When Nurse Hlope’s water broke two months ago, her mother called an ambulance to take her to Piet Retief Hospital 20 km from her rural village. The ambulance arrived six hours later & Hlope’s mother had delivered the baby unassisted.

At the time the decision was taken, the finance department admitted that the health department was in danger of collapsing due to huge overspending in areas such as employee compensation and large accrual of past debt.

By the end of the 2013 financial year in March last year, Mpumalanga’s health department had accrued a debt of about R247-million.

According to Thoko Madonko of the civil society Budgetary Expenditure Monitoring Forum, the department is set to over-spend its by nearly R500-million.

The Department of Finance has already put in place austerity measures to cut spending, but this is having a knock-on effect on services. There are staff shortages and stock-outs of essential medicines such as insulin for diabetics, children’s vaccines and HIV and tuberculosis treatment. Drug stock outs may be partially due to admitted pressure on the province’s medicine budgets as well as a top-heavy department that struggles with supply chain management.

The largely rural province is also suffering from a shortage of ambulances and emergency medical service personnel. Orthopaedic experts estimate that about 8 000 patients annually are at risk of developing permanent disabilities due to huge waiting lists for operations.

Even Mpumalanga’s Gert Sibande District, one of 11 districts nationally piloting the National Health Insurance (NHI) scheme, is facing severe problems despite getting an extra R1-million NHI conditional grant.

Health-e News takes a look at the toll of Mpumalanga’s deadly debt:

 

Thousands face disability as orthopaedic services collapse

Mpumalanga has the country’s highest rate of road accident deaths, but when survivors are pulled from the wreckage, there are just four doctors in the province who can mend their bones – and the wait to see them may kill and maim many.

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Emergency medical services leave patients stranded

Women in Mpumalanga are teaching themselves to deliver babies because there is such a dire shortage of ambulances, which take up to six hours to respond to calls.

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National Health Insurance pilot district “shows signs of collapse”

The Mpumalanga Department of Health is crumbling as the province struggles with deadly shortages of equipment, medicine and staff.

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Medicines go missing in Mpumalanga

Vital medicines such as insulin for diabetics, children’s vaccines and HIV and tuberculosis treatment are running short in Mpumalanga, which has been plagued by medicine shortages for most of this year.

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Tensions flare over poor service delivery in Mpumalanga

Overworked nurses and frustrated patients recently squared off as part of a community dialogue as communities in Mpumalanga’s Piet Retief area continue to complain about poor health care service.

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