Desperate nurses pooling money and paying out of pocket to keep basic medical equipment in stock – this is what national department of health investigators found at the Holy Cross Hospital in Flagstaff Eastern Cape. The national department of health has now pledged more than one billion rand to rebuild the province’s crumbling health system.

Last week, AIDS lobby the Treatment Action Group  (TAC) and public interest organisation Section27 released a report, entitled “Death and Dying in the Eastern Cape.” The report detailed frequent shortages of essential medicines and basic equipment and also shocking instances of poor patient care in the province.

In the wake of the report, Health Minister Dr Aaron Motsoaledi dispatched an emergency task team to the Holy Cross Hospital in Flagstaff, Eastern Cape where activists had alleged that medical equipment shortages led to at least one death – a baby boy.

When task team members arrived at Holy Cross, they found the hospital had few thermometers, no baby warmers with which to resuscitate babies and no fetal heart monitors – despite the fact that the hospital had recently received a cash injection of R105 million as part of the country’s Hospital Revitalisation Plan.

Holy Cross would have also lacked blood pressure cuffs had nurses not pooled together R17 each to buy one, said Motsoaledi at a Pretoria press conference on 19 September.

Task team members also confirmed previously alleged financial mismanagement when they found that the hospital had ordered file folders for R30,000 or ten times the actual cost.

“All nurses acknowledged that staff attitude towards patients, relative and even amongst themselves in the facility is not acceptable,” he told Health-e. “The general feeling was that management had no power over the unacceptable behaviour as they were friends with the wrongdoers.”

Following task team recommendations, Motsoaledi said he intended to suspend both Holy Cross’ CEO and nursing services manager with immediate effect pending a full investigation. The two employees would also be reported to the South African Nursing Council for breach of professional ethics, he added.

Dutch doctor and Holy Cross whistle blower Dr Dingeman Rijken, who was previously allegedly suspended for protesting conditions at the hospital, has also been re-instated.

Holy Cross received an emergency shipment of basic equipment from the national department of health Wednesday. A further 18 more hospitals in the province will receive similar shipments as a precaution, according to Motsoaledi, who stressed that the national department of health had long been aware of the province’s troubles.

Following a 2011 national audit of health facilities, engineers were dispatched to evaluate health infrastructure in each of the country’s 11 NHI pilot sties. These engineers have determined that at least eight clinics and two hospitals  – Bambisana and Zithulele – in the Eastern Cape’s OR Tambo District will have to be completely demolished and rebuilt starting in 2014.

Home to the highest death rate among children below the age of five, OR Tambo is being prioritised but Motsoaledi said that more than R 1 billion has been budgeted to overhaul the Eastern Cape health system in this financial year alone. At last R15.3 million of this will go to providing thousands of waiting patients in the province with wheelchairs, hearing aids and prosthesis.

For the 30 Eastern Cape clinics in need of additional space, the Council for Scientific and Industrial Research will be designing specially built park homes, aimed to last 20 years, which will be installed as the government plans for permanent solutions.

Motsoaledi added that he hoped in working with provincial authorities, that a Section 100 intervention could be avoided. Section 100(1)(b) of the Constitution allows national government to intervene when a province “cannot or does not fulfill an executive obligation in terms of legislation or the Constitution.”

“Truly speaking we have not yet arrived at Section 100,” Motsoaledi told Health-e. “In the Eastern Cape, our biggest problems are those of management and we think that by working together, we can save time.”

While he welcomed Motsoaledi’s announced plans to fix health in the Eastern Cape, Daygen Eagar programme manager for the Rural Health Advocacy Project highlighted that national and provincial department have yet to speak with one voice on the issue.

“The department seems to be taking the issue seriously,’ Eagar said. “There a disconnect between what the province is doing, on the one hand, and what the national department is doing.”

“We have an MEC for health in the Easten Cape that denies there is a problem,” he added. “That’s a problem because it’s the provincial government that is responsible for fixing the problem.” – Health-e News Service.

Read the minister’s full speech