Healthcare sick as a dog

2010-02-14 11:59

SOUTH Africa’s already crippled state hospitals have run out of

life-saving medicine.

A City Press investigation can ­reveal that bad planning,

mismanagement and incompetence are leaving patients without medicine to manage

diseases such as ­tuberculosis, hypertension, ­rabies, anaemia and


Virtually all the country’s provincial health departments have

massively overspent in the past ­financial year. In some cases, suppliers have

not been paid, while staff shortages across the country are wreaking havoc –

especially on ­rural hospitals and clinics.

Worst hit seems to be the Eastern Cape, where hospitals and clinics

have run out of crucial medicine. A measles epidemic is raging while pharmacies

are ­battling to get supplies.

In Mpumalanga, clinics and ­hospitals don’t have rabies ­vaccines

and malaria medicine. Clinics have reported shortages of antibiotics, tetanus,

polio and hepatitis-B vaccines, needles, ­syringes, contraceptive injections and


In Free State, clinics have not only run out of basic medicine but

have had their electricity cut due to non-payment of bills.

A sister in charge of a clinic in the northern Free State says they

have been told the health department is R33?million in debt and all ­purchases

have to be approved by the provincial treasury.

In Gauteng, the Democratic ­Alliance estimates that the health

­department owes drug and food suppliers more than R1?billion as the financial

year winds down.

Because of this, service providers have held back on stock and

­doctors have to scramble for ­alternatives to treat ­patients.

DA health spokesperson Jack Bloom says: “If institutions of

­international repute like Chris Hani-Baragwanath and Charlotte Maxeke have

stock-out problems, it points to much deeper, systemic problems.”

The Limpopo health department has overspent by about R90?million on

its antiretroviral (ARV) budget, and hospital budgets have been cut to free up

funds. Even so, fewer than half the people who need ARVs have access to


In North West and Kwa­Zulu-Natal, the problem is a dire shortage of


In one North West hospital, more than half of the doctors left by

the end of last year and community service doctors didn’t arrive at the

beginning of the year. As a result no new HIV/Aids patients can be ­initiated

into treatment.

The KwaZulu-Natal health ­department has frozen all posts as a

result of overspending. A circular sent out by the provincial treasury in

October said that the province was embarking on a massive cost-cutting drive.

The over-­expenditure is ­estimated at R1.5?­billion.

Health spokesperson Sizwe Kupelo admits the Eastern Cape’s two

medicine depots have this week become the subject of a provincial investigation.

Mthatha depot, which supplies medicines to remote clinics and

hospitals, has not had a pharmacist to dispense supplies since the beginning of

last month.

Drug shortages have ravaged the Eastern Cape for more than a

decade. Chairperson of the Rural Doctors Association, Dr Karl le Roux, says

hospitals have learnt to pre-empt erratic drug supplies by ordering as many

different versions of medicines as possible to prevent them from running out of

a particular drug altogether.

But not even this strategy has worked. At the end of last month,

hospital pharmacies found their two-weekly ­order lists returned with anything

from 70 to 200 items marked “out of stock”. A case in point is the Zithulele

Hospital near Coffee Bay on the Wild Coast. The Mthatha depot could not supply

201 items on their list.

Monique Lines, who was Zithulele’s pharmacist until two weeks ago,

says she routinely ­reported stock shortages to the health department in Bhisho,

but it made no difference.

Zithulele had to appeal to the ­Rural Health Advocacy Project in

Johannesburg to intervene. Project manager Marije Versteeg has been seeking

answers from the province without any success.

By the province’s own admission, the health department is

R1.8?billion in debt. They have put all payments to suppliers on hold for this

financial year.

But Eastern Cape health ­departmental spokesperson Sizwe Kupelo

denies there is a shortage of drugs. He says inadequate ordering at hospitals

and “bad management” is to blame.

Kupelo says an investigation has been launched into the ­Mthatha

and Port Elizabeth depots. The provincial health department has invited ­the

national Treasury to send a rescue team to the province.

With the team’s arrival this week, all delegations and mandates for

spending have been withdrawn and bid award committees disbanded.

Work has begun to redesign the procurement system.

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