As part of the vigil and protest late last week, more than 50 unpaid community health workers convened at the Free State’s provincial government headquarters. According to the Treatment Action Campaign’s (TAC) Mary-Jane Matsolo, some workers and supporters even slept outside Bloemfontein’s Bophelo House braving frigid winter temperatures of just one degree Celsius.
Workers alleged that they have not been paid their monthly stipends of R1,500 for two months after MEC of Health Benny Malakoane terminated their contracts.
“Malakoane sent a circular to all community healthcare workers terminating their contracts claiming they were ghost workers,” said TAC in a statement released Friday. “Following this, the head of department sent a second circular stating that their services should not be stopped.”
Selina Hlabahlaba has been an HIV testing counsellor for three years. The mother of two is separated from her husbands and rents a back room for herself and her two boys. Unpaid, Hlabahlaba says she is struggling to keep food on the table and the lights – and heat – on.
Her absence at work means that the clinic at which she works has two options: Take professional nurses away from regular duties to carry out HIV counselling and testing, or stop HIV testing altogether.
In the next year, the Department of Health is aiming to start 500,000 new patients on antiretrovirals (ARVs), according to figures released in September. Typically, the country initiates about 400,000 patients on ARVs annually, according to past National Treasury figures.
Community health workers like Hlabahlaba play an important part in getting people started on ARVs, not only diagnosing people living with HIV but also often conducting the ARV education that is a pre-requisite to starting treatment.
Hlabahlaba says she misses a job she loves waking up for.
“I adore my job,” she told Health-e News. “I can’t think of anything else better than this job – it’s what I love…waking up in the morning and knowing that I am going to make a difference in someone’s life.”
A poor prognosis for province’s health system
The protest is the latest symptom of a provincial health system the TAC and public interest group Section27 say is collapsing. The duo of organisations recently released a statement alleging that the Free State’s financial crisis had led to shortages of more than 200 medical supplies and medicines, including surgical gloves, HIV testing kits and antibiotics.
In a statement, Section27 and TAC called for the ministers of finance, health and cooperative to deploy a task team to the province immediately with the aim of identifying the scale of the problem and solutions as well as drafting an action plan.
The National Department of Health may have been one step ahead. According to Section27 Executive Director Mark Heywood, the National Department of Health deployed a task team of senior officials to the Free State weeks ago.
The team has already presented a preliminary report of its findings to Department of Health Deputy Director Precious Matsoso, according to National Department of Health Spokesperson Joe Maila.
While Maila said details of the team’s report could not be made public prior to Health Minister Dr Aaron Motsoaledi full debriefing, Maila confirmed the Free State Department of Health was facing financial difficulties.
“The team is expected to table their recommendations to the minister and we will work closely with the provincial government in the Free State to implement them fully,” Maila added. “Whatever we are going to do will be in the best interest of our clients.”
On 23 June, the Democratic Alliance released a statement saying that it had reported Malakoane and the Free State Department of Health to the South African Human Rights Commission for what it said were human rights violations related to, for instance, long waiting lists, patients being forced to sleep on the floors of facilities and hospital food shortages.
Free State silent on scope of crisis or response
Meanwhile, TAC Head of Policy, Communications and Research Marcus Low described the Free State government as being “remarkably unresponsive”.
“We’re seeing a continuation of (Malakoane’s) refusal to engage with civil society,” Low said. “It’s clearly coming to a serious crisis point.”
“We’re at a stage at which surgeries are being delayed and there are very direct effects on people’s lives right now,” he added. “There is no effective leadership or will to deal with these things – all we get is denial.”
According to TAC Secretary General Anele Yawa, letters regarding the crisis have been sent to Motsoaledi and Deputy President Cyril Ramaphosa. He says TAC plans to meet with top African National Congress (ANC) officials to discuss this.
“We want to know why the ANC re-installed Malakoane as MEC because he is a disaster,” Yawa said. “At the end of the day, the same people who are suffering on the ground are the same people who were queuing to vote on 7 May for the ANC.”
“The collapse of the Free State needs a national intervention so that our people will not continue enduring what they are going through,” Yawa told Health-e News.
Free State Department of Health Spokesperson Mondli Mvambi’s office declined to comment saying Mvambi was busy dealing with the State of the Province Address and would not be available for any other issue until 2 July. – Health-e News Service.
An edited version of this article first appeared in the 29 June edition of the Sunday Independent