Steuart Wright in East London
EASTERN Cape health officials, battling to form a unified administration, are being distracted by constant firefighting as the health system crumbles around them. But they are coming up with some innovative ways to cope with the situation.
In recent weeks senior health officials have been forced to run from one crisis to another. These include:
* Patients at Holy Cross Hospital in Flagstaff were left to fend for themselves when hospital staff downed tools to protest a doctor shortage.
* Pharmaceutical supplies dwindled in Transkei and the former eastern province.
* Hazardous medical waste was illegally dumped on a public disposal site in East London.
* Seven district surgeons resigned in Humansdorp after the new administration was unable to meet their demand for payment in line with private-sector rates.
* Investigations were launch-
ed into the abuse of state medicines by at least two district surgeons.
* Reports of a long-standing lack of adequate water, electricity and communications flooded in from many Transkei hospitals and clinics.
* Armed guards and soldiers had to be posted at some casualty wards to protect staff and patients.
Bisho health spokesman Khululekile Bata says the chaos crippling clinics and hospitals in the former Transkei is exaggerating the perception of disarray in the province.
“Health in Transkei is in itself a disaster area facing collapse, along with a whole lot of other services. That is what motivated the ANC to call for the region to be declared a national disaster area at its national congress,” he says. Among reasons he gives for the Transkei catastrophe are strikes, a lack of funds and infrastructure, and maladministration under the previous dispensation.
Bisho was lumped with several other health bureaucracies and their 1994/95 budgets. Bad budgeting has seen medicine supplies in Transkei dwindle. This is also at the root of the lack of medicines in what used to be the Eastern Province, says acting Cape Provincial Administration (CPA) regional health director Dr Pat Naidoo.
Most hospitals in the area are still under the control of the Cape Town-based CPA. With the redrawing of provincial boundaries, “the CPA department of finance unilaterally took control of our pharmaceutical stores. These are our stores, our staff, our drugs and our patients. Supplies started drying up and nothing was forthcoming from the Western Cape.”
Naidoo says a computer network is being installed to control medicine distribution and a meeting is scheduled with CPA top brass to discuss the “disaster, which goes to show that centralised control doesn’t work”.
Bata says senior managerial posts should be filled in a unified health structure by March and a single budget formulated this year. But he cannot say how much money is needed to tackle the crisis.
An overhaul of the bureaucracy and budget will not solve all the health department’s problems, however. Unless the reconstruction and development programme starts rolling, the shortage of clinics and good road, electricity and telephone links to rural areas will continue to hamper health-care delivery.
In order to address these problems, the health department has drawn up a list of RDP priorities, but it is eagerly awaiting the programme’s implementation.
While it waits, it is coming up with innovative ways to overcome some of the difficulties in delivering health services to Eastern Cape communities.
When health MEC Dr Trudy Thomas heard there was no water at one Transkei clinic, telephones were down at another and medicines were not being delivered, she called in the army. The South African National Defence Force delivered tanked water to Nqamakwe Clinic, provided communication equipment at Isilimela Hospital and used four-wheel-drive vehicles to help distribute medicines.
Provoked by another crisis, Naidoo has established a pilot project for district health supervision in Humansdorp, where the seven district surgeons resigned late last year. “We replaced them with two full-time doctors and amalgamated the services of the local authority, the regional services council, the CPA and national health to form a district model which we estimate will cost half of what we would have spent,” he says.
Naidoo says hospital doctors now do all medical legal work and he has roped in private practitioners by allowing them to use the hospital for private patients on condition they do public work too.
He says the scheme has won the support of health workers and members of the community who need only attend one clinic or hospital for treatment. Following its success, he hopes it can be implemented elsewhere in the province.
These quick-fix solutions have done little to alleviate the larger crisis, which the department says can only be solved by a unified administration. — Ecna