Paul Kirk
Nurses chanting freedom songs took to the streets in the Eastern Cape last week, demanding the axing of the head of the South African National Tuberculosis
Association (Santa) the largest organisation responsible for fighting the disease.
The Eastern Cape is one of the areas hardest hit by an “epidemic” of tuberculosis (TB) that is sweeping South Africa’s rural areas.
The nurses and their union, the National Education Health and Allied Workers’ Union (Nehawu) wants the chief executive officer of Santa, Dr Andrew Ratsela, dismissed.
Last year the Mail &Guardian reported that Ratsela had awarded himself a salary package of more than R500 000 a year. Ratsela works at Santa two days a week as he runs a private medical practice as well.
News of his exorbitant salary first came to light when John Budge, a
member of Santa’s executive committee raised the issue at the organisation’s annual meeting last year.
Budge said this week: “Since the first article published in the M&G, an investigation has been launched into finances at head office. Since last year Ratsela has employed a typist for R180 000 a year as well as a hefty car allowance. I have also heard that he has overspent by R75 000 on his Santa credit card which has a limit of R50 000 a year.”
Ratsela declined to comment on his salary or on any matters relating to finances at Santa. He said his lawyer had advised him to keep quiet about his earnings and the investigation.
Budge says: “Santa’s money comes from the taxpayer and from little old ladies and concerned citizens who collect money for us on street corners. The public has a right to know what the money is spent on. We are facing a crisis at the moment and we need to conserve scarce resources.”
The national Health Department declined to comment, saying funding to Santa was directed through its provincial offices.
Santa is facing increasing financial difficulties due to an increased caseload.
According to Dr Bernard Fourie of the Tuberculosis Research Programme of the Medical Research Council (MRC), HIV and TB are the most serious infectious diseases facing South Africa at the moment. According to research by his programme, South Africa is facing the worst TB epidemic yet.
Last year alone over 250 000 new cases of TB were recorded and nearly half of these cases were people also suffering from HIV/Aids.
According to the MRC more than half the total number of TB cases can be directly attributed to the HIV/Aids epidemic. The case-load is expected to increase by five-fold or more by 2005, but already South Africa has 15% of Africa’s caseload of TB.
The incidence of TB in the Eastern Cape, Western Cape and parts of KwaZulu-Natal are double that of the rest of the country. These areas have the least resources to fight the scourge.
And, in the Eastern Cape especially, the government’s latest scheme to fight TB appears to be making the situation worse.
Traditionally TB sufferers were hospitalised for six months at hospitals run by Santa. At the end of the six months they were completely cured and during this period Santa taught destitute patients trades that they could use to earn an income. Cured patients were thus returned to the community with skills to improve their standard of living.
However Dots the current scheme being used to fight TB sees patients hospitalised for two months and then released to finish their treatment at home. Members of the community are identified and given the task of observing the patient to ensure they finish their course of treatment.
However, Budge, who is also head of the municipal Health Department in Kokstad, said the system is failing dismally in the poor communities around the Eastern Cape and parts of KwaZulu-Natal.
“If the course of treatment is not completed then the patient has to come back to hospital for another course. After two months they are again discharged to complete their course of treatment at home. If once again they do not complete the course they may contract multiple drug- resistant TB. This form does not respond to treatment and is fatal.”