Fear over a lack of personal protective equipment (PPE) at clinics and hospitals in the Nelson Mandela Bay clinic has sparked a number of protests as the health department admits they have received reports that managers were “hoarding” masks and gloves for when the “real outbreak” comes. 

Spokesperson for the Democratic Nurses Union of South Africa, Khaya Sodidi said a number of nurses have already been infected and staff are struggling to access PPE at hospitals, and clinics in the metro. 

“The managers are telling them that the PPEs are for ‘when the outbreak comes’. We were shocked to find such a great lack of training under managers and even health staff in the use of PPEs and how they can spread the virus with gloves, for instance, if they are not using it correctly,” said Sodidi.

This comes as Minister Zweli Mkhize announced that the Eastern Cape now has the third most cases in the country and has surpassed KwaZulu-Natal in terms of the number of confirmed Covid-19 infections. With 148 new cases, the province now has 1,504 patients who were confirmed as infected with the virus. South Africa currently has 11,350 confirmed cases. 

Eastern Cape Department of Health spokesperson, Sizwe Kupelo said they were confronting these misunderstandings with the managers because PPE has been delivered to most facilities.

“Personal Protective Equipment has been made available throughout the province and some corporate companies, and individuals have donated as well. It would be wrong for managers to become stingy with much-needed PPEs, we cannot send front-line soldiers to a war without ammunition. The Minister of Health, Dr. Zweli Mkhize, himself made sure that 1.5 million masks and gloves were sent to the metro,” he said.

The department is also investigating claims that staff were forced to keep a Nelson Mandela Bay clinic open after a pharmacy assistant there died of Covid-19. The staff were told they could only self-isolate once they had received their test results. Staff were also forced, due to perceived PPE shortages, to wear the same masks and gloves while seeing hundreds of patients.

By 11 May 2020, 11 staff members had tested positive for the Covid-19 with more results coming.

The clinic sees up to 500 people a day. The Department of Health closed it on 11 May, 12 days after the pharmacy assistant died.

Kupelo said the operations manager had not reported a shortage of PPE to the department of health, only a shortage of hand sanitiser.

He said there were 43 staff members at the clinic. Of these, 41 have been screened and tested and 11 were positive. Those infected include four nurses, two general assistants, another pharmacy assistant, a physiotherapist, a counsellor and a security guard.

“We have a serious shortage of personal protective equipment. We do not have enough gloves or masks. We wear one mask for the entire day and there are more than 500 patients coming in and out from different communities per day. This is a serious risk to us and the patients.

Kupelo said on 29 April 2020, one of the pharmacy assistants complained that she was not feeling well. She went home and died the next morning. She tested positive for Covid-19.

According to a report drawn up for the department, the staff members were referred for debriefing to the Employees Assistance Unit. They were not helped. Social workers at an NGO and the Rape Crisis Centre were asked to assist with debriefing, but they have withdrawn their support.

The building and grounds were decontaminated on Monday.

Mziyanda Twani, from the South African Federation of Trade Unions, said: “We have a serious shortage of personal protective equipment. We do not have enough gloves or masks. We wear one mask for the entire day and there are more than 500 patients coming in and out from different communities per day. This is a serious risk to us and the patients. 

“We screen people for Covid-19 with only plastic aprons and these overused masks and gloves. And then some of these patients are later found positive.

“At Zwide clinic a few weeks ago, a staff member went home feeling tired and exhausted, took a nap, and she never woke up. She was later found to be Covid-19 positive. 

“The staff demanded that everyone be tested for Covid-19 and that the entire clinic be deep cleaned… the cleaning company only cleaned the room that the deceased staff member had been working in… They did not clean the entire building. This took place last weekend. And the rest of the clinic staff had to go straight back to work on Monday and work as normal, even though they did not yet know the results of their tests.

“On Thursday, 7 May, results started coming in, confirming that one staff member was positive. On Friday, 8 May, all health unions asked the district to close the clinic, send staff home until they know their results, and to bring the disinfecting team back to clean the whole clinic.

“In response, the district issued a new Standard Operating Plan which says all health workers who have been tested for coronavirus must continue to work until they get their results – even if they have been in direct contact with a Covid-19 positive patient.

“This means all employees who have not yet received their results will be forced to go to work. This plan ignored the regulation that says should an employee be in direct contact with a coronavirus-positive patient, they should remain home till they get their own results before returning to work.

“By Saturday, 9 May, a total of 11 staff from Zwide clinic had been found to be positive. There are more Zwide clinic staff who are still waiting for their test results. We do not know if the number of positive Zwide clinic staff will increase even more. 

“Our belief as combined health unions is that should any clinic staff member test positive for Covid-19, the staff must be tested and at least given a chance to isolate and the facilities must be entirely cleaned. Staff must only come back when they have tested negative.”

She said that after their demands, the building was cleaned and the clinic was closed.

“There is an agreement that they will clean the whole building and also outside the building.”

She said there was an agreement that PPE will be delivered (once the clinic has reopened), and that they will be allowed to check and see if it was the right type of equipment. 

“We have also received a promise that the district office will be held accountable for the plan that forced staff members to keep the clinic open,” she said.

Following a protest at the Zwide clinic, nurses also went on strike at the Uitenhage Provincial Hospital over a shortage of PPE.

“They have the same complaint. The PPE was delivered to the hospital, but the managers are saying they must keep it for the outbreak,” Sodidi said.

The chairperson of the District Health Forum in Nelson Mandela Bay, Thembisile Nogampula, said the situation at Zwide clinic was completely unacceptable.

“We are still being locked up by government as the district health office won’t give us a permit to do oversight,” he said.

“People are struggling to access their medication. Old people have to stand in the wind and cold for hours to wait for their pills. Last year, the provincial health portfolio committee was here. I have written to them now and said, you are failing us. They say there is nothing more they can do. They made recommendations. I said, ‘Your oversight achieved nothing.’

“The district health office only calls when they want us to speak to the communities. The health system is now close to collapse. This lockdown is very horrible. If we can go back to work as clinic committees, we can convince our communities on what must be done. We can teach them about physical distancing. We can take a stand. We want to join the staff in solidarity. 

“We are proposing that they allow us to go to the communities with a plan to look for HIV, TB and Covid-19. This is a major concern for us. All the focus is on Covid-19 when we know that we haven’t won the battle against HIV and TB yet. It is the TB and HIV illness that will kill our people.

“We have had training… we know what to say. Instead, we are locked up at home.

“In Nelson Mandela Bay, they have no clear direction on what needs to be done – we will be able to convince our communities – and talk to them when they arrive.”

On 23 April, during a visit to Nelson Mandela Bay, Minister Mkhize announced several interventions for the health district that currently has the highest number of infections in the province. 

Mkhize ordered that a senior member of the department’s head office in Bhisho be seconded to Nelson Mandela Bay. At the time, the metro did not have a permanent district health director, but Dalene de Vos was subsequently appointed. Dr Litha Matiwane, the head of clinical governance for the province, was sent to take over the leadership. DM/MC