Do South African patients have any rights when their doctors strike?

‘Striking South African doctors are a serious threat to the human rights of all of the country’s residents — even refusing to treat emergency cases…’

 Picture: with South Africa’s 640 public hospitals facing a devastating strike by its 18,000 doctors, do the country’s more than 30million poor patients who rely on these hospitals have any other alternative health care left, other than visiting the local witch doctors?

June 21 2009 – CAPE TOWN. For the third time within two months, the country’s 18,000 overworked, underpaid and totally demoralised public hospital doctors are planning yet another wildcat strike from Monday at the 640 state hospitals. They start the strike in KwaZulu-Natal and the Eastern Cape on Monday, and it will expand to the other provinces Tuesday and Wednesday.

The SA Medical Association spokesman Lebogang Phahladira told the Sunday Times on Saturday that the striking doctors ‘will report for duty and sign attendance registers – but will refuse to treat patients, even in emergencies.” 

  • And South Africa no longer has enough doctors in the private sector nor in the military to help out in emergencies– even if they were asked. South Africa now only has about one doctor for every 200,000 people and its public hospitals are overburdened due to the combined TB-AIDS epidemics.

In 1985, South Africa’s public health service had more than 25,000 physicians and dentists; 5,100 specialists, 222 dental specialists and 18,700 paramedical workers, registered at the South African Medical and Dental Council;  and 155,000 registered and staff-nurses. South Africa is in the midst of the world’s most devastating co-epidemic of two simultaneous killer-diseases, TB and XDR-TB — and the rapidly-shrinking medical staff can no longer cope.

“Thousands of patients face being turned away from public hospitals (Monday) if the wildcat strike by South Africa’s 18,000 disgruntled state doctors goes ahead”, reports the Sunday Times.The South African Medical Association (Sama) spokesman Lebogang Phahladira said on Saturday that it ‘’expected a total shutdown” in KwaZulu-Natal and the Eastern Cape, followed by the rest of the country on Tuesday and Wednesday.

  • By late Saturday, neither the doctors in the South African National Defence Force nor the private hospital sector — both central to government’s previous strike contingency plans — had received any requests for help.

Goverment Hospitals Sowetan CartoonSama spokesman Phahladira said members had “overwhelmingly” decided to strike. Doctors would report for duty and sign attendance registers but would not treat patients. “None of the departments will be operational and we will not see any patients, even in an emergency. We will not work until our demands are met,” said Phahladira.

Sama wants a minimum 50% salary increase for its 7000-odd members. Government has offered a mere 5% – which is less than inflation. Apparently, a revised deal will be presented at a bargaining council meeting forthcoming Wednesday.

Sama chairman Mac Lukhele said although many members planned to strike, the union had appealed for patience until the outcome of this latest meeting. Some have agreed to hold off on strike action.

  • A spokesman for the Hospital Association of South Africa, Kurt Worrall-Clare, said the group had had no requests for help. He said that in the past the association, representing all major private hospitals, had received formal requests from the government at least two or three days before anticipated strikes.
  • Morgan Chetty, chairman of the KZN Managed Care Coalition representing some 3,500 doctors in the private sector, said they would not have enough doctors to help out if asked.
  • Defence force spokesman Sam Mkhwanazi said the SANDF ‘s medical teams have also had not been asked to assist.

‘There is no crisis’ – KwaZulu-Natal health MEC…

The KwaZulu-Natal provincial MEC for health, Sibongiseni Dhlomo, told the Sunday Times yesterday ‘the department did not believe outside assistance was necessary because there was no crisis.’  However, in Gauteng on Friday, a provincial memo to Johannesburg hospitals requested contingency plans be put in place and strike committees set up. Gauteng health spokesman Mandla Sidu said it was the “prerogative” of hospital chief executives to request SANDF and private sector assistance. Western Cape health spokesman Faiza Steyn said the province had a “sufficient pool” of doctors, including part-time doctors, military doctors and agency staff, to draw from. Attempts this week to get comment from the national Department of Health were unsuccessful. — Additional reporting by Chandre Prince http://www.thetimes.co.za/PrintEdition/Article.aspx?id=1021082

