Robbed of their hospital in an National Health Insurance pilot district
By Ufrieda Ho
The “bus stop” and the “slaughterhouse” – these are the nicknames locals give for the Nketoane Hospital in Reitz and the Dihlabeng Regional Hospital Bethlehem.
Both fall into the government’s National Health Insurance (NHI) pilot area of Thabo Mofutsanyane in the Free State, one of 10 pilot districts in the country. Pilot areas are meant to assess the readiness of facilities to rollout the NHI plans and also meant to uplift the needs of the most vulnerable communities in the country first.
Thabo Mofutsanyane is, according to Health Minister Aaron Motsoaladi’s assessments (which looks at socio-economic indicators, health service performance and financial and resource management), among the most needy in the country.
Locals in Reitz and the nearby location of Petsana say the problems began with the downgrade of Nketoane Hospital in 2002 from a 65-bed facility to a 45-bed facilities, to one that now accommodates just ten patients in a step-down facility.
It is, for locals, a travesty. They feel they have been robbed of their hospital.
Even though the hospital still runs a 24-hour maternity and casualty facility, it’s a shadow of its former self; a bus stop really, they say, where ambulances pick up patients to transport them nearly 50 kilometres away to the Dihalabeng Regional hospital in Bethlehem where they are supposed to be able to access a broader spectrum of health care services.
However, they don’t trust Dihlabeng Hospital. It’s a facility that will kill you before it heals you, they say. The slaughterhouse. Reitz locals, including those who live in the surrounding locations and townships, say they are often treated with disdain by nurses at Dihlabeng, with the common snipe of “Why don’t you just stay at your own hospital?”
A Petsana local, Victor Mlangeni, who also heads the United Residents’ Front, says that one of the major problems about being serviced by a hospital nearly 50km away is that people can’t visit their families easily. A taxi ride one-way costs R30.
“They should have left that hospital as it was. Before it had all the services that we needed. Now it has nothing,” says Mlangeni.
Mlangeni says they’re also always given the run-around by the provincial authorities, who keep promising that things will improve.
“In 2010 we were told that the Reitz Hospital would be back to normal within six months and we would have all the services back. But we waited and waited. In 2015 the government came again and said we would have to wait three more months.”
During his visit to the Petsana residents in 2015, Free State Premier Ace Magashule publicly gave his support to the residents over their concerns that there was shortage of doctors at Nketoane Hospital and that the vast distance between Nketoane and Dihlabeng, and even the Phekolong Hospital, were less than optimal. He promised to look into the matter personally. It’s half way into 2016: nothing’s changed and locals are still waiting for services to improve.
The Nketoane Hospital is essentially a storage facility now. There are currently two Cuban doctors at the hospital and eight professional nurses for the still-busy maternity section. It remains well-kept, clean and tidy, but it’s also strangely silent for what should be a busy medical hub.
Inside the hospital, empty beds are stacked on top of one other, filling up rooms. Whole wards stand empty and the operating theatres remain in darkness. A hospital insider, who spoke on condition of anonymity, says everything was operational and in running order in the theatres, even though some of the equipment was old. But gradually it has been stripped, with working equipment shipped off from the hospital.
“What’s working has been taken and so when there’s and emergency we have to send patients to Bethlehem. Even then, we can wait up to two hours for an ambulance to arrive,” he says.
The insider, who has worked at the hospital for years, says the morale among staff is low and he calls the NHI roll-out in Nketoane “a joke”. The hospital, he says, has to submit plans based on the old information that it is a 45-bed hospital. It’s skewed data but no one has bothered to make the necessary adjustments. This means that the planning for the day-to-day running of the hospital is based on inaccurate information.
“When you work it out like that (at 45 beds) the hospital will always look like it is under-performing. It’s bad for the hospital and it’s bad of the morale of staff. The nurses are also not getting all their overtime pay and we aren’t getting any more staff because positions have been frozen.
“We are supposed to be an NHI hospital but we are not compliant with anything. It really is a joke and the Premier, the MEC and the HODs should all be fired.
“This is also our community, we work here, we live here. All we want is to be able to serve this community properly and we can’t,” he says.