Former ANC soldier and soccer star-cum-community paralegal Bricks Mokolo is furious after he spent some six hours trying to access Baragwanath Hospital’s x-ray department with an injured employee. Mokolo says Gauteng’s public health system is a disaster that violates basic human rights; civic research backs this up. Now the human rights activist want to make politicians give up private health care, and to start using the system they brought to its knees. By MANDY DE WAAL.
The sun warms a winter afternoon in Orange Farm where 57-year-old Jabuleli Magwaza is packing recyclables into a large truck at the local Human Rights Advice Centre. The Centre was founded by former soccer star and ANC activist Bricks Mokolo, who—now that the struggle is over—dedicates his time to South Africa’s new war – the fight against poverty and the social challenges that burden most people living in the informal settlement started by laid-off farmworkers in the late 80’s.
Mokolo has a recycling plant at the centre he runs, which also educates people on their Constitutional rights, and is the place many in the township bring their legal and other problems to, in order to get help finding resolution. There was a time when people cheered Mokolo on because of the talent he had kicking a ball, but these days, as a community paralegal, his skills are dedicated to trying to help locals resolve problems including retrenchment, not being paid for casual work, or being abused in their place of work.
The centre also acts as a collection depot where people bring glass, used plastic goods and paper that can be recycled. When you arrive at the Human Rights Advice Centre the first thing you notice are the piles of empty two-litre cool-drink bottles and masses of plastic, glass and paper. These recyclables are sorted at the centre, and then loaded on large trucks headed for the various recycling plants. The plastic, for instance, is transported to a processing factory in Vanderbijlpark, where it’s reduced to pellets.
People come from all over Orange Farm to bring bottles, plastic and paper to the plant, and are paid by kilogram for their contributions. For some, the small stipend they receive can make the difference between starvation and bread on the table. In July 2010, Daily Maverick told the story of this centre in Orange Farm in an article called Orange Farm’s struggle that never ends.
Magwaza is one of a handful of people employed at the centre, and is busy loading a truck – helping to get it ready for departure, when an accident happens. She steps onto the truck to put a plastic bag inside, but missteps and falls. She holds her hands out to break her fall, lands hard and injures them.
“I wasn’t there at the time, but I hear she was busy loading the back of the truck with goods to be recycled. Some people were on top of the truck, taking bags from people on the ground. She fell on both her hands and was seriously injured,” Mokolo tells Daily Maverick.
The injury happens at about 14:00 on Wednesday, and Magwaza is taken to the nearest clinic. There she is given a letter to go to the nearest hospital, but mistakenly goes to the Evaton Clinic, near Orange Farm. The queue is long, and the fifty-something woman stands waiting for her time to come for about three hours. At 19:00 she makes it to the front of the queue and is instructed to go to Baragwanath Hospital.
“I found her at her house and it was already 8pm in the evening when I took her to Baragwanath Hospital,” says Mokolo. “We got to Baragwanath before 9pm. We were in the queue for registering for an hour, after which we waited for a doctor. After consulting with the doctor, she was referred to the x-ray department.”
When Mokolo and Magwaza got to the x-ray department it was filled to capacity. People were sleeping on the benches and the floor of the department and its surrounds. “It was shocking,” says Mokolo. “The people had been there for the whole day. One of the staff members I spoke to said he had never in his lifetime been so overloaded with work,” the rights activist says.
When the early hours of the morning started to break, Mokolo left the hospital to return to his family. Magwaza was only attended to the next day, and finally received an x-ray to show the extent of her injuries on Thursday, six or more hours after she had been sent to the department. After the x-rays were done, Magwaza was admitted to Baragwanath and treated.
“When I was at the x-ray department, the other patients were furious. They were so angry. These patients were simply not being attended to,” says Mokolo. “Later I called the Gauteng Premier’s Hotline to complain, but I don’t have hope of my complaint being attended to because there are so very many complaints about the lack of service delivery at hospitals in Gauteng,” Mokolo says.
