Jim Day
THE Eastern Cape provincial government may often take flak for slow delivery, but the zeal of its clinic-builders has now produced another headache: in deep rural areas of the former Ciskei and Transkei, 20 brand-new and fully equipped clinics stand empty as the province frantically searches for nurses to operate them.
A shortage of doctors, nurses, pharmacists, social workers and vehicles has long plagued the Eastern Cape’s rural health facilities and has been compounded by voluntary severance packages. Rural clinics, to be effective, need a minimum staff of eight nurses, say experts. But shortage of money and staff means the province’s new clinics will have to settle for half that number.
Clinics spearhead the Health Ministry’s drive to get health-care to the masses – shifting resources away from central hospitals to primary health, particularly in previously under-resourced regions. The programme, running since 1995, aims to erect 100 new clinics in KwaZulu-Natal, 135 in the Northern Province and about 60 in the Eastern Cape. Each new clinic is expected to serve 10 000 people. But that, of course, hinges on finding staff.
The Eastern Cape has been advertising posts over the past three months, without success and is now looking outside the province to attract nurses. A provincial health department official says that another 64 clinics have been upgraded, and in many cases need extra staff. And another 33 new clinics, in the rural Transkei and Ciskei, are near completion.
The remoteness of the clinics, poor roads, ongoing faction fighting and stocktheft wars in the northern Transkei have long been off-putting to potential employees.
The Eastern Cape Health and Welfare MEC, Dr Trudy Thomas, has told the legislature that the province needs to offer “special incentives” to encourage nurses to go to rural areas. Her department is also planning to stop voluntary severance to some health workers, after admitting that the exodus means “services are collapsing”.
Thomas said the rural clinics had been completed ahead of schedule, which had caught the department without staff to fill them.
Similar problems exist in the Northern Province, but the Eastern Cape’s woes nevertheless surprise the national Health Department. The Deputy Director General for Policy and Planning, Dr Ayanda Ntsaluba, said that clinics are not supposed to be built without guarantees from provincial departments that operating costs can be met. The clinic-building has been accelerated since early last year, after it emerged that little of the R95-million funds allocated from the Reconstruction and Development Programme had been spent. If the money had remained unspent, the department would have lost it.