SPOTLIGHT IN DEPTH
Security concerns mount at Gauteng hospitals amid ongoing reports of cable theft
Already hard hit by power blackouts, operations at health facilities in Gauteng and other provinces have been further disrupted by cable theft, creating another layer of risk for patients and healthcare workers. This is despite millions being spent on security at these facilities.
Among the facilities in Gauteng where healthcare workers say cable theft has been reported in the past six months or so are the Lenasia South District Hospital, Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital. Elsewhere, theft has affected operations at Cecilia Makiwane Hospital in the Eastern Cape and at Bongani Hospital in the Lejweleputswa District in the Free State.
Often these thefts include cables and copper pipes, among other items, which are needed for vital life-saving equipment such as oxygen.
A gastroenterologist at Charlotte Maxeke hospital, Prof Adam Mahomed, tells Spotlight there have been several incidents of theft at the hospital in recent months. This includes people stealing cables and copper piping from beneath the floors.
“The bulk of these things need a big vehicle to take them out. This means security will have to be involved since this bulk will have to exit through the gate where there is security. One of the security managers of the hospital was part of the system, and he was being used as the driver to take out stuff with his vehicle,” Mahomed says, referring to an incident in December.
This, he says, happened after a new security company was appointed after a fire at the hospital in March 2021.
In January, he says, they had piping stolen that affected the oxygen and water supply. They also had water pipes and cabling stolen from ward 586 and some oxygen piping from a section above the transplant ward in area 561. According to him, there are security cameras in these areas.
“The problem with these thefts is that an emergency plan must be made for the work to continue, and that takes a lot of money, paperwork and time,” he says.
Not only are the ongoing thefts ignored by health authorities, he says, but money is paid for what he calls “non-existent security” and “abuse of nurses and doctors by security, like searching bags for small things while millions are being stolen”.
Concerns over theft in health facilities are raising questions about how security contracts are awarded and how these companies are held accountable. Mahomed says these are big contracts and since they go through the Gauteng Department of Health, hospital management is not involved.
What worries him, he says, is that no one is being held accountable for failing security in health facilities.
“All we’re doing is playing musical chairs on a sinking ship. There’s no one that’s being held accountable. There are no court cases and no one’s going to jail.”
Mahomed suggests that if something is stolen while a hospital has a contract with a security company, that company should pay for the losses.
“Money must come off your payment every month. So if you have R5-million stolen from the hospital, you’ll get R5-million less on your contract.”
Gauteng Health spokesperson Motalatale Modiba says the department has lost more than R4.5-million in copper pipes and R917,297 in copper cables/wiring, bringing the total loss in Gauteng health facilities to about R5.4-million. He says these losses were due to theft and fire incidents that happened in the past two financial years.
Responding to concerns about security tenders, Modiba says the tender has been advertised twice, in 2016 and 2020, and was subsequently cancelled due to irregularities.
To ensure continued security at all health institutions, he says the security contracts are extended on a month-to-month basis until the new contract is in place.
“The department is in the process of re-advertising the tender to ensure competitive bidding and, eventually, a regular contract is in place,” he says.
Despite several inquiries by Spotlight since 16 March for a date when the tender will be re-advertised, Modiba couldn’t provide a date or a reason for why it was taking so long.
‘Scandalous and indefensible’
On Tuesday, 28 March, during a Q&A session in the Gauteng legislature, DA spokesperson for health in the province, Jack Bloom, asked Gauteng Health MEC Nomantu Nkomo-Ralehoko about the security contracts and costs.
Bloom said the last time the security contracts were awarded was in 2014 and they were supposed to expire in November 2016.
“So, every year for more than six years now, the Auditor-General has been scathing about the irregular rolling over of these contracts month by month. I think it’s scandalous and the fact of the matter is that hospitals are not getting good security and these contracts should have been awarded a long time ago,” he said.
Agreeing with Bloom, Nkomo-Ralehoko said: “I have to speak up. I can’t defend something that I know was not supposed to be like that.” She said it was a good thing that auditors had picked up the irregularities and cancelled the tender.
“I do appreciate [this] because it’s a lot of money that is involved with those tenders. So we need to follow all the proper processes.” The MEC promised to follow up on the progress of the new tender.
“And we will ensure that probity auditors make sure they scrutinise each and every contract before we can award it. So, I agree with you. We can’t have month-to-month contracts for so many years. That’s irregular and it’s not making us look good.”
She said the department was currently spending R59-million on month-to-month contracts, and because there was no fixed-term contract in place, only service-level agreements are used to manage these contracts.
“The department is in the process of advertising a new tender, which is anticipated to be awarded early in the new financial year of 2023/24,” she said, also failing to provide an exact date.
Concerns over staff and patient safety
Yandisa Zungula, a member of nursing union Denosa and a nurse at Chris Hani Baragwanath hospital, says the theft of copper pipes that supply oxygen to critical areas like ICU and theatre not only causes disruptions, but requires more planning and extra hands. He says copper piping was stolen at the hospital in December.
“As a nurse who is directly rendering services to the patients, when there is theft that affects certain departments, it means I need more hands than I would ordinarily need. When removing a critically ill patient out of ICU to another department, I need a team of nurses and doctors who will escort one patient.”
Looking at the size of Chris Hani Baragwanath hospital, Zungula says a theatre needs to be functional. “Anything that disturbs the starting time of the theatre means a lot of problems for the hospital… that means patients will suffer,” he says.