Nightmare scenario

During the previous wild-cat strikes on June 6, 2009 and May 29 2009, accident victims who were rushed to state hospitals in Pretoria had to wait for three days for emergency surgery, and in Cape Town, it was  reported that during a protest march on Parliament, a petition was handed in by more than 100 local doctors, pharmacists and other public sector health professionals – demanding fair pay and better working conditions. The march was organised by the SA Medical Association (Sama). The document calls for the immediate implementation of the promised Occupational Specific Dispensation, which was supposed to take effect in July last year; a minimum 50 percent increase in basic salary; and the unfreezing of all essential public sector medical posts. At the moment, more than 60% of the nursing staff posts also remain because there simply aren’t enough qualified people to fill them.

Three-day wait in trauma unit for surgery:

Nurses and doctors at the Pretoria Academic Hospital, which was renamed the Steve Biko hospital in 2008, told the emergency-room patients waiting for their emergency surgery on June 6 that ‘it was out of their control about who gets to be operated when, we are overloaded with work’, telling patients that they were so permanently understaffed that emergency patients were forced to wait for days, with wounds remaining undressed and infections setting in, even without any strike actions…. For instance, emergency cases rushed to this academic hospital now already are being forced to wait without treatment in the trauma department of the Pretoria Academic Hospital for at least three days before they can be operated on.  http://jv.news24.com/Beeld/Suid-Afrika/0,,3-975_2527110,00.html

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Best public health system on African continent only fifteen years ago…

South Africa used to have the best Western public-health system on the African continent: In 1985, South Africa’s public health service had more than 25,000 physicians and dentists; 5,100 specialists, 222 dental specialists and 18,700 paramedical workers, registered at the South African Medical and Dental Council, and more than 127,000 registered nurses signed up at the Nursing Council – and by 2002, there were 155,000 nurses.

In 2002, Statistics SA showed that the country had 155,000 top-trained practicing nurses, for a nurse/population ratio of about 343 per 100,000, well above the  200 per 100,000 minimum required by the World Health Organization. Now, the country’s public hospitals show a severe staffing problem, with more than 60% of all the nursing posts countrywide remaining vacant for months on end. In many rural towns in all the South African provinces, there no longer are any physicians at all.

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Previous strike June 2007 plunged hospitals into chaos

There had also been a public service strike in June 2007, which included all the nursing-, technical-, clerical and janitorial staffers  in the country’s public hospitals —  but which at that time, had seen doctors keeping themselves aloof from striking –,  although they often publicly did sympathise with the poor working conditions of the medical staff.  And when the nursing staff did not get the pay rises they wanted even after this devastating strike, during which many people died because they were left untreated in emergency rooms, they left the public service enmasse. Now there’s a an average, countrywide nursing shortage of 60%, with some public hospitals reporting up to 90% shortages.

Cosatu president Sidumo Dlamini said the state of staffing at the country’s public hospitals was a "ticking time bomb" and noted that if doctors were not happy in South Africa, the entire country would suffer.

  • "We are saying to our government that this matter is very urgent. Workers in this country have been in recession for many, many years. When salaries get lower, it is destroying the country," he said.

36 hour shifts for $800 a month, overtime without pay :

The doctors’ two-month campaign for better working conditions also include weeks of angry picketing . Doctors warn that they are being grossly underpaid, are forced  work 36-hour shifts without any overtime pay because of the severe shortage of physicians and specialists, that there also is an often dramatic shortages of critical drugs and equipment at all the state hospitals, and heavy workloads for physicians, with shifts lasting up to 36 hours. The government had moreover offered these doctors a deeply insulting 5% in a pay-rise, which does not even cover inflation, said the South African Medical Association chairwoman Denise White.

The Health Professions Council of SA refuses to support the strike – albeit does  ‘acknowledge the need for adequate remuneration packages”.

  • "We do not support or condone the strike by public sector doctors over salaries and working conditions as they provide an essential service. However we fully acknowledge the urgent need for commensurate remuneration packages and improved working conditions," said HPCSA Registrar and CEO, advocate Boyce Mkhize. "Public sector doctors are professional health care practitioners working under sometimes extremely challenging conditions while saving lives on a daily basis and should be remunerated accordingly."

