‘SA’s health-care sector is critically sick’


Zodidi Mhlana

Johannesburg- Despite the strides that South Africa has made over the past decades to improve its public healthcare, some believe the system is still in the doldrums.

Lobby group Treatment Action Campaign (TAC) Secretary General Anele Yawa said a critical shortage of doctors, nurses, inadequate resources and exorbitant drug prices were crippling the sector.

“The public health system is broken, it’s beyond repair and the only way we can be able to fix it is only when professionals like doctors, nurses, pharmacists and healthcare users speak with one voice and say no. Both healthcare providers and users are being frustrated by the same system which fails poor people,” Yawa said.

Health professionals were leaving South Africa due to some of the problems.

“About 42 million their lives depend on the public healthcare, but the work force including doctors and nurses, it’s not over 1 million. How do we expect a small work force to be able to attend to the needs of so many? The system is not about having the state of the art building but about services.  You can’t put profits before the lives of the people,” Yawa added.

The number of people being diagnosed with different diseases has been rising.

Statistics South Africa’s Mortality and Causes report showed that TB remains the leading cause of death with 33 063 deaths in 2015.

An increase in the number of MDR-TB (multidrug-resistant tuberculosis) and XDR-TB (extreme drug-resistant tuberculosis) patients has also been observed.

Former TB patient Goodman Mkhanda is familiar with the challenges which exist in the sector.

Mkhanda’s was diagnosed with multidrug-resistant tuberculosis (MDR-TB) and later extreme drug-resistant tuberculosis (XDR-TB).

Doctors who treated Mkhanda during the period believed that his four-year battle with the disease was a “rare” case.

Mkhanda from Khayelitsha on the outskirts of Cape Town was first diagnosed with MDR-TB in November 2013. In 2009, he was also diagnosed with type 2 diabetes.

“Before the diagnosis, I vomited blood and I was tired.  After a test, they found that I had TB.  But, they told me that It was not going to take six months to cure it.  It was the first time I heard about MDR -TB.  I was also informed that I would be on treatment for two years. and I would be taking an injection for five days a week and over 25 tablets daily,” Mkhanda said.

As he struggled to receive some life -saving drugs from public healthcare facilities, he had to rely on Doctors Without Borders (MSF) for drugs like bedaquiline and delamanid, as they were not available in the public sector.

His hopes of completing his MDR TB treatment within two years were dealt a heavy blow when he was diagnosed with the much more resistant XDR -TB.

Experts believe the fact that Mkhanda is diabetic complicated his treatment.

Doctors at Groote Schuur hospital in Cape Town removed his other lung after TB was detected in it.

MSF drug- resistant TB Doctor, Anja Reuter who works in Khayelitsha acknowledged that access to life saving drugs was limited

“Goodman had access to new drugs which some people don’t usually have access to. He had bedaquiline approved. Access to some of these drugs is limited. He had delamanid applied for use through compassionate use in 2015. He was one of the few patients in Khayelitsha to get the drug. The drugs are too expensive,” she said.

In March 2017, health minister Dr Aaron Motsoaledi said that the government was spending R400 000 to treat one MDR-TB patient and nearly a million rand to treat one XDR-TB patient.

Mkhanda is involved with End TB Non- Governmental Organisation and educates school children and communities about TB.

“The stigma in the community was unbearable, the minute you start losing weight, they begin spreading rumours about you,” he said.

After a four-year battle, Mkhanda was cured of XDR-TB in December 2018.