/ 15 June 2001

N West hospitals falling apart

Roshila Pillay

The budget for the North West provincial Department of Transport, Roads and Public Works has been trimmed to such an extent that hospitals cannot do basic maintenance work.

More than R6-million has been budgeted for professional and special services in Mmabatho, where the provincial government is based. In comparison, only R652 000 and R673 000 have been allocated for professional and special services in the Brits and Rustenburg regions respectively.

These amounts have to cater for these regions’ seven hospitals and surrounding clinics. The maintenance of essential hospital equipment falls within the special and professional services category.

“The bulk of government buildings to be maintained are in Mafikeng Brits is a small area,” says Martin Sebakwane of the Department of Transport, Roads and Public Works.

Jubilee hospital is called “the worst hospital around, closely followed by Odi hospital” by doctors and government contractors. The boilers at Jubilee hospital are more than 23 years old and one was only recently serviced after more than two years.

Jubilee hospital has two incinera-tors to burn waste. One of the incinerators is new and operates on diesel. However, because diesel is too expensive, the older coal-operated incinerator is used.

The maintenance staff at Jubilee hospital and its 23 clinics share one car.

A hospital employee says most of Jubilee’s air conditioners are not working, including those in the pharmacy. Medication has to be stored under very specific conditions and temperatures.

“We often have to throw away large batches,” says the employee.

A hospital representative says: “We are struggling to give citizens a reasonable service. The hospital is inadequate to the extent that we cannot even provide basic health care.”

He attributes the hospital’s deterioration to a lack of maintenance for 10 years.

“For years maintenance work was not done at all this only began in 1996. It costs millions to maintain this hospital alone and there is no money for this,” he says.

The hospital has one laundry machine, one drier and mortuary units that often break down.

As the representative says: “The system is not perfect. Many things are not in order once something is repaired, something else breaks.”

A contractor says: “We decontaminate ourselves after leaving the government hospitals.”

Referring to Jubilee and Odi hospitals, he says: “There is no money to keep them going.”

A state doctor in the province says the condition of Odi hospital is even worse than Jubilee’s.

“The basic problem is that the districts cannot control their cash flow. It’s a case of bad management and poor administrative control,” he says.

The doctor says most state hospitals have outdated equipment and a severe lack of other essential equipment in their operating theatres.

“Machines and other equipment just disappear,” he says.

He says that there are no HIV kits available at the hospitals or clinics and medicine provisions are irregular. As a result there has been a mass exodus of nurses and hospital staff.

The flight of government employees is exacerbated by the termination of district surgeons’ contracts in the North West this week.

Molefi Sefularo, the provincial MEC for Health, says the decision was taken as a result of the racist treatment of patients and doctors’ resistance to transformation.

“Those that wished to remain were given the option of doing so on different terms. Among other things, they will be expected to work fixed hours [and] provide services at public facilities like clinics, community health centres and hospitals. Contracts will be renewable upon satisfactory performance,” says Sefularo.

One of the province’s state doctors says such chronic inefficiencies on the government’s side have affected the province’s poorest people.

State doctors based at clinics are required to refer patients to the hospital closest to the patients’ homes.

“Patients beg me not to refer them to Odi hospital. They give fictitious addresses so they can be referred to Garankuwa instead,” says a doctor.

More than R79-million has been allocated for personnel costs in the Mmabatho region, and R61-million for road and traffic safety.

Government contractors question the decision to allocate such a large amount to the provincial government’s headquarters while other areas in dire need of funds have been sidelined.

There is also a backlog of payments to government contractors.

“They [the Department of Transport, Roads and Public Works] have not even paid most of last year’s orders,” says a contractor. He also says he will not tender for government contracts in the North West province again.

Sebakwane says the budget is a result of consultation with the provincial health and education departments, and his department only “provides a service for them”.

“We consult with them and they indicate to us how to prioritise. Their needs and priorities differ from year to year,” he says.