The fact that the Charlotte Maxeke Hospital in Joburg is still closed is adding fuel to the fire, with anger mounting over the government’s inability to reopen it. This may well be the worst crisis that the Gauteng Premier David Makhura has faced, Life Esidimeni included.

Makhura has used dramatic language to illustrate the situation that his province is in. He said on Monday afternoon that the province “was on fire”, and that in Gauteng, the “pandemic is out of control”. He also railed against the fact that shops, football fields and restaurants “are full… are packed”.

He has also appealed to people, again, to change their behaviour, to prevent the virus from spreading so fast and in such a deadly way.

Speaking while welcoming SANDF personnel to Gauteng to help in hospitals there, Makhura also said that the Gauteng Provincial Coronavirus Command Council will meet on Tuesday and that it will consider recommending tighter restrictions for Gauteng.

But Makhura was also careful to remind his audiences that only the Cabinet can approve tighter restrictions, even if it is just for one province.

The nature of the crisis in Gauteng shows that some kind of drastic action may be necessary. But to have one province under much tighter restrictions than other provinces has not yet been tried before.

And Gauteng may be the worst possible province to try this approach with. It is landlocked and borders four of the country’s eight other provinces. There are also multiple transport links between Gauteng and the rest of the country (and Africa), which would make any kind of differentiated approach difficult to police.

And it may be foolish to create any kind of incentive for some people to break the law. Or, to put it another way, to ban the sale of alcohol on weekends in Gauteng may just create a massive illegal market involving the transport of alcohol across the provincial border on weekends, and plenty of crime to go with it.

At the same time, it is not clear which further restrictions on movement may actually work.

The number of new cases now being announced in the province is a predictor of how many people will require hospitalisation within the next week or so. But the new cases are people who are already infected. There are some predictions that Gauteng is in fact already at the peak of new cases and has yet to reach its peak of hospitalisations.

This means that Gauteng is in the awful position of knowing that the number of people who will need treatment will go up and that it is probably too late to impose new restrictions.

Worse, if people in Gauteng are aware of that assessment, they may just ignore the restrictions if any are imposed.

In the meantime, there is the situation on the ground that Makhura has to deal with. While it is obviously about helping patients, there is an inherent layer of politics within it.

One of the pressing concerns is that the Charlotte Maxeke Hospital, with its Intensive Care Unit and Covid-19 beds, is still shut.

This is despite the evidence that the recent fire there has not caused any damage which could result in harm to patients. Rather, the Gauteng Health Department says it cannot reopen the hospital because it does not comply with health and safety standards.

Time and time again, the Gauteng Provincial Government spokesperson Thabo Masebe has been asked in radio and television interviews why this is the case.

He has said that the hospital cannot reopen because officials cannot find the original plans for the institution. Then he said that they had to build new fire doors and that these have to be built from scratch. In yet another interview on 702, Acting Health Minister Mmaloko Kubayi-Ngubane said that the original plans for the hospital had never been filed with the municipality because the hospital had been deemed a National Keypoint under apartheid legislation.

On Monday, Masebe went as far as to say on SAfm that Makhura has got a legal opinion saying that he does not have the power to unilaterally open the hospital.

This immediately raises questions about the role of the City of Johannesburg here, if indeed the city itself is the stumbling block. So far there has been silence from mayor Geoff Makhubo, who has meanwhile been diagnosed with Covid-19 himself and is in isolation.

The present bind, that beds cannot be used because of a potential problem at the hospital (against which other precautions could be taken), also raises the question about why the hospital was still open before the fire? Obviously, if it is not safe to open the hospital now because there are no plans, then it was not safe for it to be open before the blaze engulfed it.

There are other questions to ask about other hospitals. If the Charlotte Maxeke Hospital was a National Keypoint during apartheid, what about other hospitals? Do their plans exist? If they do not, does it mean that other hospitals are also operating illegally according to the laws of the new South Africa — and what will be done to fix this?

The symbolism of this could not be worse for the ANC.

The government has declared this year, 2021, to be the “Year of Charlotte Mannya Maxeke”.

And yet the hospital which bears her name is not being used when there is more need for it than at any time in the history of the city and the province.

In the middle of this is the apparent silence of the Gauteng Health MEC Dr Nomathemba Mokgethi. She has not given interviews during this crisis and has appeared in public only twice. Once was during her budget presentation in the Gauteng Legislature, the second was on Monday, alongside the premier.

In a time when communication is absolutely vital, some voters might expect the Health MEC to be leading that communication, as it is Mokgethi who has political responsibility for her office.

It is important to remember that the position of Gauteng Health MEC is probably the toughest provincial government position in the country. And that is in normal times; having to take over during a pandemic would make it worse.

But her continued silence may well lead to questions, fairly or unfairly, about whether she is really prepared to do the job, or if she is failing to lead her department. Or if she wanted the job in the first place, or was forced into it, or even if she has opponents in the party who are weakening her deliberately.

This also brings back questions about the ANC in Gauteng and whether divisions within it have helped to contribute to this situation.

Earlier this year, Makhura warned the Gauteng ANC’s provincial executive committee that divisions among them could cost the party the province. It governs Gauteng only by one seat in the legislature. Since Makhura’s warning, the province has been accused of wasting billions of rand on PPE corruption and lost a Health MEC in Dr Bandile Masuku to an apparent PPE scandal.

This means that just months before local elections the ANC’s governance record is under a very unflattering spotlight.

All of this adds to the strain on Makhura and complicates his situation further.

While the number of Covid-19 cases continues to rise and reports emerge of people being given oxygen while sitting in chairs, it may be that the worst is to come for those governing the province. This is because so far, few images of patients in chairs, or waiting in parking lots, or simply being left with no care have yet emerged.

This is a result of the policies adopted by hospitals where people cannot enter the institution unless they are a patient, a health worker or have been tested for Covid-19 first. These restrictions stop journalists and family members from getting these images and publishing them.

This is unlikely to last, however; such is the number of people involved that images of these scenes are likely to emerge eventually. If they do, they could tell a story that thousands of words have so far failed to convey.

This would add to the pressure on the Gauteng government — and on Makhura.

Makhura himself has described the situation around the pandemic and his province as a raging fire, that the pandemic “is out of control”. For the moment, it appears that that statement is also terribly true for his government. Losing control over the province’s public systems while the pandemic is raging cannot be a good bullet point on any aspiring national leader’s CV. DM

PS Then again, this is South Africa…