He says a control room where pipes were removed in December is locked and that not even hospital staff have access. It is only the maintenance people who have access, he says.
“But if someone can have access and can cut vital pipes and cables, it raises the question of how secure we are, as the staff and patients in the institution, because people have access to a restricted area and so far no one knows what happened.”
Zungula also questions how security companies are appointed, especially when contracts are renewed on a monthly basis.
“There are people who are benefiting from this chaos. This is done deliberately for someone to profit and continue to benefit from a contract that is not advertised,” he says.
When Spotlight asked Charlotte Maxeke hospital spokesperson Tabudi Madisha about the thefts referred to by Mahomed, he denied that there had been any cable thefts in recent years that had affected the hospital’s operations.
According to Madisha, the Gauteng Department of Health is responsible for ensuring the security of all facilities. “The department has undertaken a review of security measures across all facilities with the view to strengthen the state of security, which includes the deployment of integrated measures such as the use of technology,” Madisha says.
He says employees’ safety is a top priority, “which is why we have security on site 24/7 and have increased the number of cameras in high-risk areas. Whenever any of our staff members feel unsafe walking to any section of the hospital, or even outside the hospital, our security personnel are always available to accompany them.”
Gauteng Health’s Motalatale Modiba also tells Spotlight that neither Chris Hani Baragwanath hospital nor Charlotte Maxeke hospital has recently experienced cable theft incidents that affected operations.
“The cable theft at Charlotte Maxeke Academic Hospital took place during the fire incident,” he says.
“After assessments of the incident, necessary corrective measures were taken, including termination of the contract of the then security company.” The fire occurred in March 2021.
Modiba says the security company has since been replaced by Mafoko Security Patrols, which is responsible for security at both hospitals. However, the company is not responsible for all health facilities in Gauteng.
Despite the denials of incidents of theft, police have confirmed to Spotlight that two cases of theft were opened relating to incidents at Charlotte Maxeke hospital in December and January. Sergeant Mduduzi Zondo says there was one arrest in one case, but that both cases are currently under investigation.
Lebo Nare, director of Mafoko Security Patrols, also confirmed to Spotlight that there was an incident of theft at Charlotte Maxeke hospital in January.
“The theft was done by an individual who had authorised access to certain areas in the hospital. It was discovered that the suspect was in the employ of a contractor doing some work for the hospital who had intricate knowledge of locating critical infrastructure and its value,” he says.
Nare says a comprehensive report was submitted to hospital management for action with recommendations and a case was opened with the police.
Regarding Chris Hani Baragwanath hospital, SAPS Colonel Mavela Masondo confirmed to Spotlight that a case of theft and attempted murder had been opened at Diepkloof police station. However, no arrests were made and the case is still under investigation.
Nare also confirmed that there was a case of attempted theft at Chris Hani Baragwanath hospital in December, although we have been unable to confirm whether this is the same case referred to by Masondo.
Spotlight’s attempts to get further clarification from the Gauteng Department of Health, and an explanation for the contradictory information about these thefts, were unsuccessful.
Feeling the impact
Meanwhile, the South African Medical Association (Sama) has also expressed concern over the incidents of theft.
“Our doctors are in the untenable situation of having to juggle providing quality care to patients and managing infrastructure problems caused by load shedding and cable theft,” says Dr Mvuyisi Mzukwa, chairperson of Sama.
He says delivery of most healthcare services relies on power. This includes the neonatal intensive care unit, dialysis machines, refrigeration of medicines and heating, ventilation and air conditioning in theatres, among needs. Without electricity (either through load shedding or cable theft) patients’ lives are at risk.
These thefts also interrupt the workflow as planned surgeries have to be rescheduled.
“Sama is gravely concerned that people’s lives are at stake when cable theft disrupts oxygen supply, such as at Chris Hani Baragwanath Hospital in 2022,” he says.
According to Dr Edward Ngwenya, Sama’s vice chairperson, members of the association pledge to save lives as part of their oath to do no harm, but their members want to be allowed to work in an environment that can deliver quality health outcomes.
“When they have to work in a sub-optimal environment, this does not augur well for their safety and security as they get attacked and abused by patients and loved ones who are frustrated by the health system,” he says.
“It is reported that our doctors find themselves administering intravenous lines (drips) in the dark, operating using cellphone lights as a result of unexpected power failures and lack of backup power supply. This is not the way to work and administer professional healthcare.”
Ngwenya says that non-functional healthcare equipment and infrastructure make it impossible to provide quality care. This situation, he says, is getting worse every year.
“Hospital management is not doing enough to address issues facing not only doctors, but all services provided in a public hospital environment,” he says.
Mzukwa says Sama has engaged the national and provincial health departments on safety and security issues at hospitals.
“The association supports calls for safety and security and is concerned that major hospitals’ security contracts are running on a month-to-month basis. These contracts need to be finalised,” Mzukwa says.
Denosa has similar concerns.
Bongani Mazibuko, Gauteng secretary of the union, tells Spotlight they are concerned about acts of vandalism and theft at health facilities and the safety impact this has on their members.
“As Denosa in Gauteng, we have long called for consequence management… for as long as no one is held accountable for these things, we won’t see an end to them.” DM/MC
This article was published by Spotlight – health journalism in the public interest.