The human rights activist is spot on – a report conducted by public interest law centre, Section27, in conjunction with the Treatment Action Campaign shows that the Gauteng health system is indeed in crisis. Entitled Monitoring our health: an analysis of the breakdown of health care services in selected Gauteng facilities, the study makes the telling point: “Section 27 of the Constitution of South Africa guarantees the right to access healthcare services; this right places a legal obligation on the government to ensure that access to health is not hampered and to create conditions in which there is progressive realisation of the right to access healthcare services”. The report then goes on to chronicle how these rights are repeatedly violated.
In terms of the study, public health services in Gauteng were monitored from January to December 2012, and the areas in which service was compromised in during this period were grouped into five broad categories, namely: access to medicines and consumables; the availability and maintenance of equipment; the maintenance of infrastructure; adequate human resources; and the training of health professionals and research.
The report states that during the period reviewed, there were “repeated power failures at various hospitals, notably Chris Hani Baragwanath Academic Hospital. In tandem, generators have not been a steady backup and have tripped repeatedly in instances in which they should have provided backup power. This has had predictably serious consequences including the cancellation of many operations (during one episode in a single hospital alone, 40 surgeries were cancelled). The power outages have led to instances in which surgeons operated using headlights and cellphone light.”
It is a shocking report that lays bare how hospital buildings and infrastructure have failed to be maintained; how patients are vulnerable to temperature fluctuations; how there are often insufficient hospital beds for patients in Gauteng facilities; how staff shortages are widespread; and nursing agents aren’t paid on time.
Perhaps most horrifying is information that Section27 and TAC offer on staffing levels. In May 2012 the Head of Department for Health in Gauteng instituted a number of measures “for the purposes of achieving efficiency and accountability of the management of the human resources budget,” the report reads. These measures included the abolishment of all unfunded vacant posts, the freezing of all funded vacant posts and the approval of the HOD required for filling funded posts that were not frozen. In brief, the resultant staff shortages have affected the functioning of the health care system and increased morbidity and mortality because treatment is delayed by the lack of human resources.
“The HR dept tell me that they have applied for more than 100 vacant posts to be filled since the beginning of the year. They had the applicants. Only 5 Registrars posts were approved!” an email to the civic organisations from a doctor read.
“The moratorium has meant that highly skilled specialists such as transplant surgeons applying for vacant posts are being turned away and forced into the private sector. These super-specialists take at least 15 years to train in total. In a country with such a skills shortage, it is unbelievable that this is happening,” said another doctor during interviews at a tertiary hospital.
Since releasing the report, Section27 and TAC have been flooded with emails and calls from health professionals working in the public system that once again verify the crisis. “We still receive complaints related to the same issues we highlight, with respect to shortages of medicines and consumables, broken equipment, and inadequate human resources across primary, district, tertiary and central hospital facilities,” Section27 wrote to the Gauteng MEC for Health, Hope Papo, mid-March 2013.
In April 2013 TAC activists specifically targeted Baragwanath. Health-e reports that 200 protesters picketed demanding better service. “We are tired of the bad service we often receive from Baragwanath, one of the biggest hospitals in the country,” Sibongile Tshabalala, chairperson for TAC in Gauteng tells Health-e. Activists and patients told stories of how many people travelled back and forth wasting money, trying to access treatment.
Back in Orange Farm, Mokolo says that he too has had enough. “South Africa is a country where only the rich have good health care. The government is failing the people at the government hospitals. And everyone is shifting blame to one another,” Mokolo tells Daily Maverick.
But when it comes to who’s to blame, Section27 and TAC don’t mince their words. In their report the activists say the culprits are: (1.) Improper budgeting and financial management; (2.) Poor supply chain management; and (3.) Poor management.
Mokolo believes he has a quick remedy to the situation. “People go to public hospitals because they are sick and are in pain. But if someone’s bones are broken, how can they be made to wait five, six, or more hours for an x-ray? This shows there is no dignity for people who don’t go to private hospitals.
“I doubt that the hospitals would be in such disarray if the politicians were forced only to use the public health service. Government officials must use the hospitals they manage. Even the president or Mandela should go to Baragwanath. There shouldn’t be special privileges for politicians while taxpayers who can’t afford private hospitals die in state facilities. The people of this country need to stand together on this and declare enough is enough.”
The logic is simple. The government is in charge of, and responsible for, SA’s failing public health system. Why should these politicians be treated anywhere else? DM
Photo: Bricks Moloko (Greg Marinovich)
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