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Orthopaedic nightmare in the Free State

By Anso Thom, Spotlight

Whistleblowers say patients with broken legs, arms and other serious orthopaedic conditions are being sent home in the Free State because the buckling health system is simply unable to cope with the numbers. Health workers are told there is no money to bring in outside help to reduce the waiting lists.

A week ago, when a team of outside health workers were paid to work a weekend at Bloemfontein’s Pelonomi Hospital in an attempt to reduce the waiting list, at least 40 patients were sent home because there was simply no capacity to get to them.

“Imagine this, for six weeks these patients have been lying in hospital beds

with well-meaning doctors assuring them that their surgery was imminent, only to be told that you will no longer be operated on and that this means you bones will no re-attach properly or that your ankle will remain partially dislocated,” said a health worker, who asked to remain anonymous for fear of reprisals.

What was more disturbing for the health workers who spoke to Spotlight was the fact that last year there was millions to run a dodgy, illegal stem cell practice in the Pelonomi orthopaedics department, but there was no money to bring in extra health workers to reduce the waiting list.

“It simply cannot continue like this, patients wait for 40 days for simple, straightforward treatment for fractures. Their lives are destroyed, it is an untenable situation,” said a doctor.

The Regenesis scandal

Spotlight reported towards the end of last year that illegal stem cell experimental treatment was being provided at Pelonomi Hospital, a state hospital in Bloemfontein. The issue was also investigated by Carte Blanche who produced an insert.

Shortly after SECTION27 and the Treatment Action Campaign brought details of the Regenesis project to the attention of the national Director-General of Health Precious Matsoso, the Medicines Control Council (MCC) suspended the unlawful stem cell experimentation at Pelonomi.

At the same time the Free State Department of Health cancelled its contract with the stem cell company, ReGenesis Biotechnologies following a list of questions sent by Spotlight in connection with the involvement of controversial Health MEC Dr Benny Malakoane. Before the expose, the Free State department of Health was set to spend tens of millions of Rands on unproven and potentially dangerous stem cell therapies for the treatment of musculoskeletal diseases in its orthopaedic knee patients at two hospitals. The treatment was run by a private company called ReGenesis Biotechnologies and has started on June 1, 2016.

A service level contract (seen by Spotlight) between the Free State Department of Health and ReGenesis Biotechnologies indicated that the service would be provided in Pelonomi hospital in Bloemfontein and Boitumelo hospital in Kroonstad. The department would pay R30 000 per client, with a guaranteed supply of one thousand patients per year. This adds up to R30-million per year and R90-million over the three years of the contract.

MCC investigation

MCC Chairperson Professor Helen Rees confirmed to Spotlight at the time that inspectors had been to the Pelonomi site: “Our concern was that the service level agreement made reference to medicines, injections and therapeutic research.”

She said the informed consent documents referred to the patients giving permission for stem cell therapy, permission for stem cells to be removed, concentrated and re-injected and for their stem cells to be given to another person.

The contract at the time stated that the Free State Department of Health and ReGenesis would establish a project management committee consisting of the MEC of Health as Chairperson as well as the CEOs of Pelonomi and Boitumelo hospitals, COOs and representatives from ReGenesis. It reveals that the committee shall meet monthly for the duration of the Agreement to “track progress, resolve pertinent matters to the effective and seamless treatment of patients”.

Days after the revelations Free State Premier Ace Magashule reshuffled his Cabinet and Malakoane was shifted from health. Since then, Spotlight have sent questions to the MECs spokespeople and the Premier’s people. All these attempts have elicited zero responses.

It is crucial to understand where this case is, has there been an investigation, what are the findings, will anyone be charged, was Malakoane due to benefit from this contract, were proper tender procedures followed, and so on.

A well-placed source in the Free State has shared a list of names of relevant persons who needs to be investigated. They include hospital CEOs who allegedly participated in the scheme, hospital managers who requested the waiting lists and who contacted the patients, doctors and their secretaries who played a key role in running this scheme, a doctor who reportedly gave instructions for the order forms to go through, an individual who gave the financial permissions and two heads at Bophelo House (health department head office) who were involved.

A Bloemfontein doctor said they were aware of patients who suffered due to this treatment, with reports of some dying.

Registrar of Medicines, Dr Joey Gouws recently confirmed that Department of Health inspectors have laid criminal charges against Stander “for the sale of unregistered medicine and or conduct of a clinical trial without obtaining the necessary authorization from the MCC.”

Gouws said they were in no position to advise on the status of the police investigation. She also confirmed that the MCC had reported Stander to the Health Professions Council of South Africa (HPCSA). At the time of going to print, the HPCSA had not responded to queries requesting an update on the charges.

