On Thursday, the National Education, Health and Allied Workers’ Union (Nehawu) continued its strike for a fourth day, with patients across South Africa struggling to access hospitals, surgeries and dispensaries. Ambulances were diverted from some Gauteng hospitals, and patients dodged rubber bullets at Nelson Mandela Academic Hospital in Mthatha, Eastern Cape.

Maverick Citizen has been contacted by doctors, nurses, health workers and patients across the country about the strike and the impact it has had on their lives.

Gauteng  

The Gauteng Department of Health obtained a court interdict at the Johannesburg Labour Court against the striking Nehawu members, to stop them from obstructing the rendering of health services to patients. On Thursday, numerous hospitals experienced total shutdowns, including Kopanong, Sebokeng, Thelle Mogoerane and Bheki Mlangeni.

The entrance to the Chris Hani Baragwanath Hospital was blocked during the Nehawu protest on 9 March 2023. (Photo: Gallo Images / Papi Morake)

Patients were left unattended as striking workers went inside wards, ordering staff out. Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Hospital were also affected.

The interdict is applicable immediately, preventing striking workers from doing anything that directly or indirectly impedes or obstructs access to health facilities across the province. The interdict also prohibits protesters from barricading entrances or buildings and intimidating any members of staff or patients.

Despite this interdict, there were reports that patients were going back home from Bheki Mlangeni District Hospital without receiving medical assistance. Five Nehawu members were reportedly shot with rubber bullets inside Chris Hani Baragwanath Hospital in Soweto.

Nehawu members protest at the University Of Johannesburg on 9 March 2023. (Photo: Gallo Images / Papi Morake)

Later in the afternoon, the situation seemed to have stabilised. The main gate was cleared, a fire was put out, and people could enter and exit the hospital safely.

Some Gauteng hospitals, including Charlotte Maxeke Johannesburg Academic Hospital, appeared to be sending ambulances elsewhere and not admitting patients.

The entrance to the Bheki Mhlangeni Hospital in Soweto was barricaded by Nehawu members during a protest on 9 March 2023. (Photo: Gallo Images / Papi Morake)

Minister of Health Dr Joe Phaahla, with Gauteng MEC for Health and Wellness Nomantu Nkomo-Ralehoko, visited health facilities that had been affected by the strike. Phaahla said at least four people had died as a result of the strike action.

“We have a legal team which we are consulting to look at what our options are in that regard,” he said.

Free State 

A skeleton staff worked in a surgical theatre at Pelonomi Academic Hospital in Bloemfontein, according to reports. “We are going to do an emergency C-section now. Staff are afraid to return to work — being threatened if they provide clinical care,” said a healthcare worker.

KwaZulu-Natal

The KwaZulu-Natal Department of Health also obtained an interdict against the striking Nehawu members. The department has intensified security by obtaining the services of more security companies to complement the current workforce and the police.

There were reports of pregnant women, who had scheduled prenatal visits, sitting outside the Harry Gwala Regional Hospital in Pietermaritzburg. There were long queues, with workers and patients unable to enter the hospital. Workers not affiliated with Nehawu were reportedly intimidated by those striking.

A pregnant 30-year-old woman who was involved in a hit-and-run accident on Town Bush Road on Tuesday died from her injuries, after allegedly being denied medical assistance at various healthcare facilities in Pietermaritzburg.

Mpumalanga

The strike has affected access to blood services from blood banks at hospital premises, including the Themba, Mapulaneng, Witbank, Shongwe and Ermelo blood banks, as protests have prevented some blood bank staff from entering the facilities, according to Chris Nobela, the spokesperson for the Mpumalanga health department.

“Smaller hospitals without blood banks are running low on blood supplies. However, they have the option of requesting blood and blood products from blood banks that are outside the hospital premises, such as Nelspruit blood bank, Middelburg blood bank and Teksa blood bank in Trichardt,” said Nobela.

“The department is negotiating with union leaders to allow emergency services to be accessible in all health facilities.”

It was reported that patients were forced to evacuate and leave the Poly Clinic in Lynnville.

Northern Cape

The Northern Cape Department of Health said that health facilities in the Sol Plaatje subdistrict in Frances Baard District Municipality were the most affected by the Nehawu strikes.

“Though some health facilities are fully operational — like Robert Mangaliso Sobukwe Hospital, Beaconsfield — certain facilities, mainly in the Kuruman [Hospital] as well as De Aar Hospital had sporadic incidents of striking workers,” said Lulu Mxekezo, the spokesperson for the Northern Cape Department of Health.

“Kagiso Community Health Centre in John Taolo Gaetsewe district is still not operational, with burning tyres at the entrance so staff and patients cannot access it.”

The South African Police Service was helping to defuse the protests where necessary. Certain districts, including the Namakwa and ZF Mgcawu district municipalities, had no reported incidents of unrest.

“We are grateful to staff members who diligently provided healthcare for our patients during these challenging times,” said Mxekezo.

