Managing medicine supply in the E Cape
Access to medicines is still a problem in some public hospitals and many clinics in the Eastern Cape. Despite the reassurance of better service for all by the Department of Health and the Batho Pele principle to put people first, this is not happening in many areas. Health-e travelled through the region and compiled this report.
Duration: 6min 58sec
Translation: Ukungafumaneki kwamayeza kwizibhedlele neekliniki zikarhulumente kuseyingxaki eMpuma Koloni. Nangona urhulumente eyibethelela eyokuba kumele abantu bafumane iinkonzo ezizizo, kwinkqubo nkonzo ka Batho Pele nobeka uluntu phambili kodwa oku akubonakali kwindawo ezithile. Apha aantu bavakalisa izimvo ezahlukenenyo ngendlela amayeza afumaneka ngayo eziklinikini nasezibhedlele. UThandeka Teyise uhambelele izibhedlele neekliniki zaseMpuma Koloni wenza lengxelo.
THANDEKA: Amayeza angundoqo ekufuneka efumanekile ezibhedlele nasezikliniki zikarhulumente ngalo lonke ixesha ukunyanga izigulo ezifana neezamathambo, iswekile, isifo sephepha, izigulo zabantwana, intliziyo nezinye ke. Nokwezigulane oku akwenzeki. Izigulane kwikliniki yase NU13, eMdantsane zidanile yinto yokuba lonke ixesha zisiya ekliniki azifumani machiza yaye bafumana ipanado kuphela nokuba umntu ugula yintoni yaye le nto ikhokelele ukuba abanye abantu baveske baye ezikhemisti zabucala ukufumana amachiza.
Translation: While essential drugs should be available in public clinics and hospitals for common conditions like arthritis, TB, paedriatic illnesses, high blood pressure, cardiac cases and so on, patients complain that this is not the case. In Mdantsane, East London patients at NU 13 clinic complained that each time they visit their clinic all they get is Panado. Some have resolved to go for help elsewhere in private pharmacies.
PATIENT 1: Kuya kuba worse because siyakwazi ukuza ekliniki ngo 8am ngo 1pm kuvalwe nikhuthselwe phandle nibuye ngo 2pm but kuyo yoneke lonto kuphele ugoduka ungakhange uwafumane amayeza la ubuwazelel uphinde exelelwe ukuba yiza kuleveki izayo uzakuwafumana kuleveki izayo. Siza kulufmana phi ke uncedo xa kunjalo.
Translation: Things are getting worse because you come to the clinic at 8am and at 1pm the clinic is locked. We are locked outside but at the end of the day we end up going home without getting any medicine. You are told to come back the following week to collect medicines and where else can we get help if that’s the case?
PATIENT 2: Kunzima apha nalomayeza siyakuwafumana okanye singawafumani kuthiwe zesiwalande angabikho nangoku ndinamayeza wale nyanga iphelileyo ebendingawafumananga kodwa kuphinde kwafika enye icheck up ndingawafumenanga.
Translation: It’ s difficult here because sometimes we get medicines and sometimes we don’t. We are often asked to come back and collect them later. Even now I didn’t get my last month’s treatment and I’m here for another check up appointment.
PATIENT 3: Kuqala noko wawuwafumana amayeza uyakwazi ukuba uthi uzile like mna ndandizile ndizele amathambo ndafumanan iipanado so ngoku into endiyenzayo ndibheka echemist ndifune iipilisi ze arthritis kangokuba andisezi ekliniki ndiza nje ngozokucwangcisa.
Translation: We used to get medicines but now you can come to the clinic for and you don’t get anything. For example, I used to come here for arthritis and I was given panados. I gave up and now I get my treatment from a pharmacy. I’m no longer coming to the clinic because I don’t get my arthritis treatment from the clinic
PATIENT 4: Kumane kusithiwa uzuze ngomso. Uze ngomso ungahoyeki ude umnke bangaye kwi lunch basenokungabuyi basenokubuya kuyakubuya mhalwumbi babini okanye bathathu besithi akukho yeza, apha bemke.
Translation: We are told to come back the next day. You come back the next day and you don’t get help because nurses here take long lunch breaks. One or two nurses will come back after lunch and they tell you that there are no medicines.
THANDEKA: Noko kunjalo uMphathiswa weZempilo eMpuma Koloni, uGqirha Monwabisi Goqwana umentla esithi abantu bayawafuman amachiza kwela Phondo.
Translation: However, MEC for Health in the Eastern Cape, Dr Monwabisi Goqwana refuses to believe that people are not getting medicines from the clinics and hospitals.