Collapse of orthopaedics

More recently Spotlight has received information that orthopaedic services in

An overcrowded watiting area at Pelonomi Hospital is at times turned into a hospital ward where desperate patients can
wait days to be transferred to a hospital bed

the province are in a state of collapse with a running surgery waiting list at Pelonomi Hospital of over 130 patients (excluding those who have lost faith, packed up and returned home, despite the consequences), on most days.

There are adults with trauma fractures, children with broken limbs and elderly patients with fractured hips. They are lying in overflowing hospital beds and in the passageways on trolleys and on the floor (see photos).

A health worker said that young doctors are facing abuse from frustrated patients who are in limbo, waiting for surgery which does not happen.

This is not the first time the province has faced this problem. In the past the province has been able to reduce the waiting lists significantly by buying in locums at a cost of about R6-million per annum. This is small change compared to what the province was prepared to fork out for the illegal and dangerous Regenesis project.

The domino effect of long waiting lists for orthopaedics is more complications, septic bed sores for the elderly, children left disabled and adults losing their jobs.

A doctor explained that Pelonomi is facing increasing pressure as peripheral hospitals no longer have skilled specialists to do the surgery.  The hospital is also taking in referrals from the Northern Cape and Lesotho.

Sources allege that the hospital CEO, Ms Ramadula (a nursing sister) is not disclosing the current state of affairs to the provincial government for fear of reprisals.

“Hospital management are misleading their heads who in turn mislead the national Director-General, who because of incorrect information, misleads the national health minister,” a health worker added.

Stander still practicing

Dr Wian Stander, the controversial owner of Regenesis, the company that entered into a questionable partnership with the Free State Department of Health to conduct unlawful stem cell experimentation at Pelonomi hospital in Bloemfontein is still practicing and active.

This is despite charges with the South African Police Services and the Health Professions Council of South Africa.

Registrar of Medicines, Dr Joey Gouws has confirmed that Department of Health inspectors have laid criminal charges against Stander “for the sale of unregistered medicine and or conduct of a clinical trial without obtaining the necessary authorization from the MCC.”

She also confirmed that the MCC had reported Stander to the Health Professions Council of South Africa (HPCSA).

Calls made by Spotlight to Stander’s Integrated Medical Centre in Bryanston and his Slimming Clinic in Pretoria were unsuccessful. Both landline numbers were not working, even though the websites advertising everything from weight loss to integrative cancer treatment, botox and the sale of vitamins were still live.

A further search found a GP practice in Pretoria where a woman answered stating that it was the rooms of Dr Stander. She said he only consulted at this Pretoria practice on Tuesday. She indicated that he consulted at the Centre of Advanced Medicine in Sandton every second Wednesday.

Stander’s active Facebook page reveals that he has among others been a speaker at a business breakfast in the Free State. He continues to share events linked to his slimming clinic which has the same address as the Centre of Advanced Medicine.

A further search on the Centre of Advance Medicine website (a practice with various specialists listed), links to Regenerative Medicine which in turn links to a ReGenesis page. A search also reveals that ReGenesis continues to be a co-sponsor in a popular train run series in and around Bloemfontein.

 

 

 

 

 

 

 

 

 

 

 

 

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Opinion: Return of the quacks

By Anso Thom, Spotlight Editor

For a long time, South Africa has been a country where charlatans are able to flourish and peddle dangerous remedies for all kinds of ailments.

Take a trip on a public train or a walk down a road in our city centres and you will easily find pamphlets marketing remedies for anything, from enlarging penises to bringing back lost lovers. Even more seriously, the city lamp poles are plastered in posters offering cheap pregnancy termination services. Poor people stand on street corners for hours offering pamphlets and directions to the closest ‘doctor’. All illegal, all dangerous, but almost all operating with impunity.

The reasons these quacks proliferate are many. Not so long ago we had a president and health minister who created an enabling environment for them. President Thabo Mbeki questioned the efficacy of lifesaving anti-AIDS medication, told people they were toxic, and dragged his feet when it came to signing into policy the rollout of these medicines for the thousands who were suffering and dying.

His Health Minister, a medical doctor, Dr Manto Tshabalala-Msimang spoke often and passionately about the so-called healing properties of beetroot, garlic, lemon and olive oil. People sniggered, referred to her as Dr Beetroot and shook their heads.

But what Mbeki and Tshabalala-Msimang had done successfully, was to sow seeds of doubt. Many, many people living with HIV, desperate for a remedy not only to control the virus, but to exorcise it from their battered bodies, turned to the quacks, who promised to do so. What was criminal was that these ‘doctors’ were operating with the tacit support of the leaders who had the power to close them down.

They included the likes of German multi-vitamin peddler Matthias Rath; KwaZulu-Natal truck driver and seller of a concoction called uBhejane (the recipe of which he said was revealed to him in a dream by his ancestors) Zeblon Gwala and the likes of Tine van der Maas a barefoot Dutch nurse who pushed lemon, garlic, beetroot and olive oil concoctions at the behest of the health minister, or Belgian eccentric Kim Cools who continues to claim that he had injected himself with the HI virus but remains negative due to his remedies (see previous Spotlight).

