The failed state of Free State healthcare

The failed state of  Free State healthcare

“The doctor examined me and he looked me in the eyes and said angrily, ‘What does it mean if the baby’s heart is not beating?’ I just kept quiet,” she remembers. Then the doctor said to her, “This child you are carrying has been dead since January.”

hrough tears Betty Mabuza recounted the deeply painful experience of losing her baby at Bongani Hospital in February this year. With a quiet resolve she described what was clearly an absence of appropriate medical care. She described the indifference and even disdain shown to her by nurses and doctors, people she was relying on in a time of extreme vulnerability and need, to help her. The Free State public health-care system failed her. Sadly she isn’t alone.

The system failed more than 50 people who publicly testified at the People’s Commission of Inquiry held in Bloemfontein in July. It has failed the man who had “been four months without insulin, going on to a fifth month”, as the stock-outs of medicines ravage in the province. It has failed Amelia who watched helplessly as her grandson suffered dizziness, vomiting, and even his skin beginning to peel off, only to find the 7-year-old had been “given adult pills” instead of paediatric formulations.

It has failed the young man who told his mother, “Mama, don’t call an ambulance, I’m finished.”

Moreover it has failed the countless further people who provided written testimony to the commission, and the hundreds of others who attended community dialogues to share their grievances in May. It has failed health-care workers who according to one “have simply lost their work ethics because of the challenges they are facing”. It has failed community health-care workers who have lost jobs, income, and must now watch those they once cared for, suffer alone.

In the last few years, the Treatment Action Campaign (TAC) has received an ever-increasing number of reports of medicine stock-outs, absent emergency medical services, long waiting times at clinics, health-care worker negligence, broken equipment, and poor quality facilities, to mention a few. These reports point to a provincial health-care system that is failing the people it is meant to serve. It points to a health-care system that has collapsed. “According to Section 27 of the Constitution this is a gross violation of human rights,” states TAC General Secretary, Anele Yawa. “One wonders, how can you allow such to happen under the government of the people?”

The People’s Commission of Inquiry was held to investigate these reports and expose the truth of the situation in the Free State. The inquiry was presided over by an independent group of commissioners including Thembeka Gwagwa, Bishop Paul Verryn and Thokozile Madonko. Representatives from government, civil society, and the media came to hear the voices of people such as Betty and Amelia – people who rely on the public health-care system to survive.

It was not without disruption. Around 80 school children arrived on the first day in two buses in an apparent attempt to disturb proceedings. Not long after a man from the audience, identified as “Tebogo”, stood up to demand that the Free State Health Department be able to respond to each and every testimony. “TAC is not the biggest organisation in South Africa. You are not the Public Protector or the Human Rights Commission. You must give the government the right to answer,” he says. Despite explaining that the department had been extended the opportunity to respond at the end of each day, he continued, deliberately causing an ongoing disruption. During the commotion the entire Free State delegation left on account of “fearing their personal safety”. Despite these challenges and a few further phone calls from the crime and intelligence unit, the proceedings managed to continue, and the important testimonies were heard without any further problems.

Currently the commission is finalising a report that will outline their findings from the inquiry, as well as offer solutions to reverse the collapse of the health-care system. On 10 November the commission will host an open dialogue to address these issues effectively. An invitation will be extended to the Free State Department of Health, as well as many other stakeholders, to engage in this dialogue process and work together with the commission to turn the problems in the Free State around. “Health issues are political issues and they need political intervention. As activists we are not scared to speak truth to power. We know the struggle cry of ‘freedom or death, but victory is certain’,” says Anele Yawa.