Gauteng the latest province to admit ambulance shortages

An image of the front end of an ambulance
The Limpopo health department is struggling to provide much needed ambulances.
Xolisile Sam recently testified before the South African Human Rights Commission during the body's recent hearing into alleged ambulance shortages in the Eastern Cape. The hearing followed a 2007 commission national hearing into healthcare that cited reports of ambulance shortages nationwide. Credit: Laura Lopez Gonzalez / Health-e News
Xolisile Sam recently testified before the South African Human Rights Commission during the body’s recent hearing into alleged ambulance shortages in the Eastern Cape. The hearing followed a 2007 commission national hearing into healthcare that cited reports of ambulance shortages nationwide. Credit: Laura Lopez Gonzalez / Health-e News

Joseph Marks from Eldorado Park became seriously ill on the morning of 30 May. At 10am, his family reportedly called for an ambulance. When the ambulance did not arrive about an hour later, the Marks’ neighbour, Minah Rosenberg, says she went to the Freedom Park Emergency Services Depot to repeat the family’s call for an ambulance.

According to Rosenberg, when she arrived at the station there were two ambulances in the parking lot however, she alleges she was told they were out of commission and could not respond to the Marks’ emergency. She adds that dispatchers confirmed that they had logged the Marks’ call but had not assigned an ambulance.

Rosenberg claims she waited at the depot for two hours to see if an ambulance would become available before returning home and helping the Marks’ arrange for a car to take Joseph to Chris Hani Baragwanath Hospital. He died a day later.

“Mr Marks would still be with us if it was not for an ambulance that did not arrive,” said Rosenberg, who spoke on behalf of Joseph’s family who are still reeling from the loss. “I am really disappointed by people who must serve us because they are failing.”

City of Johannesburg Emergency Services Spokesperson Robert Mulaudzi confirmed the shortages but said the province was starting to address the problem. He added Joseph’s case is already being investigated but urged the Marks family to lay a formal complaint with the department.

“We are taking this matter very seriously hence we have initiated a full scale investigation about the matter so that we get to the bottom of this matter and also find out why the two ambulance which were parked at the station failed to transport the patient,” he said “If any of our staff members is found to have conducted himself or herself in an improper manner, disciplinary steps will be taken accordingly”.

Gauteng just one of many provinces battling shortages

According to the Gauteng Department of Health, the province currently has 393 ambulances and will soon unveil 49 new ambulances as well as 10 obstetric ambulances to cater for pregnant women.[quote float= right]I was so scared I thought the guy was going to die in front of us”

However, even with the addition of new ambulances, the province is about 760 ambulances short of reaching the national target of one ambulance per 10,000 people. The Health Department has also attributed poor response times to a driver shortage, and says there are at least 280 vacant posts in the emergency services department throughout the ranks.

The Department also admits that only about 10 of its 30 patient transport vehicles are operational. These vehicles are used to ferry patients between hospitals, moving them from their closest facility to other hospitals that may offer scarce specialist services.

Gauteng is not the only province to admit to huge ambulance shortages. The South African Commission for Human Rights recently held its second hearing into access to emergency medical services (EMS). While the recent hearing focused on the almost complete absence of EMS and patient transport in some Eastern Cape areas, the hearing also found shortages of EMS nationally in a 2007 hearing.

The Mpumalanga Department of Health is also about 140 ambulances short of meeting national norms. The province currently has a total of 259 ambulances of which 45 are expected to be withdrawn from the fleet soon due to high mileage. A further 27 were in for repairs as of mid May. The department’s latest annual report also notes a 42 percent vacancy rate in emergency call centres. The department recently appointed 27 new dispatchers to try to fill the gap, according to department spokesperson Dumisani Malamule.

“A needs analysis is underway to determine how many people are still needed in the call centre to maximise capacity,” Malamule told Health-e News. “Once this has been done and budget allows more people will be employed.”

Ambulances but no drivers

In August, Health-e News exposed a shortage of ambulances in Mpumalanga, forcing some women to deliver babies at home
In August, Health-e News exposed a shortage of ambulances in Mpumalanga, forcing some women to deliver babies at home

The discrepancy between reality and national norms becomes even more pronounced in the province’s National Health Insurance pilot district, Gert Sibande. With 52 ambulances, the district is only about a third of the way to meeting national norms. Of these ambulances, 29 were in for repairs as of mid- May and four were standing idle due to a driver shortage.

According to one local clinic doctor who asked not to be named for fear of victimisation, the shortage has taken its toll on patients’ lives.

“I had a stab victim in here, he was stabbed in the chest – it was very serious and he was bleeding heavily,” she said. “I called the ambulance and made it clear that it was an emergency, but the ambulance arrived two hours later.”

“I was so scared I thought the guy was going to die in front of us,” she added.

Sfiso Nkala is a community organiser in Gert Sibande for the public interest organisation Section27. He says 47 newly purchased ambulances did nothing to address the provincial EMS vehicle shortage because new vehicles simply replace those soon to be decommissioned.

He says that Gert Sibande’s rural terrain and bad roads means the provincial EMS vehicle shortage is accurately felt in the district.

“Gert Sibande is too vast and the roads are not in good condition especially in the Mkhondo Sub-district,” Nkala told Health-e News. “The population is too big and EMS doesn’t make (it to) at least five percent of the district’s population.”

He adds staff shortages have become a life-threatening crisis and need urgent attention.

“If a pregnant woman calls at the same time of a road accident, what is going to happen?” he asked “I am deeply concerned about the prioritization of the health department especially on how to spend their budget”. – Health-e News

An edited version of this story was first published on 9 June in The Star and Pretoria newspaper

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