🔒 How the world sees SA: Covid-19 exposes chronic cracks in state healthcare

Covid-19 has exposed decades of corruption and the mismanagement of our beautiful country. Fault lines in the state healthcare sector have been opened up, revealing problems that have been ignored at great cost. Poor people in particular are the collateral damage of a system which has been broken for too long, while the government continues to justify a strict and swift lockdown in response to the coronavirus pandemic. A Moody’s downgrade of South Africa’s sovereign credit rating to sub-investment or junk status in March put even more strain on the South African economy, which was already in recession. Now, we face a steep contraction and are in desperate need of foreign investment. This report by the BBC highlights the failings of state healthcare as the proposal for a National Health Insurance system is back on the table for discussion. – Nadya Swart

By Nadya Swart

A BBC investigation has put the spotlight on filthy conditions in South African hospitals. It exposed astonishing failures throughout the healthcare sector – from exhausted medical staff struggling with overwhelming numbers of Covid-19 infected patients to a health service near collapse. 

According to the BBC, the Eastern Cape is experiencing a severe shortage of key staff who are either on strike or infected with the virus. Describing the dire scarcity of resources, one senior doctor spoke of “institutional burn-out… a sense of chronic exploitation, the department of health essentially bankrupt, and a system on its knees with no strategic management”.

Focusing on the health crisis in Port Elizabeth, the BBC reported that fundamental questions are now coming to the fore about the strict Covid-19 national lockdown and whether that time, which devastated the South African economy, was wasted.

Dr John Black – one of only two infectious disease specialists in the Eastern Cape – explained that even before Covid-19 they had a skeleton staff, which has now decreased by another 30%. “Services are starting to crumble under the strain. Covid has opened up all the chronic cracks in the system. It’s creating a lot of conflict,” he said, confirming reports that patients had been “fighting for oxygen” supplies in a ward at Livingstone Hospital in Port Elizabeth.

The BBC told its audiences: “At Livingstone Hospital – designated as the main Covid-19 hospital in the district – doctors and nurses described scenes ‘like a war situation’ with blood and waste on the floors, a lack of Personal Protective Equipment (PPE), oxygen shortages, a severe shortage of ambulances, no ventilation and patients sleeping ‘under newspaper’”.

Another shocking revelation reported by the BBC concerned the deaths of several mothers and infants in a maternity ward at Port Elizabeth’s Dora Nginza Hospital where staff were overwhelmed. “I was personally involved in the delivery of two dead infants and know there were more. This is very unusual. To have several [mothers] and babies dying in one week in one hospital is totally unheard of and unacceptable,” said one medic.

The chaos and strain caused by the surge in Covid-19 infections “has been compounded by a lack of proper management, which has seen departments turning on each other, and using Covid-19 as an ‘opportunity to air every grievance that ever happened’”, said one official.

The health crisis is worsened by the fact that Livingstone Hospital has not had a CEO or management team for 18 months. “We’ve been rudderless for some time now,” said Dr Black bemoaning the lack of “strong leadership” to stabilise escalating conflicts between different departments at the hospital, and, in particular, with local unions.

With key staff all having gone on strike at some stage, the BBC reported the “sudden, union-backed, closure of smaller clinics”, which “pushed more patients towards the city’s three big hospitals, quickly overloading them”. These closures have received both gratitude and criticism from doctors in the Eastern Cape.

Cole Cameron of the Igazi Foundation, a local health non-governmental organisation, said: “We have historic issues of staff-shortages, labour problems, lack of leadership and, sadly, corruption, cronyism, and fiscal mismanagement. Health services were circling the drain for 10 years. Now they’ve collapsed.” 

The secretary general of the Eastern Cape’s Health Department, Dr Thobile Mbengashe, is quoted as saying: “It’s very true that some of our teams are very stretched and actually stressed. But the health system in the Eastern Cape has not collapsed. We’ve really been building up [for the pandemic] and I think we are still on track and need to be given an opportunity to show we can do this.”

“As infection numbers rise across much of South Africa, the dire situation in the Eastern Cape offers some important lessons for other provinces,” the BBC continued. “But the clearest lesson from Port Elizabeth may well prove to be about human nature, and how we respond under extreme pressure.”

Referring to the staff at Livingstone Hospital, the BBC said they had split into three groups: “The dutiful, the fearful and the obstructive’. 

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