Doctors, nurses fleeing overseas:

HPCSA statistics indicate that over the past year 3,550 certificates of good standing were issued for medical practitioners alone while 22,032 certificates were issued since 1 April 2003. The majority of these certificates are requested by doctors applying for positions overseas.

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‘can any doctor still function safely after a 36-hour shift?’

Interns take home about R8,000 ($800) after deductions and specialists roughly double that, according to the United Doctors Forum deputy chair Mpho Mohlala. "We are not giving proper basic care to the patients. You are not doing justice to the patients. Do you think operating (on) a patient without having sleep for 36 hours, you are functioning? You are non-functional," said Mohlala.

Government denies there’s any crisis

"We’ve got an exodus of doctors leaving the country, going to work overseas, and we’ve got lots and lots of doctors moving out of the public sector to the private sector," she told Agence France Presse news agency.

  • The health department denies that its sector is in crisis, saying media reports are ‘alarmist’.

“Illegal strikes and illegal marches” – but would they really fire all their doctors?

At the moment, more than 60% of the nursing staff posts already are left open. The exodus of South African nurses to Western countries started from 2004 – but the government itself has made matters much worse because it failed to address the complaints issued by staffers ever since the 2007 public service strikes, which brought no improvement in the working conditions.  South Africa’s nurses started migrating abroad enmasse. And now, it looks as if South Africa’s  doctors are also throwing in the towel – thus condemning Africa’s once so brilliant First-World public health service to death. http://www.news24.com/News24/South_Africa/News/0,,2-7-1442_2523853,00.html

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History of South African public health service under apartheid:

South Africa’s present public health system was launched by the apartheid-government from 1977. It started an ambitious building programme of public hospitals, outpatient clinics and rehabiliation facilities countrywide for people of all races, and where patients could pay for health care according to their income. The motto of the SA public health service was: “Patients pay according to their income, and those who cannot afford it, get treated for free.” Anyone earning less than R20,000 a year did not pay anything at all – ever, even for the most sophisticated open heart-surgery.

Preventative care was emphasized during apartheid:

The emphasis at these facilities was on preventative care: focussing on the rapid detection and prevention of the huge number of diseases Africa is prone to, from bubonic plague, bilharzia, cholera, tuberculosis, leprosy, polio, smallpox, malaria, haemorrhagic viral diseases, yellow fever, venerial diseases and meningitis.

  • Within ten years after launching its public health service programme, South Africa had brought leprosy, yellow fever, smallpox and cholera completely under control, and polio and tuberculosis were ‘being well-managed’ because of the enforced, free immunisation of all children of all races against polio and tuberculosis.

By 1985, there were 122,402 beds in 623 state hospitals, and in 1985 the four provinces at that time, spent $23,7million each for maintaining their new public health facilities and clinics. The giant Baragwanath hospital built right next to Soweto’s railway line, added another 120,000 annual in-patients to this list — as well as treating 1,5-million outpatients a year, serving the entire greater-Soweto area. Its maternity wards, if put end to end, measures a total of 1km. Mamelodi hospital near Pretoria also was added at this time with 12,000 beds, serving the black community for the entire greater-Pretoria region. However all the public hospitals treated patients of all races – albeit they were treated in racialy-segregated facilities during apartheid, which ended officially in 1994.

South Africa’s first-world medical standards also drew calls for help from the rest of Africa: for instance when the greatly feared haemorrhagic Marburg fever broke out in Kenya and the Congo, South African virologists were asked to attend to these emergencies by the World Health Organisation, thus preventing large-scale epidemics.

Health schemes for 5,2-million black taxpayers during apartheid:

The South African government also set up medical-health schemes for the working black population: by the end of 1985, there were 262 such schemes with a total membership of 5.2-million black taxpayers, with the fastest-growing scheme, Bonitas, having a membership of 184,672 members by 1986, mostly black taxpayers in government service, on farms and even in domestic service.

