All through a lot of 2017, South Africa was gripped by a well being catastrophe of one other kind – the Life Esidimeni tragedy. It appears that evidently its classes are being forgotten already.
Between October and December 2017, the Life Esidimeni Arbitration, performed earlier than former Deputy Chief Justice Dikgang Moseneke, unfolded a story of the inhumane therapy and torture of psychological healthcare customers that had led to the deaths of a minimum of 144 sufferers throughout 2016.
One of many questions that puzzled Justice Moseneke was why accountable healthcare employees and senior officers didn’t communicate out concerning the disaster or refuse the “illegal orders” of then Gauteng Well being MEC, Qedani Mahlangu. Throughout his examination of witnesses he had requested this query repeatedly.
In his prolonged written award on the conclusion of the arbitration, Moseneke was at pains to emphasize that the primary and ultimate responsibility of public servants within the well being system is to the Structure, and to not their superiors. He questioned how senior public servants like Dr Barney Selebano, then Head of Well being in Gauteng, may ignore warnings of civil society and different well being professionals; he rubbished their claims that they have been intimidated by and “afraid” of Mahlangu and described Selebano’s excuses as “a unprecedented story … a medical physician turned a authorities chief govt of provincial well being pleads concern in resolution making”.
In response to the disgraceful behaviour of Selebano, Manamela and others who feigned ignorance or concern of Mahlangu, he wrote that:
“Our Structure hopes for public servants who hearken to the real and cheap grievances of residents and different individuals inside our borders with concern and a readiness to reply to and alleviate their concern and positively defend and promote the rights the legislation affords them. This didn’t occur right here. The general public service motto of Batho Pele was ignored.” (para 200)
Within the wake of the Esidimeni award, politicians, together with the President after which Minister of Well being, Dr Aaron Motsoaledi, have been fast to welcome Moseneke’s order and to vow “by no means once more”. However, as so typically occurs, when the mud settles it’s in a short time again to enterprise as regular. Not one of the lead actors in Esidimeni has but been prosecuted. Psychological healthcare stays grossly underresourced.
The place is Qedani Mahlangu now, one wonders? Not in jail, you may be certain.
There seems to have been little studying from Life Esidimeni. Consequently, light-fingered politicians and heavy-handed senior bureaucrats proceed to proliferate in components of the administration of our public well being system. Regardless of serial non-performance and clear proof of failure to make sure entry to high quality healthcare providers they decide up their substantial salaries, significantly if they’re politically linked. In the meantime, those that labour on the coalface of healthcare face medication stockouts, workers shortages and poor an infection management because of the mismanagement of their higher-ups.
Now now we have one more painful instance of officers who select bullying over responsiveness.
In early June, Professor Ebrahim Variava, a Chief Specialist and Head of Division of Inner Drugs at Klerksdorp Tshepong hospital, acquired a letter notifying him of his immediate precautionary suspension. Variava was instructed to right away hand over his laptop computer and requested to vacate the hospital he has served and developed for the final 19 years.
Within the letter he acquired from Polaki Mokatsane, the DGG of Hospitals and Scientific Help Providers in North West, Variava was instructed that his conduct had “compromised the rules of medical ethics” and “introduced the NW Well being division into disrepute”.
The previous is a most critical accusation to convey in opposition to a physician. However in reality evidently what actually irked the DGG has been Variava’s ceaseless calls for that these accountable repair the NW well being system. As well as, his occasional public complaints to the media had additionally been making him a nuisance to the powers-that-be.
On 22 Could, for instance, just some weeks earlier than his suspension, an article appeared about persistent drug shortages within the province. In line with the journalist:
“Docs who spoke to Highlight requested to not be recognized for concern of being singled out as ‘troublemakers’ and ‘complainers’. There’s additionally a concern that being recognized will make them simple targets for officers who would moderately go after them than addressing the issues.
“However the 4 docs who spoke to Highlight say they ‘can not in good conscience stay silent’. They are saying they’ve adopted all of the official channels to lift their considerations.”
The journalist has since confirmed that Variava was a type of docs. Variava doesn’t deny it. He says that every one different means to attempt to repair the availability of drugs fell on deaf ears and sufferers’ well being and lives have been in danger.
Well being employees strike again
“… the North West province to right away withdraw his suspension, and urgently set up a constructive dialogue to resolve their variations with out placing any sufferers in danger”.
It acquired over 250 signatures in 24 hours, a lot of them leaders and specialists in well being.
A petition of health workers at the hospital the place Variava is accused of being a “bully” additionally drew substantial assist. Different public statements have been launched by our bodies such because the Southern African HIV Clinicians Society and the Infectious Ailments Society of Southern Africa.
