despite the government’s readiness. And this shows we are not ready and don’t have the quality healthcare system as enshrined in the constitution.

“If healthcare workers are not happy, the patient won’t have access to quality healthcare. Covid-19 has exposed our healthcare system and has clarified what we have been saying – it is broken.”

Due to racism and patriarchy, 90.1% of the country’s nurses are women. Up to 83% of them are black women. Among them were single parents and a large number who were experiencing violence
from their intimate partners and have been victims of crime, said Ruth Mhlanga, private sector policy advisor of Oxfam in the UK.

“A staggering 69.4% of female nurses have reported experiencing violence from their intimate partner. Nurses also remain at high risk of gender-based violence in their places of work.

“They become targets for criminals who wait for them when they return home from work [after night shift]. They also have long distances to travel [to and from work].

“Nursing is a gendered sector and ignored because it is work done by women.”

The Democratic Nursing Organisation of South Africa (Denosa) was pleased with the report as the key findings were issues the organisation complained about to government.

Spokesperson Sibongiseni Delihlazo said nurses who work 24-hour shifts often wait up to a year to be paid for their overtime and are also at a risk of infection due to lack of PPE.

“This is what we have been complaining about.

“It turns out government does not have a listening ear.

“Many nurses are infected by coronavirus and some have died already.”

“Each time we complain about these areas, government does not care and they seem to want healthcare workers to be demoralised.

“This is exactly where we are. Let’s brace ourselves for the worst.”

– rorisangk@citizen.co.za

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