'It gives us sleepless nights': Sekhukhune's broken hospitals & water system
While Limpopo's Health MEC Phophi Ramathuba says she is doing all she can, Sekhukhune residents tell a story of hardship just to get healthcare and water.
JOHANNESBURG - Residents and civil society leaders in several areas in Limpopo’s Sekhukhune District Municipalities have raised the alarm about what they described as the region’s collapsing healthcare infrastructure and systems at the expense of people’s lives.
Of the district’s seven hospitals, activists and community members from Burgesfort, where the Limpopo border leaves behind Mpumalanga, to Ellias Motsoaledi where the province meets Gauteng, say only one facility is in a healthy state. The area has over one million residents.
This means patients in all six others must endure great difficulties to access the most basic services, they explained, while others simply have to do without due to resource constraints and sometimes just pure unprofessionalism on the part of healthcare workers.
WATCH: 'This was not what I envisioned after 1994’ - Sekhukhune’s hospital crisis
Just recently, a man from Moutse died after being turned away at the Philadelphia Hospital.
“They said the only doctor there can only attend to injuries and patients who have been in accidents,” said an inconsolable Peter Mokone.
His brother Simon complained of body aches and Peter scraped together his last cents to rush him to hospital.
After being rejected by the only hospital within their reach, they went to a clinic on their way back home. A minor inspection was performed and, armed with what Peter describes as a mixture, they were sent home.
“That same evening, that’s when the problems got worse. It was after 10 pm, I remember there was not even electricity, he just got weaker and weaker.
“I was with him still asking about how he is… but he was just fading, and I could see him lose his breath. And he died right there in front of me,” said Peter.
Limpopo Health MEC Phophi Ramathuba told Eyewitness News in an interview that the incident was regrettable as there appeared to have been miscommunication between the hospital and the Mokone family on the fateful evening of his visit.
“When I analyse the reports and the file of the patient, I realise that there was little that the doctor could do, unless we had more doctors. It's weekend, you have got other doctors who were in theatre at that time with [an] emergency caesarean section that day. Unfortunately, this was the wrong day but it would have been wrong if the doctor had allowed them to stay there and he is busy with [other] patients. He finished them in the morning,” said the MEC.
Ramathuba said Moses had a chronic condition that did not require immediate attention as the hospital had to prioritise cases according to its urgency.
However, she assured residents that the hospital has since implemented corrective measures to ensure that in future, a proper debriefing is conducted before patients are sent home or referred to another part of the hospital on a different day.
Moses Mokone, a 47-year-old man who passed away after allegedly being turned away from Philadelphia Hospital in Dennilton. Picture: Supplied
'THEY DIDN'T EVEN BOTHER WITH MY LEG'
While the Mokone family is considering suing the hospital, just under two hours away in the town of Jane Furse, a 36-year-old man said it was too late for him to seek justice after suffering at the hands of nurses.
“They did not even bother with my leg.”
James Masha was rushed to the Jane Furse District Hospital after he was involved in a head-on collision that claimed seven lives on one of the nearby roads in the area.
He said what he received there was not healthcare as enshrined in the Constitution and the country’s patients’ charter.
“When I woke up in the hospital, it was around 1 am on Sunday. When I got up, I found that my broken leg had no traction, the injured leg was my right leg, even now I cannot bend it," he said.
“They would punish me by withholding medication and when they did give it to me, they would chastise me. They would say I killed people. If they were meant to give me pills three times a day, they would give them to me once a day,” said a disillusioned Masha.
Masha now has a limp and a right leg that is as straight as a ruler.
“You see, I cannot even bend my knee,” he demonstrated to the Eyewitness News team as we sat down at a community pre-school in Mamone, just a few kilometres from the hospital.
Masha claims he was not bathed during the five days he spent at the facility before being transferred to Matlala hospital, where he received better care, albeit too late for his leg.
He said he was disempowered to act against the hospital from the onset because “I am poor.”
The Jane Furse Hospital has just over 200 beds for inpatients and is one of the busiest hospitals in Sekhukhune, catering to communities in and outside the Makhuduthamaga Local Municipality.
But its list of problems is long.