In 1985, South Africa’s public health service had more than 25,000 physicians and dentists; 5,100 specialists, 222 dental specialists and 18,700 paramedical workers, registered at the South African Medical and Dental Council, and more than 127,000 registered nurses signed up at the Nursing Council. Source: ‘This is South Africa,’ Jan 1987, ISBN 0797006540 State Printing Office, Pretoria.

sources, links:

Two Afrikaners killed in mysterious circumstances

Black man in BMW laughed as he shots dead white driver"

 Picture by Beeld newspaper: Lucas Stieler, brother of the murdered man, said his teenaged sons were in the car when their uncle Ernest, 39, was shot dead behind the wheel by the unknown driver of a luxury BMW who ‘laughed as he pulled the trigger’ on 16 May 2009 in an apparent ‘road-rage’ incident near Johannesburg. 

Jun 18 2009 Daniëlla du Plooy of Beeld newspaper has been asked by police to publish the description of a man who was driving a BMW-luxury car and had shot dead Ernest Stieler, 39, an Afrikaner who drives for UTi Sun Couriers in South Africa. He was killed on 16 May 2009. Police said they are looking for an ‘overweight black man in his thirties with a shaven head, who was with a black woman with long, curly hair and driving a BMW X5 with a GP-number plate with tinted windows." The suspect used a ‘silver-coloured revolver’ and was reportedly laughing, according to bystanders, while he shot dead the Afrikaner while driving next to him, and then chased away.  Anyone with information can contact the investigating officer, inspector J Faull at tel. South Africa 27 082 301 2410.

Eye-witness of this possibly racist road-rage incident were Stieler’s two teenaged nephews, who were riding in the vehicle with him when the shooting took place. Police spokesman superintendent Sefako Xaba of the Gauteng police department said ‘the possibility that this was a road-rage incident, is being investigated’, and they are looking for the black man in the BMW X5 who allegedly did the shooting.

The Stieler nephews said the black BMW X5 had driven up right to the bumper of the vehicle and had flashed his headlights, riding the bumper. When Ernest Stieler failed to move over, the black BMW pulled up next  to them, and the driver fired a shot at Ernest, who had started to slow down because they were approaching a traffic light. The shot hit Ernest in the chest and he died instantly, his family members said. "The suspect drove off,’ said Lucas Stieler, father of the boys. He said one of the boys had pulled on the hand brake, bringing the vehicle to a stop.  "The boys are now being treated by trauma experts for the horrendous experience. They told me the man looked straight at them and laughed while he pulled the trigger. It haunts them’.
http://jv.news24.com/Beeld/Suid-Afrika/0,,3-975_2531002,00.html

Afrikaans journalist/author André Potgieter killed in attack on smallholding

Jun 19 2009 Bloemfontein. – Pictured here is the well-known Afrikaans author/journalist André Potgieter (72), who died at the Pelonomi hospital in the Free State from trauma incurred during an armed attack at his smallholding in Jan Coetzee Avenue, Waterbron near Bloemfontein. He was bashed with a carjack and an angle-iron while asleep in his bed – and forensic examinations have shown that he also was stabbed with a knife in a ‘clearly ferocious assault’ on the sleeping man. He is survived by his wife Mara, sons Leon and Piet, and four grandsons. Two arrested men, Joseph Lechuti, 36, and Isaac Molefe (24) are being charged with murder at the Bloemfontein magistrate’s court on Wednesday, June 24 2009, reports Beeld journalist Loraine Kalp. Thus far, no known motive has been provided for the ferocity of this murder. http://jv.news24.com/Beeld/Suid-Afrika/0,,3-975_2531294,00.html

‘You whites live so nicely here – I am here to rape you…’

 
Pictured above by Beeld Afrikaans newspaper is Mrs Ohna Strauss, who with husband Jaco and their little baby girl were robbed at gunpoint at their high-security Kameelfontein smallholding east of Pretoria on Friday-night June 22 2009 by a gang of five blacks who told them: “you white people live so nicely while us black people are suffering out there’. Beeld journalist Daniel Maluleke reports that Ohna, 37, was then told by the men that "I am here to rape you..’
Normally, the race of attackers and victims are omitted from South African news stories – however it was mentioned in this case because the attackers had referred to the race of their victims, and giving this as a motive for wanting to rape Mrs. Strauss.
 

The five men showed up at the high-security Sable Hills Waterfront Estate during the early-morning hours. One had a firearm, the others were armed with a monkey wrench and a car jack. The attackers were worried about the couple’s  14-month-old baby girl Anni, and told each other they must give the baby a bottle ‘otherwise she’d cry’ – and one proceeded to give the baby her bottle while the others tied up the couple. The baby fell off the bed and injured her face against a cupboard.

