Mpumalanga’s health department, once viewed as corrupt and inept, is getting back to business.
When Hussein Verachia was appointed head of the department last year he inherited what he refers to as a “dysfunctional department”.
These are polite words to describe the situation he found: accusations of tenders manipulated to benefit friends and family; alleged mismanaged funds; and underspending of the budget.
Verachia’s predecessor, Riena Char-les, and former provincial minister Sibongile Manana were moved to other departments last year, following media exposés of massive corruption. Charles and her brother-in-law have since been charged with fraud and contravening the Public Finance Management Act, and Charles was suspended this month.
When Verachia was appointed, the department was spending only 33% of its budget. By March this year spending had risen to 93%.
Now radio advertisements extolling the virtues of the region’s public health services form part of an aggressive new campaign.
Dr Thapelo Mokola, CEO of Nelspruit’s Rob Ferreira and Themba hospitals, says the department’s agenda has moved from “the confrontational to the developmental”.
Verachia found vacancies and low morale among staff to be pressing issues. So 1 000 posts were advertised and 600 have been filled — 130 with doctors.
One health care facility to benefit from the recruitment drive is Shongwe hospital in the rural Nkomazi district, 10km from the Swaziland border and about 40km from Mozambique. The district is home to about half a million people, but migration from the two countries into the area makes it difficult to estimate accurately.
Shongwe is situated among lush farmlands and exotic-sounding estates and trout farms. But there is nothing glamorous about the poor roads, lack of sanitation or proper water supply and high illiteracy levels that the people in nearby villages experience.
Many work on the farms but even more are unemployed, says Dr Jackie Mncina, Shongwe’s medical manager. Mncina first worked in the hospital in 1997 and 1998 and returned in October 2002. “I heard so many things about it after I left — the shortage of doctors, one problem after another … I had to come back.”
Attracting staff to a largely rural province is a challenge, Mncina admitted but, thanks to a team of young doctors who’ve chosen to stay on after completing their community service, things are happening, in spite of difficulties.
The 350-bed hospital increased its complement of doctors from nine to 22 and there are now 313 nurses. It is estimated that there is one doctor per 6 097 people and one nurse per 1 116 people in the province.
Mncina’s “dream team” last year opened a HIV clinic that operates twice a week; doctors there saw 75 new patients in April. So far it can only provide voluntary testing and counselling services and treats opportunistic infections, but Shongwe is one of six sites in the province that will be providing anti-retroviral treatment.
The clinic has started identifying patients to enrol in its treatment programme.
The provincial health department says there are 165 operational voluntary counselling and testing sites and 112 that offer nevirapine for the prevention of mother-to-child transmission (PMTCT) of HIV.
Jabulile Masuku, who runs the PMTCT clinic, said the programme has been running at Shongwe since September 2001, but the uptake is still low.
Post-exposure prophylaxis (PEP) for rape survivors is also a thorny issue in the province.
Manana evicted rape activist group the Greater Nelspruit Rape Intervention Project (Grip) from Rob Ferreira hospital when she discovered that anti-retroviral treatment was being provided for rape survivors. Grip director Barbara Kenyon says the NGO has returned to the hospital.
Although the province claims that there are 22 healt-care facilities providing PEP, the system is “patchy”, says Kenyon. She notes that Grip is still not allowed to operate in some of the province’s hospitals.
The NGO has the funds to complement health services but, she says, the department has refused to engage in partnerships. — Health-e