Mistakenly, the officers within the North West well being division appeared to have thought that they will behave like bantustan despots and root out whistle-blowers with out an outcry. Sadly, as we’ll reveal with additional stories in coming weeks, suspending whistle-blowers seems to have grow to be the modus operandi within the “reformed” well being division.
However it was Veriava’s very integrity and dedication to his sufferers that made many well being employees determine sufficient is sufficient. One specialist doctor and nephrologist, Dr Kagiso Motse, captured the temper when on 18 June she wrote to the MEC and the Premier telling them that:
“The NWDOH doesn’t need assistance with placing itself into disrepute. It has multidimensional issues which vary from historic lack of infrastructure to poor planning and execution of the mandate to offer high quality healthcare, inexplicable important drug shortages, as effectively deeply rooted corruption and incidences of wasteful expenditure, all of that are throughout the public area. The division is below administration due to its gross inefficiencies and whether or not or not the professor is the alleged whistle-blower is irrelevant. The problems raised by the media and the NGOs are an correct description of the state of healthcare providers within the province.”
Beneath rising anger from well being professionals on 17 June the MEC for Well being in North West, Madoda Sambatha, referred to as a press convention within the boardroom of Tshepong Hospital the place, below regular circumstances, Variava works. Sambatha admitted that within the face of Covid-19 they have been “in want of all our important well being employees” however “the place there’s ill-discipline the division will take motion …”
At that time Prof Veriava had nonetheless not acquired any extra element of the costs in opposition to him (aside from the obscure allegations contained within the 12 June letter). Nonetheless, having been “briefed” by Jeanette Hunter, the administrator of the Provincial Well being division, the MEC alleged that Variava had:
- “Acted in opposition to in opposition to present Covid-19 pointers, compromised restricted variety of take a look at kits and acted in a fashion suspicious of unapproved analysis,
- “Failure and disrespect of administrative protocols, e.g. requesting computer systems from NGO and instructing that they be put in within the wards with none approval.
- “Obstructive to administration of the hospital in all conferences deliberate to organize for Covid-19.
- “Failure to behave as a part of administration by means of a bent to put in writing emails to stakeholders together with exterior ones reminiscent of media, Part 27 and completely different nationwide authorities departments with none effort to have interaction inside issues fixing mechanisms or permitting administration time to resolve points.”
It’s protected to say that every certainly one of these prices is each defamatory and spurious, concocted by Mokatsane to justify his motion. A letter from Kerrigan McCarthy, a senior official on the Nationwide Institute for Communicable Ailments (NOCD), has already supplied an correct image in relation to the allegation regarding improper Covid-19 testing. However that may be a matter greatest left for Veriava’s legal professionals and the Labour Courtroom to pronounce on.
Nonetheless, the problems transcend the suspension of Veriava and factors, as soon as once more, to a troubled provincial health department that’s failing to fulfill its constitutional obligations. In consequence, the well being rights NGO, SECTION27, has written to the Minister of Well being requesting an investigation into the administration of North West throughout the Covid-19 epidemic.
SECTION27’s letter consists of an electronic mail from Veriava to the administrator and DDG, despatched on 31 Could, drawing consideration to continued persistent medicines shortages in addition to the shortage of readiness of district hospitals for Covid-19 regardless of the 2 months of lockdown and referring to an “ugly trade between himself and the DGG” and complaining that nobody desires to just accept accountability for the failures.”
Be part of the dots …
Immediately, 23 June, Prof Variava remains to be suspended. So, what classes ought to we draw from this sorry saga?
In our Structure, access to healthcare services is a elementary proper belonging to everybody. Good well being is inextricably linked to different core rights reminiscent of life and dignity. So, too, are the rights to freedom of expression, to impart data and to simply administrative motion.
In line with the Rural Health Advocacy Project, talking out internally about deep-rooted issues of administration or corruption within the well being system is an moral obligation for all who work in it; and, when elevating the alarm internally fails (because it clearly has finished in Variava’s case), then talking out publicly by way of the media can be an moral obligation.
We’re popping out of a time when components of our well being system have been captured and handled by corrupt officers as an object for plunder and theft. Life Esidimeni was one manifestation of this.
However as we enter a time when the well being system and well being employees are below huge pressure we can not afford quick reminiscences about what it taught us. Fact telling is extra essential now than ever. The Covid-19 pandemic is rising quickly all around the nation, together with in North West, the place the variety of confirmed instances is escalating (2,315 on 22 June) and the place hospital outbreaks level to systemic weaknesses complained of by Veriava and others. Corruption, sadly, has not miraculously gone away.
This isn’t the time to be suspending sincere hard-working well being professionals. However it’s a time to insist on a tradition of openness, transparency and supply.
That’s the reason one of the best factor for the well being division to do now could be instantly reinstate Veriava, apologise for defaming him and let him and all different well being employees get on with the job of saving lives. DM/MC