The men then started dragging the couple around through the house by the hair while their home was being looted.  One of the men took off his own clothes and put on clothes belonging to Mr Strauss. They then locked Mr Strauss into a bathroom while they took his car-keys and fled in the family car.

Mrs Strauss managed to get out of her bonds and was able to remove her gag and started screaming for help. A neighbour who rushed in to help had to break down the bathroom door to free Mr Strauss. The couple had only moved into the high-security estate two weeks earlier. Police constable Portia Maleka said no-one has been arrested for the attack as yet – but they have confiscated the robber’s clothes for forensic testing: his DNA will be all over these clothes.

Security manager at the complex, Braam Fourie refused to comment about the attack to Beeld newspaper – he was quoted by the black Beeld journalist as saying that he wouldn’t speak to him ‘unless he could prove he worked for the newspaper”. 

  • The developers of the complex claim on their website that security is paramount for them: “Taking the rising crime figures into consideration, it is of utmost importance that we are assured of the safety of our families. We have thus ensured that the whole estate has a security fencing, and entry is controlled, with guards at the entrance gate 24 hours per day.  No one can enter without permission of  the inhabitants.Therefore, if you are looking for  a country lifestyle, where you can be safe, close to nature but yet near the city, consider buying a property at Sable Hills Waterfront Estate. It is a decision that you  will never regret. http://jv.news24.com/Beeld/Suid-Afrika/0,,3-975_2530995,00.html  also http://www.emacplan.co.za/sable_hills_waterfront_estate.htm

Man selling white woman’s body parts to witchdoctor arrested in South Africa

South African police arrest man selling a white woman’s breast and hand to traditional healer

 June 21 2009 — Willem Pelser  of Rapport, the Afrikaans Sunday newspaper, writes from Nelspruit that police have arrested an unidentified 48-year-old man from Acornhoek while he was trying to peddle carved up body parts of an unknown white female to a traditional healer. One hand offered for sale had ‘immaculately-manicured finger-nails’, police report. Busbuckridge Police Captain Leonard Hlathi said police forensic experts ‘strongly suspect that this woman may have been murdered, and that she had died only recently — as the body parts offered for sale were still ‘in good condition’. He issued an urgent call for members of the public who are missing a relative in South Africa, to call him at telephone South Africa (31) (0) 82 462 0804 with all the details. It is a new development that white victims are ‘harvested’ for the manufacture of traditional African medicine, ‘muti’, but this is the fifth reported white victims falling prey to this horrifying practice in South Africa this year.

Immaculately-manicured finger nails:

The traditional healer kept the man talking after he’d contacted the police. The man had shown up at his muti-shop with a white woman’s body parts. The organised crime unit of Mpumalanga province quickly showed up to arrest the muti-salesman.

  • Items offered for sale were a woman’s breast and one hand with ‘immaculately-manicured finger nails", Hlathi said. The suspect allegedly told the muti-doctor and the police that he’d ‘stolen the body parts from a mortuary” – however police strongly believe that the woman was killed for this purpose as the body parts were ‘still fresh’.

Hlathi said the body ‘may have been buried without being identified by her next of kin, and they may not be aware of her death.’ The woman’s organs were taken to the Acornhoek government mortuary for forensic examination and DNA-identification testing. Police are continuing to investigate the case, with the man remaining in custody and is being closely questioned. He is scheduled to appear in the Acornhoek magistrate’s court this week for his arraignment.

Very few public prosecutions of muti-killings:

Captain Hlathi is one of only a handful of police officers in South Africa who has actually managed to obtain successful prosecutions of muti-killers. And it’s nearly impossible to get convictions for the witchdoctors due to the very real fears of witchcraft among African police and public prosecutors.

