- A Nehawu report revealed the dire state of the public healthcare system and the dangerous working conditions of health workers.
- Lack of PPE, non-compliance, incompetence and staff shortages were a few issues the union raised.
- The union has created a list of demands and proposals for the government and oversight bodies to address.
A fact-finding investigation by the National Education, Health and Allied Workers' Union (Nehawu) has uncovered shocking and dangerous working conditions under which health workers and staff have to perform their duties in some hospitals in the country.
At a briefing on Tuesday, the union's general secretary Zola Saphetha detailed the mission's report, which included demands and proposals.
The report has brought to light the dire state of South Africa's public healthcare system, which poses dangers for workers and patients alike, and warns of protest action starting in late August.
Lack of personal protective equipment (PPE)
In almost all healthcare institutions the union visited, a general shortage of PPE was identified.
This was despite the government's assurance there was enough just four months before, saying they would embark on procurement to replenish stock.
The union found there was managerial incompetence in many healthcare facilities when it came to how long PPE would last, with no plan to avoid stock running out.
Challenges with PPE distribution to frontline workers was also a problem, with cleaning staff and porters in some institutions left unprotected because of a misconception that PPE was only for clinical staff.
PPE stock was never adequate in the first place, the report said, and are still not adequate now that the country was nearing peak infections.
Occupational Health and Safety (OHS) Act
General non-compliance with the OHS Act was found in every healthcare institution the union visited, despite officials who were appointed to oversee this.
"In fact, some of our teams have found that the authorities at institutional level shockingly demonstrated complete ignorance of this legislation as well as the departmental guidelines that have been issued since the [Covid-19] outbreak," the report said.
This means that those responsible were not able to explain their risk assessment strategies or prevention and control measures.
No regular briefings are held with the labour representative on the state of infections in facilities, the report said.
A key factor in all healthcare institutions visited by the union was staff shortages.
The shortages do not only relate to specialists, doctors, professionals and nurses, but also to non-clinical staff.
"This generates an unbearable environment and experiences for patients and visitors, not to mention the extreme work overload imposed upon the current workforce in the face of Covid-19," the report said.
It added the problem was so pervasive that some nurses are made to do the work of cleaners and porters - without PPE.
Authoritarian and destabilising management
A seemingly toxic work environment has been created in many healthcare institutions, the report found, with workers being victimised "on a daily basis".
This after some staff raised concerns about a lack of PPE, the absence of screenings and the refusal of managers to allow workers to go into self-isolation if they suspect they have been exposed to the virus.
Shop stewards have been forced to sign confidentiality forms to prevent them from reporting or raising concerns over how the institution manages Covid-19.
Written warnings are also regularly issued by managers to healthcare workers who refuse to work under conditions they deem as unsafe.
The report said that, in the Western Cape, "managers have rejected reports of infection in the workplace from workers and they would even go so far as to compel such workers, who may even have already been diagnosed Covid-19 positive, to work as long as they did not have or present symptoms".
Dysfunctional district healthcare system
The report found that many problems within the public health sector are as a result of a dysfunctional district healthcare system, with problems in coordination and a broken referral system.
In some cases, these problems have caused overcrowding, which puts patients and workers at risk.
Nehawu added that its members have questioned the authenticity and accuracy of statistics supplied to the government on daily infections. It says there is deliberate under-counting, especially regarding incidents and causes of death.
Decentralised response to the epidemic
PPE procurement and human resource deployment to meet requirements where the need is highest have been left to provinces to plan.
Demands, proposals and protest action
The union listed seven demands to address the shocking findings, including consulting with the government and oversight bodies.
The union has decided to meet with key government stakeholders to implement a plan of action.
In August, it plans to embark on protest action, including stayaways and pickets.
"Full Blown Action" is planned for 10 September, which involves "complete withdrawal of labour in all sectors if there is no response favourable to our interests until all our demands are met".