Eastern Cape patients using public health facilities report being turned away, those living with HIV being shouted at, while key populations face hostile services from healthcare workers. 

These are some of the findings outlined in a new report by Ritshidze, which is a coalition of non-profit HIV advocacy organisations. The report was launched on Tuesday this week, during a community meeting at Buffalo City in the Eastern Cape.

The report indicates ongoing staff shortages, disorganised filing systems, limited pick-up points for ARVs, lack of information about access to harm reduction services. 

Key populations – those at higher risk of HIV infection – continue to face harsh treatment from health care workers. They are also unable to get essentials such as lubricants, which are only available in 20% of facilities monitored by Ritshidze.

The report also states that access to harm reduction services such as (methadone and unused needles) remain outside the reach of most of the people they are meant to serve.

Patients turned away from facilities

Monitoring took place at 46 facilities in the Eastern Cape. And 2 514 public healthcare users were interviewed. Fifty-five percent (1 388) of the respondents are living with HIV, and 17% (426) were younger than 25. 

Five-hundred and three patients reported being denied services since 2022 for not having a transfer letter. Close to 300 patients say that they have been denied access to healthcare services for not having identity documents.

“A significant number of people we interviewed also reported being refused access to services in the last year because of being someone who uses drugs, being a sex worker or being a part of the LGBTQIA+ community,” reads the report.

Mavis Mosile* who is living with HIV says that she was denied access to healthcare services for not having a transfer letter. She uses the Central Clinic in Nelson Mandela Bay and was interviewed by Ritshidze in June 2023.

“I came to Port Elizabeth for work from Cape Town where I was initiated on ART. Unfortunately, I was refused ARVs because I did not have a transfer letter and I did not have the contact number of the clinic in Cape Town,” says Mosile*.

She says that due to the issue, she had stopped taking treatment for a while, until one of her friends started sharing her medication with her. This was before a local organisation that works with sex workers came to her rescue.

Alicia Green*, is another patient who has been denied health services in the Eastern Cape. She uses the East London Central Clinic in the Buffalo City Metro and spoke with Ritshidze in August 2023.

“I moved to the Northern Cape and I disengaged from treatment for about eight months because they could not give me treatment there, because I did not have a transfer letter. When I called East London Central Clinic, they refused to send the transfer letter via email as they do not know who they are speaking to over the phone,” says Green.

She says that when she returned to East London she had to explain why she stopped taking ARVs, and why it took her so long to return to get her treatment.

Patients’ privacy violations

Lack of confidentiality is one of the challenges outlined in the report. People with HIV continue to battle in the Eastern Cape. Patients say that they are being shouted at by healthcare workers in the facilities. 

“I lost my clinic card but I knew my return date for my ARVs. But a nurse in the consultation room called me a ‘defaulter’ shouting at me while the door was open. Some of the patients and clinical staff were moving around and they could hear what was going on,” says Mpho Monyaki*. 

Monyaki* gets her treatment at Gompo Clinic in Buffalo City. She was interviewed by Ritshidze in March 2023, and says that she was also kicked out of the facility by a healthcare provider. 

“The nurse told me that ‘she does not have time for defaulters, there are serious people who seek her help’. As she said this she was standing up and telling me to sit outside while she helps serious people first and I was going to be the last,” says Monyaki*. 

Monyaki felt sad, humiliated and disrespected, because she made every effort to visit the clinic early so that she could return to work. 

Little Improvement

There’s an upside. Despite the ongoing staff shortages in the province, waiting times have reduced in the last year in the monitored facilities. The waiting times have reduced from 3:59 hours down to an average of 3:14 hours waiting.

But critical gaps remain. More health workers are needed to ensure high quality services. –Health-e News.

*Indicates a name change.