Ranilda Mathinya (19) and her partner, Delson Maunza (33) were left confused when an employee at the Tembisa Hospital took their 3-day-old baby’s Road To Health booklet; and ordered them to pay R621 before it could be returned to her. Health workers give this free booklet to every mother after they’ve given birth in both public and private health facilities.

Two couples, same experience

The ordeal started when Mathinya took her baby to Thafeni Clinic for a scheduled postnatal visit.

“The nurse at the clinic noticed that there was something wrong with my baby’s health and referred me to Tembisa Hospital so they could assist us. But when I got there, I never got a chance to explain why I was there.”

The hospital’s staff member, who could not understand the Xicopi language (spoken in Nyambeni province, Mozambique) that Mathinya used, took her baby’s road to health booklet after she had admitted to not having a valid passport in hand.

“She asked what I had come to do at the hospital and when I tried to explain, she said she couldn’t understand the language that I was speaking,” says Mathinya. “She then took my baby’s booklet and told me to come back with R621, together with my passport, then I will get the booklet [back].”

Another mother, Jizela Chauke (21), gave birth at the hospital after being transferred from Thafeni Clinic, was also told that she had to pay R621 by a nurse.

Chauke, however, was given her baby’s road to health booklet, but it was not stamped.

“She [the nurse] told me that the booklet would only be stamped once payment has been made. She also told us that without the stamp, my baby will not receive medical care from any health facility in the country.”

While exiting the hospital, a security guard also emphasised the need for them to pay up.

“At the gate, the guard asked us if we knew that we had to come back to pay the amount of R621? We said yes and then he let us go,” Chauke says. 

Health and financial concerns 

Maunza, Mathinya’s partner, is more concerned about the health of his infant who had been referred to the hospital but never received any medical attention.

“I don’t know what to think because we tried taking him to a clinic and they told us that they couldn’t assist us without the booklet,” he says. “I am very disappointed by all of this but I feel helpless because this is not our home country and we must do as we are told. I would pay if I was employed but my job at a construction company ended two months ago.”

Felix Zavale (38) is Chauke’s partner and works as a scholar transport driver.

“If they say we must pay then we will pay but I can only pay the amount in instalments because R621 is a lot of money to pay in one go,” Zavale says.  

“Not having money doesn’t mean that we don’t deserve fair treatment and I believe they were unfair to us by not even informing us before my partner was transferred to the hospital that we had to pay. Now we don’t know what is going to happen should the baby get sick, since they told us that no clinic or hospital will assist us without a stamped booklet.”

What the law says

The National Health Act 61 of 2003 states that “pregnant and lactating women and children below the age of six years, who are not members of beneficiaries of medical aid schemes, must be provided with free health services”.

Hospital spokesperson, Nothando Mdluli says that they had adhered to provisions made in the act.

“Children under the age of six years are exempted from paying, as well as South African pregnant women, provided they produce identification and doctor’s report that verifies pregnancy so that they can correctly be classified as non-paying patients. Non-South African women are also exempted from paying, provided they are immigrants permanently residing in the country. In this case, they must bring proof regarding them residing in South Africa.”

Mdluli states that “foreign private patients” are however requested to pay for services at the hospital.

“A private foreigner, according to the National Health Act and Immigration Act, is a non-South African citizen who visits the country specifically for medical treatment and whose visa is endorsed for ‘medical treatment’.”

According to Mdluli, only admin clerks are authorised to collect payments from patients.

“Nurses don’t work with payments, only admin clerks who are supposed to collect revenue according to tertiary requirements. It is an eye-opener for us because it means that we must communicate with our staff so they can know who can and can’t collect payments from patients. Security guards are also not allowed to address patients regarding payments,” adds Mdluli.

Anti-foreigner health practices not new

In March, the national health department came under fire when two provincial health departments — Gauteng and KwaZulu-Natal — released directives that instructed facilities to charge foreigners in full for health services including “emergency services”. The directives were later withdrawn, however, experts at the time pointed out that this is xenophobic and unconstitutional. 

“Such actions have serious ramifications including furthering anti-foreigner sentiments within, and beyond, the public healthcare system,” said Professor Jo Vearey from the African Centre for Migration and Society at Wits University.

The health department has a “worrying track record of scapegoating foreign nationals for the poor performance of the South African national healthcare system”, Vearey adds.

“Denying access to foreign nationals is a public health disaster, with negative public health implications for all in South Africa and the SADC region.”

Mathinya received her confiscated booklet following questions that were sent by OurHealth to the hospital. Chauke has also been invited to go back to the hospital to get her baby’s booklet stamped.

“The booklet was taken from the patient under the impression that it needed to be stamped. For us to provide the stamp, we would need a passport. The mother came to the hospital to collect the booklet because, after our assessment, the booklet did not need our stamp as it had already stamped at the clinic. The other mother must also go back to the ward where the booklet was taken because she is also not supposed to pay and the booklet must get stamped. She must go back with an identity card or passport.” – Health-e News