/ 28 November 2013

Fresh woes for dodgy doctor

Another complaint has been filed regarding Dr Allick Msebe Dube, who currently acts as the senior clinical chief executive officer at Messina Hospital in Musina, Limpopo.

On Tuesday, the international advocacy organisation Aids-Free World, which is headquartered in Canada but works internationally, filed an official complaint with the Health Professions Council of South Africa citing concerns that Dube may have fraudulently obtained his South African medical licence, demanding immediate revocation of his licence, and offering new evidence regarding his criminal past. Publicly obtained police records outlining Dube's criminal history were included in the complaint.

As the Mail & Guardian has previously reported, Aids-Free World's complaint notes that Dube only served three years of a 15-year sentence after pleading guilty to involuntary manslaughter in 2004. He was also banned from practising medicine in the US for 10 years. Dube was released after three years in jail on the condition that he would be placed on parole, meaning that he would "not change [his] present place of abode, move outside the jurisdiction of the Court, or leave the State [of Georgia] for any period of time without prior permission of the probation supervisor" for the remaining 12 years of his sentence, according a warrant for his arrest for parole violation issued in July of this year, and obtained by an Aids-Free World staff member who visited the Douglasville County Clerk's office in the state of Georgia. Despite being legally required to remain in Georgia for an additional 12 years in order to complete his parole, in 2009 Dube was working in Ethembeni Clinic in KwaZulu-Natal before taking up a post at Messina Hospital.

Aids-Free World learned about Dube while conducting a site visit in Limpopo earlier this year to look into high rates of rape on the Zimbabwe-South Africa border. Because of a series of complaints by hospital staff and patients about Dube's clinical competency and his treatment of staff, the organisation decided to undergo an independent investigation into the matter.

Aids-Free World also notes that US public records show that Dube's medical licence expired in 2002, but that he obtained a South African medical licence in 2009 without an exam. "We are confident that Dr Dube either received his South African medical registration through fraud or in error," Seth Earn, legal advisor for global advocacy at Aids-Free World, told the M&G. "While we have not yet seen the documents he provided to the HPCSA upon filing for registration in South Africa, we suspect that he did not disclose his criminal convictions and hid the fact that he was no longer a foreign-qualified doctor. If that was the case, then his licence was fraudulently obtained, and the relevant government authorities should also be held accountable for not conducting a thorough background check. If Dr Dube's background was already known to the authorities then the fact that a known convicted felon on parole was waived through the licencing procedure is unacceptable, and would clearly be a concern to all South Africans."

Health department 
As his licence was obtained through the help of a national fast-tracking programme to register foreign doctors, run by the department of health, Aids-Free World sent a copy of their complaint to the minister of health. Despite the M&G repeatedly asking for comment from the Ministry of Health spokesperson, Joe Maila, no response was given. Earlier this month, when asked whether the national health department would intervene in the matter, Maila said, "in this particular case it is something that falls within the ambit of the provincial department of health. We will hear from them what they have done or not done….from that we will see what course of action to take."

Responding to Aids-Free World's complaint, Bertha Scheepers, national spokesperson for the HPCSA, said "These allegations are of a serious concern to the HPCSA.  Due legal processes are being followed and the Council is conducting its own investigation, including contacting our sister bodies in the USA to obtain further information." The Council is responsible for registering, and de-registering, all doctors working in South Africa.

The Aids-Free World complaint comes on the backs of many other complaints issued by individuals and organisations. In May, Nehawu organised a strike at Messina Hospital that was attended by hundreds of staff who called for Dube's ouster and cited concerns over Dube offering inadequate medical treatment, refusing treatment to foreign patients, and harassing foreign doctors. Dube was temporarily put on paid leave before being promoted from clinical manager to his current position of senior clinical chief executive officer, the hospital's highest position. After the strike, a task team was appointed by the province to look into myriad issues at the hospital, and wrote a report of their findings, which has not been made public. While four Nehawu members working at the hospital were dismissed for inciting unprotected strike action, no disciplinary action has been taken against Dube. According to Nehawu, the MEC for health, Dipuo Letsatsi-Duba, has promised to visit the hospital to discuss the matter further, but after an initial visit, has not yet returned. "No further disciplinary action is considered against Dr Dube," said Adele van de Linde, spokesperson for the Limpopo department of health and social development. "He was suspended pending the outcome of the [task team] investigations. He was reinstated and the [task team] report has not recommended any further action. The allegations made by staff was investigated by the task team and the findings are contained in the report….The MEC will visit Musina when her schedule allows." As the Nehawu members have appealed their dismissal, they remain working at the hospital.

Trial by media 
Responding to the submission of the Aids-Free World complaint this week, van de Linde said "we regard the issues as allegations that have to be verified and investigated. As a department we are not going to conduct any trial in the media. The documents received will still have to be verified for their authenticity. If there is such a warrant of arrest, logically the matter will be dealt with by the relevant and competent courts that know the international protocols and procedures to execute orders."

The medical humanitarian organisation Médecins Sans Frontières, which provides support to rape survivors at the hospital, filed complaints with the hospital in March, and the HPCSA in May, alleging that Dube refused care to rape survivors, did not give post-exposure prophyaxlis to some victims–which can help to prevent HIV, and was not aware of or did not follow national guidelines. The organisation says that it is still waiting for an adequate response from both.  In an email to community members, media, the HPCSA, and the provincial department of health written earlier this month, Avril Benoit, the organisation's Musina project coordinator, said, "The Limpopo department of health and the HPCSA have failed to communicate any concern whatsoever about his victims."  

Meanwhile, the Hawks are currently investigating corruption in the health sector in Limpopo. "We are looking at the province, but it takes us to individual hospitals," said spokesperson Paul Ramaloko. "We are looking into possible allegations of fraud at Messina Hospital." When asked whether Dube was part of the investigation, Ramaloko said, "we won't mention individuals now because they haven't been taken to court. We will only mention them once we have taken them to court."