South Africa - Health 
Hospitals held ransom over financial mismanagement 

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Mpumalanga Official site 
AENS /, 17 February - Medicine supplies will finally be restored to hospitals in the Mpumalanga province, northeast in South Africa, on Monday when the province settles long overdue accounts totalling R23 million. The payments will attempt to pacify 13 of South Africa’s largest pharmaceutical companies, which froze deliveries of 996 types of vital medicines and other supplies to provincial hospitals after the government failed to pay accounts dating back to October 2000.

Mpumalanga province in South AfricaThe blacklisting of Mpumalanga's health department is only the latest in a spate of service cuts caused by apparent financial mismanagement in the province. Environmental affairs department staff were forced to work in the dark and take their own water to work in January after local authorities cut water and electricity due to unpaid accounts.

- Not even the toilets worked, so we either had to take bottles of water to flush or had to drive into town every time we had to answer the call of nature, said an official.

The government also ordered Telkom to cut the department's main switchboard on December 14, after denying that it was an official number, said Telkom spokesman Andrew Weldrick. Blundering officials only confirmed that the number, which is clearly listed in telephone directories and on the government's own Internet site, was in fact registered to government on February 5.

Even emergency services have been affected, with the central ambulance control room in the provincial capital, Nelspruit, paralysed for hours after the municipality cut power due to a R400 000 overdue electricity bill.


THE freeze on medical supplies to Mpumalanga hospitals is already disrupting basic services at some of the province's biggest hospitals.

Rob Ferreira hospital in the provincial capital Nelspruit has warned it may have to close its theatres and cancel all operations dues to shortages in basic supplies such as needles, antibiotic, sterile latex glove and medical waste disposal bags.

The shortages have forced doctors to barter for alternative supplies from neighbouring hospitals, or use cocktails of more expensive wider spectrum medicines. Senior hospital staff, who refused to be named for fear of victimisation, said stocks of sterile gloves ran out after staff were forced to use them when supplies of less expensive general purpose latex gloves were depleted.

- It’s really quite desperate and is having a severe impact on patients, said one doctor. The shortages aren’t however confined to medical supplies. Rob Ferreira is currently forced to refer between 30 and 40 patients to Pretoria hospitals every month because it has no money to fix a urology theatre table or C-Arm equipment used during hip or femur operations.

The hospital, which serves roughly 500 000 people, also only has one ambulance which doesn’t have a spare tyre and only one ambulance crew. The hospital, doctors say, should have at least three ambulances on duty at any one time, and another on stand-bye.

Rob Ferreira has also been forced to cancel all cataract eye operations and related treatment because there is no money for replacement lenses for patients. "We used to do roughly eight operations per week, but people are now simply put on a waiting list. God knows when they’ll ever get the operations, but even if we started today, we have enough people on the list to last for two years," said the doctor.

Equipment shortages at Mpumalanga’s second biggest hospital, Themba, are already being probed by the Human Rights Commission after at least two young boys were crippled and left severely brained damaged during routine surgery.

Zweli Methule and Bheki Mokoena are only 10 and 13-years old but are not expected to live beyond their 26th birthdays after surgery to fix their broken arms went horribly wrong. Themba hospital staff claim that the boys were left paraplegics and brain damaged after an oxygen machine failed mid-operation.

The department is accused of ignoring the boys’ plight and denying them physio-therapy for four years before a media expose three weeks ago. Social workers immediately visited Methule’s family and promised specialised care if the family promised to stop speaking to the press. Mohlomunyane also insisted that Mathule had received therapy and had been admitted to Themba’s children’s ward for treatment, but refused to provide documentary proof.

SAHRC commissioner Charlotte McClain is investigating the case. Mpumalanga’s health department is meanwhile also systematically shutting down its district offices in an attempt to save money. Staff members have been redeployed to clinics and hospitals, but have halted all community work due to budgetary shortages.

The district offices were responsible for monitoring and co-ordinating health projects like home-based care for people with Aids, mobile health clinics and mother and child health care and nutrition. The Malelane district office, which serves the impoverished and densely populated Nkomazi area, was closed down on December 30 when its 18 staff were redeployed 35km away to Shongwe Hospital.

- We’ve asked staff affected by the longer distances to report to their nearest clinic until we’ve developed a redeployment system, said Lowveld health district manager Gladness Mathebula. "We pay tens of thousands of Rands on rent when there is space for us at clinics and hospitals." She confirmed that district offices in KaBokweni and Nelspruit would also be closed.

Welfare organisations, including old age homes, child welfare groups and victim support groups, have been unable to pay salaries and are facing bankruptcy after Mpumalanga's social services department failed to pay their monthly grants in January. The problems are not new. 

Provincial Auditor General Douglas Maphiri warned in a series of reports issued last week that Mpumalanga also failed to pay its accounts in both 1998 and 1999 and that hospitals ran out of medicines and other stock in July 1999. Government denied the crisis at the time and branded media reports as "blatant distortions".

Maphiri warned this week that officials who failed to pay for services were breaking the law and were personally liable. The growing crisis comes despite tight new cost curtailment measures implemented by Premier Ndaweni Mahlangu and the confiscation of all order books from departmental officials.

Mpumalanga's finance department head Zakes Dube also attempted to cut costs by forcing all his employees to take extended leave over December and January to minimise telephone, electricity and related costs. Provincial communications director Joy Letlonkane attempted to downplay the crisis on Friday, insisting that Mpumalanga was managing its accounts appropriately and that the "slight" delay in settling accounts was caused by a computer glitch.

She again slammed media coverage of shortages or power cuts as "distortions and blatant factual inaccuracies" but confirmed the province had been forced to pay R10,1 million to pharmaceutical companies earlier in the week and was making a second R9 million payment on Friday in an attempt to restore medical supplies to hospitals. 

- All departments have [also] been advised that there must be timeous payment of electricity, telephone, water supply accounts ... any delays in payment by departments will be death with, she said.

National finance spokesman Moeti Kgamanyane meanwhile described Mpumalanga's plight as serious on Friday and confirmed that minister Trevor Manuel attempted to convince Mahlangu in September last year to allow the national Treasury to take over direct financial management of the province. "The premier was not impressed and insisted that he would personally take responsibility and deal with the shortfalls. Provinces have some autonomy over their management, so we cannot force them to accept advise and are now only able to monitor the situation closely. We are however worried," said Kgamanyane.

Manuel is also concerned, Kgamanyane added, at the enormous expense lavished on Mpumalanga's plush new R650 million legislature and government complex. The complex was initially only supposed to cost R120 million. The province pushed ahead with the development even when Manuel withheld approval for its funding model and has to date barred journalists from the construction site on pain of arrest for trespassing.

By Justin Arenstein, African Eye News Service (AENS) 

© African Eye News Service (AENS).

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