Limpopo health system in need of resuscitation

Shocking statistics related to perceived human resource shortages, poor infrastructure, tuberculosis infection control measures and adequate stock of medicine in the Limpopo health care system motivated Treatment Action Campaign (TAC) Limpopo Chairperson Helen Nkuna to describe the province’s health system as broken, on life support and in need of critical resuscitation.
TAC, initially established in 1998 to campaign for access to Aids treatment, today represents users of the public healthcare system and campaigns and litigates on critical issues related to the quality of and access to healthcare.
TAC Limpopo marched to the Department of Health last Thursday to hand over a memorandum in which they address certain issues to MEC Phophi Ramathuba. A detailed and comprehensive report compiled by TAC Limpopo on the state of healthcare in the province were also handed the Ramathuba. “We have received numerous complaints and reports of system failure which has dire consequences for patients. Our own monitoring in recent months at facilities across the Mopani and Vhembe Districts confirm the extent of the crisis and if the MEC does not take our demands seriously, we will be back in our numbers,” Nkuna said.
Report outcome
The results of local facility monitoring by TAC branches during October 2017 at Mopani and Vhembe districts highlighted a number of issues with regard to the state of primary healthcare in the province. In addition to monitoring facilities, TAC branches engaged with members of the community to understand their challenges and collect testimonies and complaints.
According to the report only 35 450 out of 44 000 funded posts at the department are filled leaving a vacancy rate of 75% doctors and 67% nurses. This results in long waiting hours, longer hospital stays, higher number of deaths and increased pressure on staff.
At some clinics and hospitals, patients reportedly wait longer that five hours just to get their files and then for another two to five hours to be seen by a doctor. In some instances patients queued from as early as 05:00 while doctors only arrived at 10:00. At some facilities patients had to wait for hours while doctors took their lunch break. At Elim Hospital TAC Limpopo came across a patient lying on a trolley in the corridor since being admitted six hours earlier.
Seventeen out of 21 facilities surveyed did not have enough staff with only one facility having waiting times of less than 30 minutes. Seventeen facilities were identified with poor infrastructure which needed urgent renovations. At Malamulele Hospital it was noticed that there had been no constant water supply for the past three years and patients were unable to wash while only small amounts of container water was used for toilets. This hospital’s laundry is outsourced to Polokwane Provincial Hospital.
TAC Limpopo also assessed TB infection control measures and 17 out of 23 facilities were found to be in a red state with very poor infection control measures in place and only one in the green state with good measures in place and the remaining facilities having moderate control measures.
Regarding medicinal stock TAC Limpopo noticed that the shortage of antiretrovirals (ARVs) has mostly been addressed due to the organisation’s interventions, but medicine for malaria, diabetes, hypertension and paediatric medicines are regularly out of stock. The survey revealed stock shortages at nine of the 21 facilities.
There are currently three psychiatric hospitals in Limpopo, however, the majority of users of these facilities are not people with mental illnesses but rather people with learning and intellectual disabilities.
The report lastly revealed that Limpopo faces a number of challenges when it comes to cancer and oncology. Complaints were received that women faced extremely long waiting times to get the results of pap smears. They also complained about nurses at a primary healthcare level lacking understanding on the prevention and diagnosis of cancers. In terms of treatment Polokwane Provincial Hospital provides certain chemotherapy while other forms of chemotherapy, radiotherapy and other cancer treatments are not accessible in the province and patients have to be transported to Steve Biko Academic Hospital.
Demands
TAC Limpopo demands a human resources plan as well as a list of vacancies in the province and that all vacancies be filled in the next financial year. They further demand a full-funded plan to address infrastructural issues; a full audit be carried out of all public facilities on TB prevention control measures and masks and educational posters on TB be distributed to facilities and urgent provincial strategy to address the continuous shortage of medicine and HIV testing kits. TAC Limpopo lastly demanded an audit report of the functionality of clinic committees and hospital boards by February 2018.
Ramathuba addressed the crowd assuring that she would attend to each complaint and demand in the memorandum herself.
Departmental Spokesperson Derick Kgan­yago confirmed that the MEC received the memorandum herself and gave her word to respond to some of the demands by the end of the month.

Story & photos: RC Myburgh
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