No shortage of blood supplies was reported at any Northern Cape health facilities as a result of the strike.

North West  

The situation has reportedly improved at Tshepong Hospital in Klerksdorp. Strikers were not blocking entrances, staff were willing to work and patients were allowed in. Military health personnel were assisting onsite.

Western Cape

Mark van der Heever, the spokesperson for the Western Cape health department, said strike action has been reported outside Michael Mapongwana Community Health Centre in Khayelitsha.

However, no Western Cape hospitals had been damaged by strike action and facilities were not facing any shortages of resources or staff, he said.

When Maverick Citizen visited Khayelitsha District Hospital at midday, there were no protesters present. However, Baxolise Mali, the secretary for Nehawu Western Cape, said that protesters had been active outside the hospital in the early morning.

“Tomorrow [Friday] we will still continue [striking]. Remember, our strike action continues until the employer comes to the table, and then tables something that will convince workers to actually go back to work,” said Mali.

Patients at health facilities were affected by the strike, as the number of staff servicing them had been reduced, he said. While he described this as an “unfortunate situation”, he maintained it was unavoidable.

Mali said wage increases in recent years had failed to keep up with inflation, leaving workers unprotected in the face of rising food prices.

“The price of petrol has been up. There’s a crisis of electricity, forcing people to use paraffin, to buy [generators], and all of those things actually affect workers in a very detrimental manner,” he said.

Eastern Cape

Hospitals in the two metros, Nelson Mandela Bay and Buffalo City, put out requests for volunteers to help the remaining staff with patient care.

In Nelson Mandela Bay, protesters abided by a late-night interdict obtained on Wednesday and were no longer barricading the roads to hospitals, except for Mission Road leading to the Jose Pearson TB Hospital.

In Mthatha, security guards wielding sjamboks fired rubber bullets at protesters, reportedly injuring four. Security guards escorted patients to and from entrances at Frere Hospital.

Read more in Daily Maverick: “Strikers shot with rubber bullets at Mthatha hospital” 

No patients were allowed access to Zithulele Hospital where protesters had locked the gate.

Other unions join the strike

The South African Police Union (Sapu) has served the Department of Public Service and Administration with a notice indicating the union’s intention to strike from 17 March. Sapu spokesperson Lesiba Thobakgale said the union would join Nehawu in its strike.

“As Sapu, from today we have served a strike notice and we are joining the other unions,” said Thobakgale.

It has been reported that the Democratic Nursing Organisation of South Africa and the Police and Prisons Civil Rights Union are also joining Nehawu in striking for wage increases.

People’s Health Movement South Africa 

The People’s Health Movement South Africa (PHMSA) noted that it supported the right of health workers to take strong, even disruptive, industrial action to improve wages and working conditions.

“While the Labour Relations Act limits the right to strike of workers who render essential services, it clearly renders those who work in the public sector vulnerable to exploitation,” it stated.

“If, as is the case here, health workers have inadequate pay, poor working conditions and unsafe working environments, the entire health system becomes unsustainable and people’s health is endangered.

“We believe that such circumstances justify disruptive industrial action when other means fail, particularly when the intentions behind the action include the protection of the public healthcare system, ensuring sustainable access to quality service delivery, and safeguarding people’s constitutional rights to health and healthcare.”

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It appeared clear, from all media reports and statements from Nehawu leaders, that the current strike had no such intention, said PHMSA. The organisation noted that while Nehawu’s demands were reasonable, their “violent, destructive and unavoidable lethal actions amount to violations of human and children’s rights.

“They intimidate and undermine healthcare workers by, for example, their aggressive behaviour and by taking sjamboks into healthcare facilities. They violate rights to healthcare when they damage infrastructure, turn ambulances away, block access to facilities, and prevent access to medications and surgery through their acts. They violate the most basic rights of children when they prevent sick children from getting food.”

PHMSA urged Nehawu to focus, without compromise, on its legitimate demands. “In doing so, it is essential for them to include protection of the public health system and everyone’s human rights, including the right to health, among the explicit goals of the strike.”

National Department of Health

The National Department of Health stated that the Nehawu strike had become violent and a “threat to human life”, as protesters had prevented non-striking workers from entering facilities to provide services to communities. Many of these communities were dependent on the public health service for access to their healthcare needs.

“As a consequence, the department advised provincial departments to seek and apply for court interdicts to protect workers and property against the violence meted out by the Nehawu striking workers,” stated the national department.

“The department has assigned senior managers to all affected districts and health facilities to provide support to assess the situation and provide the necessary support.”

Contingency measures

The contingency measures to be implemented by the National Department of Health include:

• The rescheduling of all medical appointments that could not be attended to;
• The formation of a catch-up programme; and
• The provision of enough medications for those patients who needed to be discharged, to alleviate pressure on the health system.

Elective operations have been postponed until the situation normalises. However, non-elective surgeries are being prioritised. DM/MC