/ 18 April 1997

Minister Zuma in Cuban cover-up

The health authorities fudged the damning findings of an investigation into the deaths of four patients at the hands of one of Zuma’s Cuban doctors. Mungo Soggot and Marion Edmunds report

MINISTER of Health Dr Nkosazana Zuma has been implicated in a cover-up of circumstances surrounding the deaths of four patients – including a seven-year-old girl – in the care of a Cuban anaesthetist.

The health authorities cleared the unidentified doctor in March and said he had returned to Cuba after suffering a nervous breakdown caused by sensationalist media coverage.

But the Mail & Guardian has established that eight anaesthesiologists who conducted an investigation into the deaths at the Pietersburg Hospital raised serious concerns about the Cuban’s performance and were astonished at the way in which he was subsequently “cleared”.

The report, which has not been released, was the subject of discussions involving Zuma and the Cuban embassy. It was completed on February 19.

On March 12 the Northern Province MEC for Health and Welfare, Joe Phaahla, was quoted on national TV as saying the report exonerated the doctor.

A press statement issued the same day – under the general heading “The recruitment of foreign doctors” – said of the fatalities: “All in all, because of the sensationalist coverage that this [sic] cases attracted, the affected doctor found himself under such pressure that he could no longer perform optimally and has had to be released from his contract.”

The MEC added that “media people picked on these [deaths] and sensationalised them to discredit the whole Cuban volunteer programme”.

The statement, which implicitly exonerated the Cuban, said: “They [the society’s investigators] were critical of some aspects of the management in the cases.

“But as with all such reports, the reviewers had the benefit of hindsight and it would be next to impossible to have two doctors, especially specialists, agree 100% about the management of any specific case.”

Phaahla told the SABC: “They [the peer review committee] felt certain other techniques could have been used … you know … and they had some comments about which medicines to use …”

The president of the South African Society of Anaesthesiologists – the body that conducted the investigation – Professor Leon du Preez, said this week there was “complete variance between the findings of the committee and the comments attributed to Phaahla”. He declined to comment further.

It is understood Phaahla has refused to discuss the matter further with the society.

A spokesman for Zuma said on Thursday that she had “delegated” the matter to Phaahla, and had been satisfied with the full briefing he had given. Phaahla was not available at the time of going to press.

But Health Department Director General Olive Shisana told the M&G yesterday: “I don’t believe he was exonerated. Certainly the Society of Anaesthetists had problems with him.”

She added that people also died under anaesthetic while they were being treated by South African doctors. “Let’s not focus only on this person’s origin being from Cuba, let us look rather at death by anaesthetists in South Africa.”

The Northern Province Health and Welfare Department’s Director General, Dr Nicholas Crisp, who personally commissioned the report, said he had recommended that the Cuban be sent home after receiving the findings.

He said he did not “feel comfortable” with the anaesthesiologist continuing to practice in South Africa without further training.

“I said [to Phaahla] that we should not renew his contract when it expired and he [Phaahla] accepted … Even if he [the Cuban] was not negligent, he would have had that stigma wherever he worked in the province,” Crisp added.

Questioned about the apparent discrepancy between his and Phaahla’s interpretations of the report, he said: “Politicians will generally word their [opinion] in a way that gets across the necessary content without going into too much detail.”

Crisp said he had handed the report to Phaahla because the MEC had wanted to discuss it with Zuma. “She [Zuma] signed all the Cuban doctors’ employment contracts and wanted to keep in touch …” He said the Cuban embassy was also consulted before Phaahla appeared on SABC-TV and issued his press statement.

Zuma personally piloted the programme to import Cuban doctors, bringing in a first batch of 450 doctors last year to plug gaps in health resources in some of the poorer provinces.

But serious concerns were raised in the medical fraternity about their experience, following Cuba’s prolonged isolation.

The Interim Medical and Dental Council said this week South Africa would not recruit any more Cubans this year as their command of English is inadequate.

Relatives of at least one of the four who died in the Pietersburg hospital are considering civil action against the health authorities.