/ 20 June 2014

Free State’s ‘collapsing’ health dept needs help, stat

Critics say the NHI will be unsustainable
Critics say the NHI will be unsustainable

Three different ministers have been urged by Section27 and the Treatment Action Campaign (TAC) for drastic and immediate intervention in Free State’s “collapsing” health department.

This follows a recent investigation by the social justice organisation and HIV advocacy group that revealed the department has been out of stock “of more than 200 essential drugs and supplies at the provincial depot, desperate health workers begging for help and stock outs of supplies needed for critical investigations such as electrocardiographies (ECGs)”.

“ECGs monitor heart activity for various medical procedures. Out of stock drugs at the depot include antiretrovirals, antibiotics, pain killers, meningitis treatment, anti-psychotic medication, anti-rabies drugs, high blood pressure medication and epilepsy medicine. Supplies include anti-TB masks for health workers and solution to sterilise theatre equipment. The depot also has no HIV tests,” the groups said in a press release issued late last night. 

Section27 and the TAC have called on the health, finance, co-operative governance and traditional affairs ministers to immediately form a crisis task team and urgently deploy it to the province, and to identify drug shortages and address the human resources crisis.

“Every hour that passes translates into the lost lives of patients, including children. This is not the first time that the Free State has faced such a crisis. We want this to be the last,” the groups said. 

A doctor working at a hospital in Bloemfontein reported to Section27 that the facility was “increasingly running out of essential devices that they need for life-saving procedures”. The doctor said these devices included infusion sets (which connect infusion bags to venous catheters), central venous lines (catheters placed into a large vein in the neck, chest or groin to administer medication or fluids, especially in emergency situations and in critically ill patients) and spinal needles (used for spinal anaesthesia and lumbar punctures to test for, among other illnesses, meningitis).

“Many day and district hospitals are unable to write ECGs due to lack of paper or electrodes (the stickers placed on the chest), but you cannot diagnose a myocardial infarction (heart attacks caused by poor blood flow to the heart) or arrhythmias (problems with the rate or rhythm of the heart beat) in severely ill patients, or start an extensively drug resistant TB patient on Bedaquiline, without writing an ECG,” the doctor said.

Last week, doctors told Section27 that the medical depot supplying the department of health’s pharmacies in the district, which includes Bloemfontein, had no antibiotics left and almost no antihypertensives or antidiabetics. “This would translate into doctors being unable to treat acute infections [such as pneumonia] or to control high blood pressure or blood sugars in chronically ill patients. These patients will sustain complications and damages to their health. While some facilities may still have drug supplies, they will not be able to restock from the depot once they run out,” the groups said.

The TAC and Section27 said they have also been told that “on the human resources front, recent medical graduates [both from the under and post graduate streams] have not been appointed, resulting in them sitting at home or searching for work in other provinces”.

A specialist doctor told them that his “main concern is the health and life of our patients, but I am also worried about the human resource problems that we are accumulating by burning out personnel and losing them to other provinces and countries”.

In the eastern Free State, one hospital stopped performing elective surgical procedures, and non-emergency patients are being turned away because of the lack of funds. And even at the tertiary hospitals in Bloemfontein, elective (non-emergency) operations are cancelled due to a lack of resources, to the detriment of both the patients and the young clinicians who work at the academic centre to be trained in such procedures.

Documents in possession of the TAC and Section27 revealed that on June 11 2014, the provincial depot was out of at least 11 types of antiretroviral drugs used to treat HIV infection, paracetamol, surgical gloves and masks, surgical blades, needles, surgical gauze swabs, and antibiotics. One list had 23 items out of stock and the other 182.

“The above picture is that of a system which has collapsed”, the groups warned. “While we are shocked by all these revelations, we are sadly not surprised. The health system crisis in the Free State dates back at least to 2008/09 when financial mismanagement led to a moratorium on [antiretroviral viral] treatment that cost hundreds of lives.”