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The dilapidated state of the healthcare system in the Eastern Cape has again been exposed by a new report. 

The report is the second for the Eastern Cape using data from Ritshidze, a community-led monitoring system developed by organisations representing people living with HIV, including the Treatment Action Campaign (TAC) and the National Association of People Living with HIV. It highlights issues such as clinic waiting times, infrastructure, staffing, clinic conditions, anti-retroviral treatment (ART) and ART continuity, and viral load literacy.

Earlier this month, Elitsha reported on the Ritshidze report on the state of health in the Free State.

The report finds that the Eastern Cape is performing poorly in terms of filling vacancies within community healthcare centres (CHCs): “Understaffed clinics mean healthcare workers are overburdened. This leads to longer waiting times, limited time to attend to public healthcare users and at times, bad attitudes of healthcare workers.” 

It recommends that, by June 2023, the Eastern Cape department of health should fill 70% of vacancies in the province (including 322 vacancies reported at Ritshidze sites), and fill the remaining 30% by the end of the 2023/24 financial year.

While waiting times have been reduced by 46 minutes compared to last year, the report states that healthcare users still spend hours for each visit to a facility. Stories from community members reveal the challenges that continue to make it hard for people to access HIV and TB prevention and treatment in the province. A patient, who voiced his challenges when trying to access healthcare, said in New Brighton in Gqeberha, patients have to wait two hours outside the clinic before it even opens. “Even if it’s raining you have to stand there and there is not a proper place for you to wait; people are getting sick having to be outside from early in the morning,” he said.

He was put through this bitter wait in winter this year when he accompanied his cousin to the clinic for what turned out to be an ear infection. After the long wait, he was refused entry into the clinic by security staff. “These guards are so rude; even when they see you are there helping someone who is sick, they will tell you that only one person can go inside.” Inside the clinic, patients face the same kind of confrontational, unprofessional attitude from the New Brighton clinic nurses. “They shout out whatever your illness or condition is in front of everyone because they don’t care for your privacy. They are also slow and they waste time – I think it’s because they don’t know how to do their jobs properly,” he says. 

The patient also shared that it has become increasingly common for patients to be sent home without their medication as stockouts and medicine shortages are being experienced more frequently. 

Unions agree health services in EC are poor

Democratic Nursing Organisation of South Africa (Denosa) provincial secretary, Veli Sinqana said most of the problems in health facilities should be blamed on the department of health in the province. “Staff shortages are very serious in the Eastern Cape healthcare system. It’s a glaring issue. One of the main causes is that staff resign, some retire and others pass away but the department does not fill these vacancies afterwards. This means the staff that is left is overburdened by the workload, ” said Sinqana. The union, he added, does not dispute what the Ritshidze report says about staff attitudes, but that it cannot be reduced to only nurses. 

Covid-19 exposed the ailing healthcare system in the Eastern Cape. Archive photo by Joseph Chirume

National Union of Public Service and Allied Workers Union (Nupsaw) provincial secretary, Vuyani Dabepi said as a union they are still scrutinising the Ritshidze report but that they believe most of the issues it raises are things Nupsaw has been fighting for. “As a union, one of our objectives is to ensure the proper distribution of health services in the province. We are continuously engaging the EC department of health on many platforms.  In August we held a summit with the department, and we discussed the issues that the Ritshidze report highlights. We need the department to provide solutions,” said Dabepi. 

Eastern Cape health department responds 

Eastern Cape health spokesperson, Yonela Dekeda said, “The report has been presented to the MEC and is still to be presented to the extended top management for consideration of recommendations and where all the relevant management should consider the report for actioning.”

Dekeda said the department notes the areas where it can improve and the report is assisting them to monitor the impact of their service. “We will aim to improve the areas such as staff attitudes and waiting times. The department has allocated an amount of R700-million towards the implementation of an approved annual recruitment plan for 2,941 posts for the 2022/23 fiscus. With regards to shortages of medication, the department is also using stock visibility solution (SVS) to monitor the available stock in health facilities,” said Dekeda.