Activists told stories and journalists wrote articles of the heartache these people had caused – the undignified deaths of mothers who left families orphaned as they dumped their antiretrovirals for Rath vitamins, the fatal and excruciating suffering of the much-loved DJ Khabzela after the health minister sent Van der Maas to heal him, or the illegal Rath clinical trials conducted on poor people, made to strip, have their photographs taken and give their blood.

And then there was Virodene – a powerful chemical detergent peddled by a bunch of crazy scientists as a cure for AIDS, which had as its cheerleader President Mbeki.

Mbeki and Tshabalala-Msimang were not alone in the rejection of proven treatments. Tshabalala-Msimang’s MECs either turned a blind eye to the fact that people were being used as guinea pigs, or did everything in their power to deny poor people access to lifesaving drugs.

Sibongile Manana was the MEC of Health in Mpumalanga at the height of the denialism years from 1999 to 2003. Now she is a Member of Parliament. As MEC she gave the Greater Rape Intervention Project (GRIP) in Nelspruit hell. She bullied Rob Ferreira Hospital’s Dr Thys von Mollendorff, a gentle caring doctor whose only crime was to try and help rape survivors. He offered them a dignified, safe space in his hospital where they were given the option of accessing legal, tested antiretrovirals to prevent infection. But Manana hounded Von Mollendorff and GRIP out of the hospital and treated them like criminals, dragging them to court and evicting them from the hospital.

Penny Nkonyeni, MEC for Health in KwaZulu-Natal during the Manto years, often rolled out the red carpet for her Minister. She printed quack pamphlets for distribution, hounded doctors who dared to offer pregnant mothers the option of treatment to prevent transmission of HIV to their babies, and she was a willing partner in finding crooked NGOs prepared to run illegal clinical trials using quack concoctions. Nkonyeni was later the speaker in the provincial parliament and Education MEC before being removed in a Cabinet reshuffle earlier this year. She indicated she was joining the private sector.

The examples are many and for those who were there, these memories are painful. Those who were there made a pact saying, never again.

Fast forward to 2016 

Dr Benny Malakoane is a medical doctor and was until recently Health MEC in the Free State. Over a three-and-a-half year period he oversaw the collapse of the public health-care system in the province, and turned the state machinery on elderly community health workers who were asking inconvenient questions, while facing multiple charges of fraud and corruption (these cases are still ongoing due to continued delays).It now appears that, much like Manana and Nkonyeni, Malakoane enabled a quack to operate with impunity in a state hospital, using unsuspecting state patients as guinea pigs in an illegal stem cell trial. In fact, this operation had been signed and sealed in a three-year contract which was due to further impoverish the Free State health system and enrich the shareholders of ReGenesis Health with millions of rands.

Questions must be asked over the enthusiasm of the MEC in signing this contract and personally overseeing its implementation. One has to ask how the MEC could be so enthusiastic in rolling out an untested stem cell intervention in the Pelonomi hospital’s orthopaedic department while his health system is collapsing and failing to get basic medicines to clinics and hospitals.

The Medicines Control Council led by Professor Helen Rees intervened within days of health minster Dr Aaron Motsoaledi becoming aware of this contract. It is refreshing and heartening to know and see in action the difference an ethical, incorruptible and no nonsense health minister and medical doctor can make. If only we had someone like Dr Motsoaledi in the early 2000s.

The MCC swiftly closed the ReGenesis operations at Pelonomi and have made it clear that according to the information they have, an illegal trial was being conducted, using an untested intervention.

For now, the operations have been brought to a halt and the Free State Department of Health has cancelled the contract. The MCC has sent ReGenesis a comprehensive list of questions, and Free State Premier Ace Magashule has been left with the task of holding his MEC accountable. Don’t get your hopes up.

Within a day of the information being revealed by Spotlight and the investigative television show, Carte Blanche, Free State premier Ace Magashule shifted his Health MEC to Economic and Small Business Development, Tourism and Environmental Affairs, and installed his former Police, Roads and Transport MEC Butana Kompela as the health custodian.

However, we cannot allow another quack enabler to get away without being held accountable.

The Free State Department of Health and Premier Magashule have to provide answers to some very serious questions. For instance, why did the Free State Department of Health publish a tender for stem cell therapy in the first place? On what basis was ReGenesis appointed in June? Why was Malakoane so closely involved with the project, chairing the board that would provide oversight of the work and research done by ReGenesis?

Simply shifting Malakoane to another post doesn’t make these questions go away. For there to be any accountability we need answers to these questions. The people of the Free State are not guinea pigs. They are not pawns in an alleged scam to enrich charlatans.

Not on our watch. The ball is in your court Premier Magashule.