“The problems we uncovered were that the CEO has staff shortages, he also pointed to water access, other problems were about workers in general,” said Nkopodi Kgalema of the Mamone Residents Association.
Minutes of meetings held with the hospital management as far back as 2017 show that indeed these issues were brought forth by the hospital as in need of attention.
However, four years later, there has been no resolution and instead, the services at the hospital are getting worse by the day.
A confident Ramathuba challenged the Eyewitness News team to visit hospitals in other districts in the province to make a fair comparison between the situation there and in Sekhukhune.
She said the Jane Furse Hospital had improved remarkably since a turnaround strategy was introduced to deal with the issues raised by members of the public.
James Masha (36) is a former patient of New Jane Furse Memorial Hospital. He was mistreated there after being involved in a head-on collision. Hospital staff there verbally abused him there didn’t give him a bath for five days. Picture: Abigail Javier/Eyewitness News
'THE EVERGREEN WATER CONTRACT'
One of the key issues that got the residents’ association to the doorstep of the hospital’s management was why the Jane Furse District Hospital was still making use of water-supplying contractors for over 10 years.
“Workers in the hospital, including the CEO, when you mention the water issue, they get goosebumps. They say, 'it's politics and we don’t get involved'. They do not give you any real answer, they just say the water issue is politics,” said Kgalema.
It has been reported that the contract is worth R20 million every six months.
Despite having boreholes above its premises and a big empty reservoir just 1km away, the hospital has no running water and has not had any for the better part of its relocation to the newer premises.
“There is a reservoir above the hospital. Just above the hospital, there is a dam. We asked them why not take water from there and connect it to the hospital. We did not get an answer to that question either, when they answered us, they told us 'it's politics' and that is where we are confused because we don’t know what politics has to do with hospitals,” said Sheila Mokgoatjana, a resident of Mamone.
The situation is particularly personal for 63-year-old Mokgoatjana who is a former uMkhonto we Sizwe freedom fighter.
She feels betrayed by her former comrades, whom she said now question her education credentials when she requests meetings to see if millions of rands in taxpayers’ monies cannot be saved by putting an end to the water contracting situation.
“It has been about 10 years or more since the contractors have been coming and going. We call it a syndicate now. Because they are not concerned about the communities or people, they are only looking to help themselves and their friends.
“If our government had care, they would guarantee that there is a shortage of water and be transparent about where the water comes from. Our government just ignores us; we just see water being transported this way,” Mokgoatjana said.
Ramathuba explained that although boreholes were installed at the Jane Furse hospital, there was no water to draw.
Although she admitted that the current method was not ideal, she said her only concern in the issue was to ensure that there was water supply to the hospital, a service procured from the municipality.
“That is a municipality arrangement, for me all I want is water in the hospital. All I want is water in the hospital. If I have no shortage of water, I can’t fight with the municipality,” she said.
A wide view of Jane Furse in Sekhukune district in Limpopo. Picture: Abigail Javier/Eyewitness News
'SELLING GOVERNMENT WATER TO GOVERNMENT'
An hour away in Apel, which falls under the Fetakgomo Tubatse Local Municipality, also in Sekhukhune, residents are feeling the wrath of the “evergreen” water contract.
How the communities around Apel are connected to the Jane Furse District Hospital water crisis sounds like modern South African daylight robbery.
Exposed in North West a few years ago, officials involved in the scheme conspire with private contractors, create problems around the provision of municipal water supply to areas or key institutions – only to issue tenders for water tankers.
Sekhukhune residents and activists told Eyewitness News this is the modus operandi at play at Jane Furse Hospital.
Upon entry in Apel, the dozens of green water tankers collecting water from a municipal office stood out like a sore thumb.
“The people from Makhuduthamaga are taking water from here, selling government water to the government, to my surprise,” said a young Apel activist Lucky Raphiri.
Meanwhile, water provision to the area’s households remained rare, with many blaming the trucks for guzzling all their supplies.
Trucks with water tanks queue to get filled with water by the pumps of Fetakgomo Tubatse municipality. These tanks will be transported to the New Jane Furse Memorial Hospital in a different municipality, between 60km and 80km away. Picture: Abigail Javier/Eyewitness News
THE HOSPITAL THAT NEVER WAS
The residents in Apel were somewhat used to being overlooked, though.
