As the second Covid-19 wave rips through the Eastern Cape and the country, medical oxygen manufacturer Afrox has confirmed that it has invoked the force majeure clause in its contracts with industrial manufacturers to enable it to recall industrial oxygen cylinders to be converted for medical oxygen. 

In a presentation to the parliamentary health committee this week, Dr Sibongile Zungu, acting head of the Eastern Cape Department of Health, said the department had received a letter from Afrox, the sole supplier of medical oxygen in the Eastern Cape, saying its capacity to supply oxygen was under strain and that it had therefore released the department from parts of its contract barring it from procuring supplies elsewhere.

Zungu said this was “a little bit of a challenge at this point because the other suppliers are also stretched. We have engaged our treasury for this work.” Zungu, who is also the head of the Covid-19 project team, said the Joe Gqabi district (around Aliwal North) and Chris Hani District (including Cradock and Komani) were mainly affected.

By 15 December, 4,000 cylinders had been converted.

Zungu said that to cut down on the need for oxygen cylinders the department had commissioned bulk tanks at hospitals including Mthatha Regional, Victoria, Stutterheim, Butterworth, Settlers, St Barnabas, Bhisho and Grey, so that cylinders could be reallocated to other hospitals. 

Installations and commissioning of bulk oxygen tanks at Stutterheim Hospital had been delayed due to copper and component shortages. There had been a delay at St Barnabas Hospital as an access road for contractors had to be constructed. Installation of tanks at Madzikane Ka Zulu and St Patrick’s hospitals were also scheduled to begin this week, depending on the availability of copper components.

There are also plans to install bulk tanks at the hospital in Aliwal North and the All Saints Hospital.

Zungu told Parliament this week that Afrox had to invoke the force majeure clause in its contracts with industrial oxygen customers so that it could convert industrial oxygen cylinders to medical cylinders.

“Bhisho and Settlers hospitals were using in excess of 150 cylinders of 9.2kg… every two days,” she said. 

She said a WhatsApp group had been set up for hospital CEOs to raise urgent oxygen issues.

Zungu said insufficient stock of oxygen and availability of fleet at the Queenstown and Mthatha depots had hospitals sending their drivers to help transport oxygen cylinders. She said there were concerns about drivers’ safety and occupational health and safety requirements. 

As a contingency plan, oxygen concentrators had been supplied to some facilities to enable interventions for patients having trouble breathing while awaiting transfer to facilities where oxygen is available, said Zungu.

“We have provided oxygen concentrators to primary healthcare facilities and district hospitals to ensure that they can do some kind of intervention,” she said.

Afrox communication manager Nolundi Rawana confirmed that Afrox declared a “force majeure” to its industrial oxygen clients in December.

“Due to the large number of hospitalised patients requiring oxygen therapy certain hospitals administer up to 400% more oxygen via bulk tanks and oxygen delivery systems to patients than the designed capacity at the hospital.

“Afrox monitors hospital tank levels nationwide via telemetry (all installed bulk tanks at hospitals have telemetry systems), and schedule deliveries accordingly,” said Rawana.

“In some instances, deliveries are now scheduled twice a day instead of twice a week. This additional demand requires Afrox to have flexibility on bulk delivery tankers to transport the oxygen to hospitals. Afrox allocated a portion of the industrial tanker fleet to medical oxygen tankers to enable fast delivery to hospitals.

“Afrox is also converting additional tankers used to transport other liquid gases to liquid oxygen tankers and will have additional distribution capacity available soon,” said Rawana. 

“Afrox has experienced an unprecedented demand for cylinders due to infection spread and has converted 8,000 industrial cylinders to medical oxygen cylinders. Another 7,000 will be converted to bring the total to 15,000 cylinders. Afrox cooperates with hospitals and the Department of Health to ensure fast turnaround times for cylinders.

Rawana said that the impact of converting 15,000 cylinders meant that Afrox could not guarantee deliveries to industrial customers “during these unprecedented times”.

“The impact is on all manufacturing market sectors Afrox supplies,” she said.

She said Afrox had supplied adequate medical oxygen in South Africa to contracted customers. “Afrox has successfully cooperated with the medical fraternity, and together with the impact of the actions taken above, managed the situation to meet unprecedented medical demand,” said Rawana.

Zungu said that given the demand for oxygen cylinders in the Eastern Cape, the department was thinking of asking the South African National Defence Force to help with the collection of oxygen from Queenstown and transporting it 200km to the hospital in the Joe Gqabi District (around Aliwal North) “in case of our own capacity becoming exhausted”.

She said Afrox had kept its distribution centres open during the festive season and weekends to meet hospital oxygen needs. DM/MC

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