DR. GOQWANA: The latest information is that ezi zinto ozibalayo azisenzeki kodwa ke mhlawumbi isenokuba khona iminqandandanayokuba kubekho izinto ezinjalo. Kodwa ke mandiyichaze into yokuba ibikade iyingxaki ezi zinto uzuthethayo. Ndiyarhalela ukuba abantu bayazi into yokuba xa uthetha ngamayeza, amayeza anikezelwa ekliniki ohlukile kwawanikezelwa kwi district hospital ohlukile kwawanikezelwa kwi referral hospital. Umntu ofumene amayeza kwi referral hospital adibane nomntu obeye ekliniki ambonise amayeza akhe usenokucinga ukuba akawafumananga amayeza akhe kuba engafumananga la ereferral hospital. Okwesibini amayeza ebebiwa iyinyani loonto leyo kodwa andiqondi ukuba isenzeka lonto leyo nalento yokunqongophala ezi clinics nasezibhedlele. Into yokuqala esiyenzileyo siqonde ukuba masibe neHuman Resource ezakusincedisa ekunqandeni oku kubiwa kwamayeza. Sinee pharmacists ezi qashiweyo yi Department of Health eMpuma Koloni ezi more than 40 ukwenzela ukuba amayeza akwazi ukujongwa ukuba angalahleki kuphume the right prescriptions. Ndithetha nawe nje there’s a tender ngoku there’s a tender that is going on between iprivate companies ne public health sector apho sizama ukuba sifumane iinkampani ezizakusebenzisana norhulumente in the private partnership where we are going to be looking after iidepots, amayeza ase depot siwajonge netransport ukusuka kwawo edepot ayokufika kwi institution le aya kuyo and lomayeza a-barcode(we) for a particular clinic not into yokuba amayeza edepot aye esibhedlela then iklinik iwafumane esibhedlele and sele eqalisiwe ukubarcode(wa) la karhulumente ezi companies ke xa sele zifumene loo tender ziza kuthi look after lamayeza and kubekho ne security.
Translation: The latest information I have is that these things you’re talking about are not happening but there could be some hiccups. I should say that yes, we used to have such problems but what people should know is that when we talk of medicines, medicines that are given at the clinic will differ from those given at the district or referral hospitals. That’s why a person who gets medicine from the clinic and not from the hospital shouldn’t worry because s/he did not get medicines from a hospital.
Secondly, medicines used to be stolen but I don’t think that is still the case now. We employed human resources personnel to curb the theft of medicines. The Eastern Cape Department of Health has employed about 40 pharmacists so that proper prescriptions and management of medicines can be attended to. A tender circular is out at the moment for a partnership between the private and public health sectors. We want to fix up our depots as well as the distribution and transportation of medicines. Government drugs will be barcoded for a particular clinic where they are supposed to be delivered. Clinics will no longer have to wait for medicines to be delivered to them by the hospitals. Once private companies get the tender they will be responsible for looking after the medicines and the security of the depots.
THANDEKA: UNocawe Thipa ojongene namayeza kwi Port Elizabeth Hospital Complex uthi uthi kunyanzelelkile ukuba amayeza athile efumanekile kwizibhedlele neekliniki zikarhulumente ngalo lonke ixesha. Uthi ikomiti yase Mpuma Koloni ejongene namayeza yenza konke okusemandleni ukuba amayeza afumaneke kumasebe ezempilo.
Translation: Nocawe Thipha, Middle Manager for Pharmaceutical Services in the Port Elizabeth Hospital Complex says essential drugs should be available in hospitals and clinics at all times.The Eastern Cape Pharmaceutics and Therapeutics Committee is making sure that drugs are available in all hospitals and clinics.
NOCAWE THIPA: Le komiti ke, iProvincial Pharmaceutics and Therapeutics Committee ithe yavelisa incwadi esiyibiza ngokuba yi Eastern Cape Provincial Formulary esikhokhelayo isibonise ukuba ngawaphi amayeza esithi thina apha e-Eastern Cape sithembise ukuba ngalo lonke ixesha ayakufumaneka kwizibhedlele zethu neekliniki zethu. Xa sithenga amayeza siwafumanaphi siwathenga njani. Apha e-Eastern Cape kukho ii-depot zamayeza ezithi ke sifumane kuzo ke thina zibhedlele neekliniki zimbini eyokuqala iphaya eMtata eyesibini ilapha eBhayi. Lento ke iyabonisa ukuba noko akunzimanga ukuba sithi izibhedlele zethu azinawo amayeza kuba sinencwadi esi guide(ayo) into yokuba nanga amayeza ekufuneka sisoloko sihleli sinawo kwaye sinee depot esifumanelayo from the manufacturing companies lamayeza.
Translation: The Provincial Pharmaceutics and Therapeutics Committee, produced a book called Eastern Cape Provincial Formulary that serves as a guide for which drugs are essential in our clinics. The question might be, where do we get these drugs from and how are we purchasing them? In the Eastern Cape we have two medicine depots one in Umtata and one in Port Elizabeth. These supply our clinics and hospitals. With this system it shouldn’t be difficult for our hospitals to have [a constant supply of] drugs.
THANDEKA: Kuye kubekho ke iingxaki zokuba amayeza angafumaneki kwii kiliniki ingaba sube kwenzeke ntoni?
Translation: Patients often go home without medicines that they are supposed to get after they have visited their clinics. What could be the problem?
NOCAWE THIPA: Kuzuke idepot iyeyanengxaki nemanufacturers kuba ngamanye amaxesha amanye amayeza awaveli apha eSouth Africa avela ngaphandle kwemida yeli kuthi ke kubekho oogqwidigqwidi okungafiki kwamayeza kwlapha eSouth Africa ibe idepot ngaloondlela inengxaki.
