TB patients coughing up for cash

2009-09-12 15:53

DESPERATE people are paying TB patients for their saliva to get access to social grants. City Press has found that TB sufferers charge between R50 and R100 a sample.

TB patients apparently easily smuggle sample bottles out of government clinics to customers. The bottles with ­infected sputum are then handed to health workers for testing. Once they are certified infected, “patients” can then obtain temporary disability grants of R1 010 a month from the Department of Social Development.

The practice is especially rife in Western Cape.

Inquiries in Khayelitsha quickly revealed three TB-infected residents willing to sell their sputum.

A 54-year-old man who legitimately receives a disability grant for his illness sold City Press two samples for R50. He said on average he made about R500 a month through selling his saliva.

He said “business” was not good, however, because many people in the township were infected with TB, which meant a lot of competition.

The man’s samples were taken to the Nolungile Clinic in Site C, Khayelitsha, for a TB test, where the health workers do not normally insist that the sample be coughed up in front of them. It was easy to hand over the bought samples.

Western Cape spokesperson for the South African Social Security Agency (SASSA) Shivani Wahab said a temporary disability grant was provided for a minimum of six months and for a continuous period of not more than 12 months.

Wahab said applicants were assessed by a medical doctor who recommended an applicant, based on their medical condition, for a grant.

Those receiving the grants would then be re-assessed after a six- or 12-month period.

However, a TB patient who had qualified for the grant said it was rare that doctors did a proper physical check-up. They mostly just checked the test results.

South African National Tuberculosis Association (Santa) chief executive John Heinrich said he had heard of the practice and recommended that patients be required to cough up their samples in front of a health worker.

However, that could present ­logistical challenges as the best samples for TB detection were produced early in the morning.

Heinrich said another worrying issue he had come across was that some TB patients deliberately neglected taking their medication in order to continue receiving grants.

He said patients abandoning their six-month course of medication risked multiple drug-resistant (MDR) TB or even extreme drug-resistant (XDR) TB.

National health department spokesperson Fidel Hadebe said the department was aware of TB patients selling their sputum.

“This is wrong and cannot be allowed. People have to be tested by professional workers,” he said.

Social Development Department spokesperson Mandla Sidu said he had no doubt that such scams existed. The department was, however, not aware of specific cases.

He said the correct procedure for accessing grants was to have a TB test at a clinic under the supervision of a professional nurse.

If the results were positive a doctor would write a report stating whether the patient qualified for a grant or not.

According to SASSA records for this month there are about 30 015 temporary disability grant beneficiaries nationally.

Deputy director-general in the Department of Health Gorvan Molefe could not provide statistics on how many TB patients there were in the country at the time of going to press.

The World Health Organisation’s Global TB Report 2008 ranks South Africa fourth in the world for TB infection, with an incidence rate of 940 cases for every 100 000 people – up from 338 for every 100 000 in 1998.

The Western Cape health department said there were 50?156 TB cases in that province in 2008. – West Cape News


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