On 13 September, civil society groups, medical associations and unions delivered a memorandum, under the banner of the Eastern Cape Health Crisis Coalition, to recently appointed Eastern Cape Head of Health Dr Thobile Mbengashe. The memorandum demanded that the provincial department of health release a plan aimed at fixing the province’s crumbling health services by 11 October.
About a week later, Health Minister Dr Aaron Motsoaledi held a Pretoria press conference that made public the results of an emergency task team’s visit to the province and announced more than one billion rand towards rebuilding the province’s health services.
According to Eastern Cape Health Department spokesperson Sizwe Kupelo, the provincial department of health feels that Motsoaledi’s previous press conference qualifies as a plan and fills the conditions of the memorandum.
“The national minister has already responded by tabling his plans to address the concerns raised,” Kupelo said.
The Eastern Cape Department of Health did however take out a full-page advertisement in the 29 September Sunday Times that listed the department’s achievements and plans in regards to health infrastructure.
According to the advertisement, the province has upgrade 222 clinics and the province aims to build 16 new clinics.
The ad, which cost the department R425,000, was not in response to the Eastern Cape Health Crisis Coalition’s protest, according to Kupelo, who added that the department received a discounted rate on the advertisement in line with the department’s contract with The Times Media Group.
“We will continue to tell the good stories about our achievements through the adverts, which form part of our pro-active media strategy for the year,” Kupelo says. “The media campaign had been initiated long before the march.”
But coalition’s member the Rural Health Advocacy Project (RHAP) says that the minister’s announcement does not qualify as the rescue plan envisioned by the group’s memorandum,
“It’s ludicrous to say that the plan presented by the minister was a rescue plan,” said RHAP Project Manager Marije Versteeg.
“The minister’s press conference cannot be seen as an implementation or a recovery plan – it was merely setting out some of the interventions that the department of health was undertaking,” she adds. “There was no timelines, no clarity of who would take the lead for which activities and, the biggest problem, was that there was a complete lack of engagement on the issue of human resources.”
According to Versteeg, gains in infrastructure development are meaningless unless the province addresses human resource issues, including developing rural recruitment and retention plans.
At least one hospital in the Eastern Cape is planning to enter 2014 without any rehabilitation staff, who typically assist disabled patients.
“It will be good to have facilities, but my hospital’s rehab services are going to shrink again next year,” said a health worker who did not wished to be named. “This is only due to poor human resources, not any other good reason – we have lists of both physical therapists and occupational therapists who want to work here.”
“There are excellent people who want to work in this province and are not always patiently waiting until we finally get things together to appoint them a year later,” the health worker added. “This really has to change.”
A September report by public interest group Section27 and AIDS lobby, the Treatment Action Campaign, health care posts in the province take an average of six months to fill.
In early September, the South African Medical Association (SAMA) issued a statement complaining that most doctors in the Eastern Cape were not being paid their correct salaries. The body alleged that the department of health had acknowledged that millions of rands were owed to doctors but had yet to propose how or when it would repay these debts.
Days later, SAMA members joined the march on Bhisho and issued a statement saying that MEC of Health MEC Sicelo Gqobana had repeatedly refused to meet the association to address grievances.
The coalition has sent letters to both the national and provincial departments of health. According to Versteeg, the National Department of Health has said that the issue remains a provincial matter.
Mbengashe has offered to meet with the coalition and hear its recommendations and Gqobana has proposed a meeting for 22 November 2013. While the coalition has accepted Gqobana’s offer, Versteeg says a meeting almost two months after the memorandum was delivered doesn’t convey the sense of urgency that the coalition had hoped for.
The coalition will meet on 14 October in East London to plan its next steps in the fight for better health in the province. – Health-e News Service.