Translation: When that unfortunate problem happens, it’s because our depot is encountering problems with the manufacturers because sometimes drugs are coming from outside South Africa and that puts our depot in trouble.
THANDEKA: Ingaba ke mhlawumbi niqhube njani kuleminyaka ilishumi amahlandenyuka enithe nanawo nalapho mhlawumbi ke nithe naphucula khona kweli cala lamayeza?
Translation: How has it been in the pharmacy unit in the past ten years? What were the challenges you were faced with?
NOCAWE THIPA: Kwiminyakana engaphambili bekusoloko kukho nengxaki yokuba ufumanise ukuba apha ezibhedlele kungabikho pharmacist ingu pharmacy manager isibhedlele sisikhulu kufuneke ukuba ii-senior pharmacists ezikhoyo zizenzele ngokwazo ukuba zizibekele ngokwazo into yokuba zizibekele ukuba abaphathe kodwa ndiyakuthembisa into yokuba isibhedlele ngasinye sinomntu onikwe i-responisbility the full responsibility ukuba abe ngu pharmacy manager into eyenza ukuba izinto zihambe ngendlela awazi umsebenzi wakhe ukuba uyintoni na. Ukusuka apho sine district pharmacists ezithi i-district pharmacist nganye ibe neekliniki eziliqela eziphantsi kwayo ngakumbi eza clinics ziphaya ezilalini zikwazi ukuba zihoyeke nazo. Ngoko ke xa kukho ii-pharmacists i-procument ihamba kakuhle ne stock control sihamba kakuhle njengokuba sithetha ngoku izinto zihamba kakuhle kakhulu.
Translation: In past years we used to have problems where there were no pharmacy managers, what happened was that the senior pharmacists in the main hospitals would put someone in charge of the pharmacy but now things have changed and in each and every hospital we have a pharmacy manager. We also have district pharmacists where each district pharmacist runs clinics, including in the rural areas. The procurement is going well and the stocktaking is functioning well. Everything is in place.
THANDEKA: Noko luyabonakala lona utshintsho kwicala lamayeza, kwizibhedlele ezifana nesase Mtata General, Cecelia Makiwane, Uitenhage Provincial noko abantu bayawafumana amachiza ngangona ingxaki bathi isesezi kliniki. UBuyiswana Vumazonke wase Tinarha uthi wanelisekile ziinkonzo zempilo athi azifumane nase Uitenhage Provincial kodwa uthi ingxaki ziyafumaneka kakhulu kwiikliniki.
Translation: There’s visible progress in the pharmacy and dispensary unit of hospitals in hospitals like Umtata General, Ceclia Makiwane, Uitenhage Provincial Hospitals to mention but a few but clinics seem to be battling. Buyiswana Vumazonke of Uitenhage is happy with health services that are provided at the Uitenhage Provincial Hospital although she admits that clinics are problematic.
BUYISWANA VUMAZONKE: Ndixolile kwicala leZempilo ngaphandle kwase Day (kliniki). Ndiye andafumana zipilisi nda complain(a) bandinika iphepha lokuba mandize apha esibhedlele ndifumne yonke into ke ngoku.
Translation: I’m getting care from the hospital because when I come here I get medicines. I only encounter problems when I visit Day Clinic. I had to complain at the clinic that I was not happy because I didn’t get medicines and they (the clinic) wrote a referral letter and I came to the provincial hospital and I got my medication.
THANDEKA: UNocawe uthi ukufika kwee manejala ezijongene namayeza kwizibhedlele kuye kwaphucula kakhulu nalapho kuye kwagxilwa kwingxaki yokunqongophala kwamayeza.
Translation: Nocawe says the appointments of pharmacy managers has brought tremendous change in addressing the drugs shortages.
NOCAWE THIPA: Iimanagers zize zahlala phantsi zenza i-analysis zibone ukuba yinto unobangela walento yokuba abantu banqabe bangabikho ii-pharmacists zokusebenza apha zathatha ke ngoku isigqibo sokuba masizame ukulungisa ezi zinto zenza ukuba abantu babone lendawo ingenamtsalane kungoku nje ipharmacists zingena zingenile ukuzokusebenza. Ezi queue zinde i-patient waiting time, siye enza ukuba noko mayehle ngokuhlengahlengisa indlela yokusebenza namaxesha okusebenza namaxesha okuya ekhefini njenge tea nesidlo sasemini sibone ukuba ngalo lonke ixesha kusoloko kukho umntu epharmacy akukho xesha kukhe kuthiwe ngoku kusemiwe kusetyenzwa ukuqala kusasa kude kuye kuba sekugqibeleni.
Translation: The managers discussed problems and concluded that we should address causes of scarcity of pharmacists and they devised means by telling the pharmacists that their working conditions will be improved and that attracted them and more pharmacists are now coming in. We also handled the patient waiting time where you’ll find patients waiting in long queues and we organized our time tables whereby there has to be a pharmacist all the time and even during tea breaks the staff should rotates.
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