For 19 years Professor Ebrahim Variava worked at the hospital that is the Covid-19 designated treatment facility in the province.

The U-turn on the precautionary suspension by Polaki Mokatsane, North West Deputy Director-General of Hospitals and Clinical Support Services, on 15 June, comes after outrage and public petitioning by Variava’s colleagues. It also follows week-long discussions between Variava, the MEC for Health Madoda Sambatha and administrator Jeanette Hunter. The North West Department of Health has been under National Department of Health administration since early 2018.

Variava welcomed the unconditional lifting of his suspension. “I feel vindicated and I have been warmed and touched by the overwhelming support from doctors and patients – it kept my spirits up,” he said of dealing with the suspension that was slammed by some colleagues as “bizarre and bewildering”.

Matter to be investigated

Hunter said that an investigation into the suspension and related matters “would be expanded to include a team of two seasoned professionals to determine whether management/administrative processes as well as the organisational structure contribute to tensions amongst staff”.

She said the investigators would at the end of the process recommend remedial action and a reconciliation process for managers at the hospital. She did not give a timeline for when this would be completed.

Variava welcomed the further investigations that he said would “allow us to move forward and for structural issues that exist to be sorted out”.

He added that a speedy conclusion to an investigation would also help to resolve human resources relations that need attention and give clarity on issues like who takes leads on various initiatives and projects.

‘High-handed suspensions’

Professor Neil Martinson, chief executive director of the Perinatal Research Unit at Wits, who drew up a petition calling for the withdrawal of Variava’s suspension, said Variava’s return to work would restore much needed capacity for fighting Covid-19 in North West.

“There are some lessons to be learnt here. One is that Prof Variava’s case got attention because it is high-profile and he had a lot of support, but we’ve heard about other high-handed suspensions in the province that have not been resolved for months and years,” Martinson said.

Last week the North West Department of Health confirmed to Spotlight that 26 of its employees in the province are suspended. Eleven of these have dragged on for longer than six months “due to the nature and complexity of the investigations”. Among the suspensions are those of five deputy directors and six directors.

Questions remain

Martinson added that questions remain over the manner in which Variava was suspended, including that the suspension came without warning, was made a day before a public holiday and that additional charges were made against him via the department’s Twitter account two days later. These, he said, were not put to Variava formally. He has also called for these tweets to be taken down from the social media platform.

Sambatha’s allegations against Variava, made on Twitter and in a press statement on 17 June, included that he “acted against current Covid-19 guidelines, compromised limited number of test kits and acted in a manner suspicious of unapproved research”. Sambatha at the time also charged that Variava had been “obstructive to management in Covid-19 planning, failed and disregarded administrative protocol, including requesting computers from NGOs and instructing that these be installed in the wards without any approval”. The statement went on to say that Variava had “threatened labour peace” by only testing certain members of the nursing staff and some patients, a decision that apparently upset labour unions.

Sambatha also called out Variava for his “tendency to write emails to external stakeholders such as the media, SECTION27 and different national government departments without any effort to engage internal problem-solving mechanisms or allowing management time to resolve issues”.

Variava however reiterated that clinicians and senior staff are in the best position to flag issues that need urgent intervention and that they have a duty to demand prompt intervention when it comes to having the medicines, equipment and leadership in place in order to save lives.

“I believe in appropriate action and following the channels, but when we’ve done that we can and nothing changes, we should not be afraid to speak out immediately,” Variava said.

Martinson added that even as Variava ended up in the crosshairs of management for raising alarms against flaws and failings in the department, doctors, nurses and healthcare practitioners have an obligation to speak out against the things that compromise patient care.

“The Life Esidimeni tragedy should have reinforced the lesson that doctors and nurses have a responsibility to act not as employees first and doctors and nurses second,” he said. DM/MC

This article was produced by Spotlight – health journalism in the public interest.

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