Dr Tim De Maayer, the paediatric gastroenterologist who wrote an open letter to administrators at the Gauteng Department of Health about the conditions at Rahima Moosa Mother and Child Hospital, says its remains to be seen whether health ombud Professor Malegapuru Makgoba’s recommendations in the Rahima Moosa Mother and Child Hospital (RMMCH) report will be implemented. The report was handed over to minister of health Dr Joe Phaahla on Tuesday 14 March after a year-long investigation.

Health ombud Professor Malegapuru Makgoba hands over the Inverstigation report into allegations against Rahima Moosa Mother and Child Hospital to minister of health Dr Joe Phaahla. (Photo: GCIS)

Among other problems the report found that RMMCH was “dirty, unsafe and filthy” and that there was incontrovertible evidence that pregnant women were indeed sleeping on the floors, sanitation and sewerage services were not working and that the hospital did not have a laboratory service or blood bank, and only one CAT scan machine, which was broken – all of which are vital for patients’ wellbeing.

“I can tell you that the last weekend that I did, we had bloods that were done on Friday afternoon and did not reach the laboratory until Monday. That is three days that we are treating a child without any idea what the blood results are, it’s ridiculous! They’ve been talking for many many years about a 24-hour lab but it never materialised,” De Maayer said.

Speaking to Maverick Citizen, De Maayer said that he was one of the 34 people interviewed by the health ombud and his team, and that the report’s findings were indeed accurate when it came to the recommendations.

“I like the recommendations but I am worried that they’re not going to materialise. After the story last year we had many delegations from the national department of health, provincial department of health, private funders etc, and lots of things were talked about and planned – and absolutely nothing has happened.

“Yes, we’ve had small improvements but overall I think the patients haven’t seen any benefits. The infrastructure is still crumbling, we’ve had no change in our staffing complement despite punting for this for many years and the staff morale is low.” De Maayer also expressed concern that should things not turn around there was a possibility of losing their specialists in the next five years.  

De Maayer said that the report also failed to spotlight the human face and impact which was central in his open letter to the Gauteng Department of Health in May last year. “What’s upsetting me the most is that we are providing very much a second-rate service and five kilometres down the road the doctors and nurses that I work with are providing an excellent service in the private sector. It’s very upsetting to see the difference in treatment that kids are getting.”  

The report highlighted that one of the problems at the hospital was the absenteeism of the former CEO Dr Nozuko Mkabayi who was found to only have been at the hospital for a total of 182 days between 2021 and 2022. It was also found that in comparison to other provinces the criteria for CEOs in Gauteng was lower and recommended that the former CEO face disciplinary action and be replaced by a new “fit for purpose” successor.

Asked by Maverick Citizen whether De Maayer thought the hiring of a new CEO would make a marked improvement at RMMCH, he said the current acting CEO Dr Arthur Manning had made vast improvements in the management of the hospital. He said “we still run out of equipment but at least we have a CEO who cares and who responds and actually seems to care about the patients rather than the image of the hospital and that the business of hospitals is not to appease politicians but to serve the patients and that is very often lost.”

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An exasperated De Maayer told Maverick Citizen “I am absolutely, 100% dedicated to my job. I love my job, I love the hospital but it is coming to a stage where we don’t have resources … the equipment we need, we are more than 20 years behind the first world and the private sector in getting drugs for kids and at some stage you’ve gotta ask, “am I still providing benefit?” I see the gap between the public sector and private sector growing and it’s highly distressing. It is criminal what is happening to patients.”

Treatment Action Campaign (TAC) national chairperson Sibongile Tshabalala told Maverick Citizen, “What we can do as TAC is advocate and continue to put pressure to ensure that these recommendations are implemented because this is not the first time that we’ve had such outcomes. Around 2016 we had such outcomes about Tembisa Hospital but if you look at the situation up until now there’s nothing much that has been done.” 

Tshabalala said if implemented correctly the recommendations could possibly impact on how other hospitals are run and improve the services rendered to communities.

Referring to the blame being put on foreign nationals for the strain on the health systems, Tshabalala felt that “even if we can take all the foreign nationals out of our healthcare system today, that won’t change anything because the problems that we have are issues of mismanagement of funds, people that are incompetent, a tender system that is not working for communities and only working for politicians and government officials that are corrupt.”

Tshabalala stressed that it is time for civil society to force government to “do the right thing” and get South Africa out of the current health crisis. She said in the past the TAC had to take government to court in order to save five million lives and that the time for marching and handing memorandums is over. “Now it’s time to say how do we use laws in our favour, how do we take the very same government to court in order for them to implement these recommendations?”

Sharing De Maayer’s scepticism, convenor of the Progressive Health Forum Dr Aslam Dasoo told Maverick Citizen, “There are likely to be cosmetic changes at RMMCH but not much else, if past experience is a guide. The fundamental restructuring and proper governance required for the entire system of hospitals, of which RMMCH is a part, will not occur. The GDoH is incapable of conducting the overhaul. The recommendations seek to restore the impaired dignity of patients there, but it is not likely that [they will] be sustained after the spotlight moves off RMMCH. 

“The GDoH may start preparing another of its series of interminable turnaround plans, which reference the previous failed turnaround plans. 

“GDoH needs to be reconstructed, not turned around by the same people who caused the problem. The top management, political and administrative, needs to be replaced with people with requisite knowledge and skill so that Gauteng’s health system can be made functional again.” DM/MC