They have been waiting for a hospital to be built in the area for 24 years, with all indications that they would have to wait even longer.
Before 2016, the area had its municipality, Fetakgomo, which was amalgamated with Greater Tubatse and now resides over 400,000 people. Even then, their letters to the provincial government, protests and meetings with authorities failed to garner sympathy.
Instead, the site where the hospital is meant to be built is now home to the Nchabeleng Community Health Centre.
The clinic offers a limited number of services, which the Limpopo Health MEC said were far better than at other facilities that accommodated a higher number of patients than Nchabeleng.
Ga-Nchabeleng resident, 61-year-old Lucas Tebeila, said the consequences of not having a hospital nearby complicated their lives.
“The hospital issue is a difficult one, it gives us sleepless nights... Now if someone is pregnant and is in labour, they will just give birth in the street or the wilderness, trying to rush to Jane Furse Hospital. Our wish is that there should be development here and the hospital be completed,” said Tebeila.
Tebeila was still wearing his Sekhukhune municipal workers’ uniform, a two-piece overall, when he welcomed Eyewitness News to his modest home. We first encountered him outside the municipal offices about 3km away as we watched water tankers queuing for water.
Lucas Tabiela, a Sekhukhune municipal worker for 30 years. Picture Abigail Javier/Eyewitness News
He said he was due for his pension next year after working for the municipality for over 30 years, but still had no idea why the government kept reneging on its promise to build them a hospital.
“When you ask questions, you don’t get answers. We are pleading with you to speak to those in power to get this area developed so that we can be like other communities,” explained Tebeila.
Ramathuba explained that “there was bad planning” when she acknowledged that the community had indeed been promised a hospital.
However, now in charge, she has resolved to reassess the plan, using data on the community health centre's usage by the community to determine whether there is a need for a hospital.
And so far, she has yet to hear a compelling argument that supports the notion that a hospital is needed in the area.
“Since my appointment, I have been dealing with this Nchabeleng Health Centre matter. Nchabeleng was planned at that time. When they planned, they were planning a hospital. They built it and they stopped… It is my understanding that whoever had planned, had poor planning because they started building and thought [later] that we might have made a mistake by building a hospital in this particular area,” she said.
According to a document seen by Eyewitness News, the Nchabeleng clinic is far less busy than the Mohlaletse Clinic and is inferior in stature to the latter.
Meanwhile, Raphiri described the clinic as a terrible reminder of what should have been a local hospital.
“It’s a very big shame, the yard itself shows you it was supposed to be a hospital, as you can see, but due to the political dynamics and whatever, we ended up having a CHC than a hospital,” he said.
Ramathuba said she had no reason to have a vendetta against the people of Nchabeleng as some of her predecessors and top managers in the health department hailed from the area but have also failed to make a convincing case for a hospital to be built.
Lucas Tebeila, resident of Apel, passes a water tank being filled by the pumps of Fetakgomo Tubatse municipality. Picture: Abigail Javier/Eyewitness News
'A BROKEN SYSTEM'
Sixty kilometres away from Apel, we entered the Mecklenburg Hospital in Moroke. Here, we found dozens of people queuing on the pavement leading to the facility’s doors.
Before we reached the entrance, the overgrown grass, unkempt doctors and nurses’ homes, dirty mops leaning against the hospital’s windows and walls told a story of anything but a hygienic environment where healthcare is dispensed.
Despite witnessing the hospitals in Sekhukhune including Mecklenburg at their worst regularly, chairperson of Sekhukhune Resident’s Forum, Mankalakatje Phasha, said it still shocked him.
“Overall, the Sekhukhune has almost non-functional hospitals. All the hospitals have collapsed. Whether it's poor infrastructure, maintenance, or services people are getting from there, they are in a poor state. It is shocking, especially now in this COVID-19. To have a situation like that is very shocking,” he said.
A second hospital, also along the R37 outside Burgersfort, is referred to by patients and community members as maotong a gago, a Sepedi phrase meaning “your death”.
