Since 2022, the Eastern Cape has experienced annual heavy rains that have damaged almost 120 clinics and hospitals.  This constant cycle of destruction and repair of these facilities has strained the already cash-strapped health department’s budget. 

Provincial health spokesperson Siyanda Manana says the severity and frequency of weather events appear to have increased over the past five years.

“The provincial health department has not been spared from the harsh reality of climate change, with coastal districts being particularly affected,” he says.

Destructive weather cycles 

In December 2022,  47 health facilities across five districts were damaged by storms and heavy rains.

Manana says the worst-hit areas included Amathole district where 27 facilities were destroyed, OR Tambo with 10 affected, and Alfred Nzo which saw five facilities damaged. The repair costs amounted to R20 million.

In August 2023 the department reported 78 health facilities across the province were damaged by gale force winds. According to the department, the estimated cost of repairs was R55 million, with the final cost still being determined as restoration work continues.

In June 2024, severe flooding damaged several health facilities across the province. Flooding was particularly severe in the Nelson Mandela Bay and Buffalo City Metros. Some hospitals experienced flooding in specific areas, but remained operational.

“The June 2024 weather damages were declared a disaster, and an application has been submitted to the National Department of Cooperative Governance and Traditional Affairs for funding. The damages are estimated at R128 million, and the department is still awaiting a determination,” he says.

This year, Greenville Provincial Hospital in Mbizana was severely flooded and will be refurbished. Even before the recent floods, the 100 bed facility, established in 1900, was reported to be in a dire state, plagued by years of neglect and insufficient maintenance. The project is expected to cost between R150 million and R200 million.

Manana says that millions of rands have already been spent on the repairs and renovations of the affected health facilities.

According to Manana, the facilities that were damaged in 2022 have been repaired. Recently health MEC Ntandokazi Capa said during her policy and budget speech that R32 million has been budgeted to repair facilities that were damaged in 2023. 

She says 17 affected health facilities in the Buffalo City Metro, Sarah Baartman, Chris Hani and Amathole have been assessed and the procurement assessment will begin in the new financial year to address the damages in these facilities.

Impact on service delivery

The DA’s Eastern Cape health spokesperson Jane Cowley tells Health-e News that unless the province can get conditional grants from the national government it will be impossible to ring fence money to fix the damaged facilities in the short term. 

“The provincial health department has a reduced budget because of all the medical legal claims. There are also moratoriums on many things including a lot of maintenance that needs to be done,” Cowley says. 

“This has a huge impact on service delivery,  a non-functional clinic cannot service the community. This on top of staff shortages and the accruals which were around R8 bn by the end of last financial year. So the department is in a lot of financial trouble,” she says.

Russell Rensburg, director of the Rural Health Advocacy Project (RHAP), stresses that it is critical for the health department to maintain infrastructure. 

“South Africa has seen an increase in extreme weather events recently, and many health facilities have been affected by heavy rains. It is important for the country to begin transitioning towards climate-resilient buildings that are not impacted by extreme weather events,” he says.

He suggests that a critical step would be to review the department’s existing infrastructure and develop a detailed infrastructure plan.

“Underinvestment in infrastructure means that facilities are unable to cope with the pressure of providing adequate health services to those who need them the most,” he says.

A health worker at All Saints Hospital in Engcobo raised concerns after a section of the hospital roof was blown away in 2022.

“Only part of it has been repaired. I don’t know what’s happening with the rest. It’s very frustrating – on rainy days, we have to place buckets around and lay blankets on the floor to stop the flooding. As a result, the blankets meant for patients are getting ruined,” she says.

EC health’s intervention

Manana says that due to the extreme weather conditions being experienced, the department is considering introducing shelters that will serve as waiting areas for patients who have to wait outside of crowded health facilities. 

“However, the implementation of this programme will depend on the availability of the budget in the coming years,” he says.

He adds that, by using contingency plans like providing mobile clinics, the department has continued to offer health services despite the damage caused by severe weather. 

“The department has worked tirelessly to ensure that healthcare services are maintained, even in the face of ongoing challenges,” he says. – Health-e News