However on August 20, 2008, Hlathi reported that three men, arrested for for selling traditional medicine harvested from a living human being  in Bushbuckridge, Limpopo province,  were actually jailed for it: a highly unusual event… read his report: http://www.sapsjournalonline.gov.za/dynamic/journal_dynamic.aspx?pageid=414&jid=10428

 

Pictured above, are the only three men who were convicted in 2008 in South Africa for a so-called ‘muti-killing": harvesting human body parts from live victims for the use in traditional medicine. South African restaurant-owner Floyd Mokoena, 58, son Toto Mokoena, 33, and family friend Justice Mjojo Ndubane, 28, were found guilty and jailed by the Bushbuckridge Magistrates’ Court for the muti-murder of Floyd’s nephew Clarence Brown on 15 August 2008. The testimony was that the men had slaughtered Brown alive for body parts on 23 February 2008 on behest of a witchdoctor which made ‘lucky potions’ out of this human flesh for them. However, the witchdoctor was not charged.

Also pictured: "Kill the Boer, kill the Farmer’,  is the ANC’s widely used anti-Afrikaner hate-slogan which was daubed on the walls of a farmer’s homestead with the blood from two murdered white women, one of whose breasts was cut off while she was still alive for the use in muti, traditional medicine. Muti is widely used in South Africa and is a multi-billion Rand industry — however most traditional healers do not order the harvesting of human body parts to manufacture their products. The traditional healer who was offered the body parts in Mpumalanga’s Acornhoek district immediately called the police and had the man arrested for offering him a white woman’s breast and hand for sale.

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Captain Hlathi reported on 15 August 2008, that these three men had been arrested by his team and convicted by the Bushbuckridge Magistrates’ Court. Their testimony was that Floyd told his son that he desperately needed human body parts for goodluck medicine, or as he put it, ‘to make his four businesses quickly churn big bucks’.

New trend: white South Africans becoming victims of muti killings:

Until just recently, there were very few reported incidents where white or Indian residents of South Africa had ever been killed to have their body parts ‘harvested’ for the use in traditional medicine, whereas this happens frequently to black residents.

Farmer Van Wyk’s mutilated body was found in the dining room of his homestead. ouse. One of the suspected murder weapons and beads covered in blood were found buried in the fields next to a lion camp on Venter’s homestead – another clear indication that witchcraft had been involved. Van Wyk,  a retired policeman who only alone stayed on his farm over the weekends, was allegedly lured outside where he was bashed over the head with a shovel, dragged inside the homestead while still alive — and then mutilated.  There seems little doubt that the same Lesotho man was also involved in the murder of Basie Venter. Venter’s widow Mary, 68, had witnessed the attack around 21:15 on Monday through a window in the house. Kroonstad police spokesman Maselela Langa confirmed these murders. He said the 25-year-old man, a Lesotho citizen, appeared in the Viljoenskroon Magistrate’s Court. He was not named and the man provided no reason for the murders. Nothing was robbed except the body parts. http://www.news24.com/News24/South_Africa/News/0,9909,2-7-1442_2495253,00.html

Hate-slogans against Afrikaners painted on walls with murdered women’s blood:

 And in on April 1, 2009, two Afrikaner farm women, Alice Lotter, 77, and her daughter  Helen, 57, were also tortured to death at their farm in Allenridge near Welkom in the Free State. According to forensic evidence, the Lotter mother and daughter had died excruciatingly painful deaths: they were first tortured by being stabbed with broken glass bottles into their vaginas. One of the women also had her breasts cut off while still alive – and then the women’s blood, police forensic experts found, had been used to paint anti-Afrikaner hate slogans on the walls of their homestead. They were then allegedly killed by strangulation – the women were hanged.  These all were clear indications of a ‘witchcraft-related’ or ‘muti-harvesting" crime, police say. Afrikaner police officers who investigated this horrific slaughter and had to gather forensic evidence, were severely traumatised and required trauma counselling. And, despite the fact that the Lotter homestead was only one block away from the police station, no-one responded to the screams from these women while they were being slowly tortured to death. The local farm community protested outside the heavily-guarded law court of Odendaalsrust by holding a re-enactment of the women’s torture-deaths (picture)

Picture below: a muti-shop in Diagonal Street, Johannesburg, South Africa. The sale of traditional medicine is a multi-billion Rand industry in South Africa. Most black Africans first go to their local traditional healers with their ailments before they will travel to ‘Western-medicine’ facilities such as local health clinics or state hospitals, although South Africa has a modern network of 650 public health facilities across the country.