The besieged MEC says the fact that protesters are still alive is proof of Free State health’s good work.
Benny Malakoane’s young children were exuberant when they saw their father “all over the news” on television on the evening of July 10 last year.
It was a few months after he had been appointed Free State health MEC and they thought the media were praising their dad for his “good work”.
But the MEC knew that exactly the opposite was unfolding.
That morning the Hawks had arrested him on charges of corruption, fraud and money laundering, crimes he allegedly committed between 2007 and 2010 when he was municipal manager of Matjhabeng municipality in Welkom.
With seven others, including the Free State’s arts, culture and recreation MEC, Nokwanje Leeto, who was the municipality’s executive mayor at the time, he was being accused of receiving kickbacks to the tune of about R13-million for “irregularly awarded” contracts.
The next morning, when one of his three sons arrived at school, some classmates mocked him.
“Your father’s going to jail. He’s a criminal,” they said.
Malakoane recalls: “My boy was crying and I was saying, ‘No, no, I’m not going to jail.’ I explained that there is this presumption of innocence before being proven guilty. And he understood.”
Video cameras and witnesses for “legal recourse”
Malakoane leans back in a black, executive chair in “Boardroom B” in his Bophelo House office in Bloemfontein. He’s dressed in a shiny grey suit with a white shirt, sans tie, and black, pointy shoes.
There are eight of us in the room. Besides the MEC and his spokesperson, Mondli Mvambi, there is another man with a backpack sitting ominously. There is also a woman with a leopard-print scarf and notebook; a leather-jacketed woman toting a video camera; a man in a blue shirt, who seems to be in charge of setting up a tripod; the Mail & Guardian photographer and me.
The MEC came prepared: the woman with the video camera will record our interview for “legal recourse” in case he is misquoted.
“The media can make or break you,” Malakoane says. “It can be an instrument of destruction of individuals. It’s exactly what happened to me. The media have tarnished my integrity.”
He raps his knuckles on the large wooden boardroom table and continues: “The police have been infiltrated. There are certain connections, there are inappropriate attachments. Before I got arrested, I knew in the media that I was going to get arrested … maybe people in the media have access to certain things and plans.”
According to the court register, his next appearance is on August 27 in the Bloemfontein regional court.
Malakoane shifts in his chair.
“I don’t believe it’s government taking me to court, even though we’re prosecuted by the state. The detail of that I would not want to get into.”
A grimace spreads across the MEC’s face.
“What incentive is there for anyone to be pursuing this agenda? Do you know what ‘they’ want to do? They’re trying to get me jailed. Not for a year or two. When you are found guilty on those allegations, you will be jailed for 15 years or more.
“Are you aware what that means? Destruction of your livelihood; you are being destroyed because some people have a particular agenda, which you don’t understand ... I’m normal. I’m a human being. This thing would worry any person against that backdrop.”
ICU controversy denied
I am one of those journalists the MEC is talking about. After all, I was one of the authors of a story about Malakoane, which the M&G published on July 4.
“You know what makes me happy?” Malakoane asks me. “That I see who is this individual who writes these negative stories about me without getting my side of the story.”
In the report, “How a dying woman’s bed was taken by an ANC official”, doctors at the Dihlabeng Hospital in Bethlehem in the eastern Free State accused Malakoane of instructing them to “create” an intensive care unit (ICU) bed for an ANC official, who, in line with national clinical protocols, did not qualify for one, because his chance of recovery from the chronic illness he was suffering from was extremely low. This, the doctors said, was at the cost of other patients, with far better prognoses, who had to be turned away.
“No other ICU in the country would admit a patient like that, especially over other patients we could more likely save,” a senior doctor at Dihlabeng told the M&G at the time.
Dihlabeng had only three ICU beds. A fourth one had to be created for the official, whose identity was known to the M&G but couldn’t be revealed because of patient confidentiality.
On a Saturday morning in June, the doctors said, an instruction from Malakoane was delivered by deputy director general Teboho Moji to the clinical manager on duty at Dihlabeng: an ICU bed had to be opened “because the MEC has promised family members the patient would go to ICU”.
According to the doctors, two other critical patients, one with a mild heart attack and another with burn wounds, had already been turned away from the ICU on the Friday night because of space constraints.
The ANC official died a week later.
Other than accusing the M&G of being on a witch hunt, Malakoane did not respond to several requests for comment at the time.
But today he wants to talk. He shakes his head. “That’s another allegation which was grossly uninformed,” he says. “Do those doctors know what I look like?”
Malakoane said it was a “blue lie” that he had told the patient’s family he would secure an ICU bed for their relative. “I didn’t even know the patient’s identity or that he had been transferred to ICU. I learned that, and his political affiliation, from you,” he insists.
What really happened, according to him, was that he made an unannounced, routine visit to the nearby Phekolong Hospital in Bethlehem, which did not have ICU beds. “All I did was to ask [medical personnel] to isolate the patient, who appeared to be in a coma, to prevent psychological trauma to the ones next door.