Dilokong Hospital, which was built at the peak of mining activity in the Driekop area, started as a model facility. People would drive past Mecklenburg, travelling there for “better service”.
But it was not long until this was a thing of the past.
Kholofelo Rachidi blames this on a culture inspired by the top leadership of the hospitals.
“The innocent workers come into a system that is already rotten. They come in as clean as they are, fresh from university and college but they find themselves in a system that is already rotten to the core and with time they also become part of the problem," he explained.
“So, with the energy that they come in with, it goes with time, and they join those that have already lost hope in changing the system. So it goes down to the culture that is created in all these institutions. They raise these issues with us in the communities and the forum,” he said.
He too has witnessed his fair share of hospital failures in the district.
“There are a lot of issues that are very problematic in our hospitals. One is the state of infrastructure, as you look around you can see the area is dirty. It is a problem across all our areas in the districts. We also have taps and door handles that are not functioning. We have an issue with the quality of food that is provided to patients,” he said.
Communities of Apel have resorted to buying water to fill their JoJo tanks from private tenders as government does not provide an adequate supply. Picture: Abigail Javier/Eyewitness News
'MEN DON'T HAVE TO PROVE THEMSELVES'
In her lengthy interview with Eyewitness News, the Limpopo health MEC expressed disappointment with the handling of the healthcare facilities' issues by the NGOs in the Sekhukhune District Municipalities, relaying that some of their actions could be akin to political sabotage, while unhealthy business competition also played a role.
She agreed that there were serious challenges at a lot of the facilities when she became MEC, yet pointed to cases where her interventions led to stellar results, such as the improvement and capacitation of Philadelphia Hospital and the H.C Boschoff Hospital in Maandagshoek, which was wasting away before she transformed it into a maternity specialist facility.
However, it appears nothing she does ever pleases the community as issues at play are far beyond what meets the eye.
Questioned why the communities and civil society organisations’ sentiments were at odds with her understanding of the situation on the ground, Ramathuba said: “When dealing with Sekhukhune, it’s like when you are a woman and get an executive position, you must prove yourself. When men don’t [have] to prove themselves.
“What is good is that people must judge us from the results. How many people have died before I was appointed and how many people I am saving? With the limited resources - we’ve got no nurses - we still run the biggest campaign,” she said.
On 3 June 2021, Limpopo Health MEC Dr Phophi Ramathuba officially handed over more than 20 Emergency Medical Services vehicles of which five of them are specifically meant for COVID-19 response, fitted with high flow oxygen. Picture: @HealthLimpopo/Twitter.
As many hospitals across the country pulled out all the stops to prepare their facilities for the COVID-19 pandemic and on the back of cash injections to help ease the process, activists and residents claim the hospitals in Sekhukhune remained the same.
The “disrepair, ill-treatment of patients and lack of basics” remain entrenched in the system, they complained.
“If you look at the state of our infrastructure, it is not up to standard to be able to respond to the crisis should there be an outbreak. The state of our resources inside the hospitals, they are old and dilapidated, they are broken, and all those things are very key. The quality of water provision gets interrupted sometimes and that is why I think, should there be any outbreak, we are going to have problems. The district would not be able to respond to the crisis,” said Rachidi.
Limpopo has been praised for its handling of the coronavirus vaccination drive, leading in the country with its registrations and vaccinations.
While the situation in the country’s public hospitals has been bursting at the seams for years, it is not often that the problem affects an entire district.
But in Sekhukhune’s case, it appears that the problem, whether real as activists say or imagined as the MEC is convinced, is but part of a failing municipality that lies atop trillions of rands in mining deposits.
It is an inescapable feature of the district.
As you drive along its main roads, be it the R37 or R555, scarred mountains tell a story of mining production at a grand scale. Smelters, coal trucks and other mining infrastructure also bear testament to the mining activity in the district.
However, despite its rich history and land, all indications are that a lot is brewing under the surface in Sekhukhune, and its not just the minerals.
Thabiso Mokgatjana lives next to the big reservoir but doesn’t benefit from it. He is forced to buy his own water. Picture: Abigail Javier/EWN