“I regret being a nurse in Limpopo. We are under-staffed and working under constant  pressure. We are working with ‘skeleton’ teams and we have to do double the work, no matter how tired and fatigued we are,” says Shirly Sithole*.

33-year-old Sithole, a nurse stationed at Nkhensani Hospital in Giyani, is concerned about the shortage of healthcare workers, especially nurses, within public health facilities. 

Recently, the Health and Allied workers Indaba Trade Union (HAITU) marched to the Limpopo Department of Health head offices in Polokwane, demanding that health MEC, Dr Phophi Ramathuba address the issue of staff shortages within public health facilities in the province.

HAITU deputy president, Mulatedzi Ramaano says that the shortage of nurses in Limpopo has been made worse by the termination of 706 nursing posts earlier this year. The posts were created during the Covid-19 pandemic.

Ramaano says it’s concerning that nurses continue to be blamed for poor healthcare services, while in most facilities nurses are working without adequate support as the health department has failed to fill open vacancies. According to HAITU, there are over 1 200 vacant nursing posts in Limpopo. 

A 2021 report on Limpopo’s state of health by community monitoring group Ritshidze cited open vacancies, mostly of professional and enrolled nurses in clinics, among the challenges faced by the provincial health department. .

Dire shortage of nurses

The Democratic Nursing Organisation of South Africa (DENOSA) Limpopo chairperson, Lesiba Monyaki says there is a gross shortage of nurses.

He says that nurses working within public health facilities in Limpopo are often fatigued due to being overworked, which leads to litigation and disciplinary proceedings.

“Imagine being required to treat 20 to 30 patients alone, it is not easy to render quality nursing care hence some mistakes and adverse effects will happen. At the same time when you go back home you do not have that job satisfaction then you become overwhelmed and as a result, in most cases, our nurses are stressed  and depressed,” says Monyaki.

Sithole says that when they complain about being overworked to hospital management, they are often told that they are ‘just lazy to work’.

“Nursing is a calling and we are employed to provide healthcare services to patients but we cannot do that properly when we are tired as we hardly take breaks, because there are not so many of us on duty. Most often you might find that a single ward which is supposed to have more than five nurses is being cared for by one or two nurses and that also puts the lives and health of patients at risk,” she says.

Patients

She says TB patients are now housed in the general ward to allow for the few nurses on duty to treat both TB and other patients at the same time. 

Sithole alleges they are being exploited, forced to add cleaning to their duties, and are not being paid for overtime work.

“The worst part is that we are no longer receiving any form of compensation for working overtime as we are told that the department does not have the funds. But over the weekend they also expect us to also clean the facility as hospital cleaners no longer work over the weekend,” she says.

Speaking to Health-e News, Democratic Alliance (DA) Limpopo health spokesperson Risham Maharaj says that they are concerned that the staff shortages in critical occupations in the province continue to decrease the quality of patient care.

“The appointment of critical staff must take precedence over the appointment of ineffective senior management and officials in the provincial health department. The failure by the provincial health department to address the critical occupation vacancy rate and understaffing will result in the further reduction of care in Limpopo,” says Maharaj.

Maharaj says that the filling of critical posts within the department of health in Limpopo should be a priority but is being hampered by the need to reduce spending in the province.

“The failure to fill critical posts leads to overworking the available staff and it is no surprise that the department has R15 billion in contingent liability due to litigation. In most of the litigation against the department health professionals were found to have provided substandard care,” explains Maharaj.

According to the DA in November 2022, in Limpopo the vacancy rates in critical health positions rates were as follows.

• Professional Nurses-40.71%(8754 posts filled out of 14765
• Medical officers-54.57%(1307 posts filled out of 2877 posts)
• Pharmacists-16.82%(529 posts filled out of 636 posts)
• Specialists-76.83%(130 posts filled out of 561 posts)
• Allied Health Professionals-58.03%(1372 posts filled out of 3269 posts)
• Paramedics-79.51%(25 posts filled out of 122 posts)

Maharaj says that they are concerned that nothing is being done to fill the outstanding health vacancies in Limpopo, putting more strain on currently employed health care workers.

“They (the department) always cry poverty when we tell them that there is a gross shortage of healthcare workers,” says Monyaki.

The Limpopo Department of Health failed to respond to our request for comment.-Health-e News.

*Name has been changed.