“That he was moved from that hospital [Phekolong] to another hospital [Dihlabeng], I also learned from you … My only belief is that it was at that doctor [on duty]‘s discretion to transfer the patient to Dihlabeng … There was no wrongdoing from my perspective.”
But doctors at both hospitals are adamant that the MEC is “blatantly lying” and that there was a “clear instruction” directly from Malakoane through Moji.
Malakoane studied medicine at the Medical University of South Africa. “I’m not a lay person. I know what patient care is about.”
For the past year, Malakoane has been the subject of a campaign by the HIV lobby organisation Treatment Action Campaign (TAC), calling for his resignation because of what the it considers to be an extremely badly managed, “collapsing” provincial health system.
Investigations by the pressure group Stop Stock-Outs Project in the Free State have found that the provincial health department has the worst drug stock-outs in the country, with more than half of the facilities surveyed running out of drugs over a two-month period in 2013.
Earlier this year, the social justice organisation Section27 found stock-outs of more than 200 essential medicines and supplies at the provincial depot in Bloemfontein and interviewed several “desperate healthworkers begging for help”.
But Malakoane’s department has labelled these investigations and analyses as “opportunistic, mischievous and unscientific”. “[The TAC] are largely people who are unguided and misinformed about what’s going on ... They call me a killer when I know I’m a saviour of life. Because that’s me; that’s my profession,” he says.
“On the other hand, [the TAC’s actions] epitomises the success of [the provincial health department’s] HIV-treatment campaigns. If those are self-confessed HIV-positive individuals [and they can demonstrate], it means our treatment is so accessible and available to them that they are able to hit the streets in the manner that they do. They have energy, they have vitality, which is music to me. I see health outcomes alive.”
According to the TAC, many of those participating in its marches are not HIV-positive but health activists, and some of the 2?200 Free State community health workers, whose employment was ended at the provincial health department’s behest earlier this year.
Malakoane insists that the white-and-purple HIV-positive T-shirts that many TAC protesters wear are proof of their status. He slides his hand across his chest. “They write here HIV positive.”
Protests are proof of the department’s success, says Malakoane.
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HIV drug stock-outs are often “misperceptions”
Malakoane is adamant that the drug stock-outs are often misperceptions. For instance, HIV patients who have been switched from a three-drug combination to the government’s new three-in-one antiretroviral pill are confused about the amount of medication they should receive. “People no longer get three packets, they get one. That’s where the gripe was,” he says.
But it is not only health activists who have found fault with the provincial health department. In July, the M&G reported that the department was placed under the financial administration of the provincial treasury to deal with “the nonpayment of critical medicines and medical suppliers in the province”, according to an email from the chief director of provincial budget analysis in the national treasury, Edgar Sishi, to the civil society group, the Budget Expenditure Monitoring Forum.
According to the forum, the provincial health department has racked up R700-million in debt, dating back to the department’s financial crisis in 2008-2009.
But Malakoane says that is exactly the point: the problems started long ago, during his predecessors’ reign, and he emphasises that he has been health MEC for just over a year.
“I was the very first to take a stance and say, ‘I’m not going to let this happen during my tenure’ … that’s why I escalated the condition of the department, even prior to the financial year starting, to the [health] minister.”
Health Minister Aaron Motsoaledi also intervened in the Free State department last month and assisted with procurement.
Malakoane says his assessment of his department’s problems has revealed that the biggest problem was with “consequence management”.
“People were getting away with things, with wrongdoing. They did things with impunity. But in my tenure, that’s not going to happen. People will account.”
But, according to the TAC’s provincial chairperson, Sello Mokhalipi, who is leading the campaign against the MEC, the “biggest problem” with Malakoane is that he is in fact not accountable himself.
Mokhalipi told the M&G two weeks ago that he had received several anonymous death threats over the phone and, he says, on two recent occasions cars followed him and his colleagues. On one occasion, he says, the cars tried to force them off the road. He claims the “intimidation and aggression” started shortly after he began exposing the “wrongdoings” of the health department.
Malakoane responds that Mokhalipi gets “a sense of satisfaction” from being “vindictive to vilify or insult me in public …” because the provincial Aids council, which works closely with the health department, “fired” Mokhalipi last year “due to absconding”.
“I get the impression that he insinuates that it’s me who is involved in the alleged road incidents. I have never heard of something so laughable. What is he, or who is he, for me to want to kill him?”
It is unfair, Malakoane insists, to expect him to turn around a malfunctioning department in just 12 months. He needs more time.
“You need to have a thick skin to be able to endure that which goes with the profession one is in, especially the public sector. I always tell my officials it’s a thankless profession.
“The greatest of all [my achievements] was to make my children understand why their dad will be like a dart board where everyone would throw any form of dart on him and why they should not be hurt by that because it’s all in the game.”
He seems to contemplate this for a while, then continues speaking.
“You can tell the Free State public the department of health is not collapsing. We may have gone through challenges – a ship sailing in the rough seas, but not sinking. The seas have calmed down. We are literally back in business.”
He rises from his chair and walks to his office: “People need to know I’m a person of flesh and blood. I’m just a normal township boykie from Kroonstad.”