News / Africa

South African Health Care Might be Rationed

A Paramedic from the Kwazulu-Natal Emergencies Medical Rescue Services (EMR) inspects one of the 150 new Ambulances stationed at Durban's Wentworth Hospital, South Africa, 28 Feb 2010
A Paramedic from the Kwazulu-Natal Emergencies Medical Rescue Services (EMR) inspects one of the 150 new Ambulances stationed at Durban's Wentworth Hospital, South Africa, 28 Feb 2010

South Africa continues to be in a health care crisis.  Doctors and nurses are leaving the country.  Equipment, supplies and hospitals are inadequate.  And, there are charges that the health care system is rife with fraud and mismanagement.

This woman, who does not want to be identified by name, has tuberculosis. Every day she comes to this clinic to get her medication.

"I lost two brothers because of the TB," she said.  "That is why I want to take the treatment for TB and finish this course.

She is one of the lucky ones.  The Eastern Cape is poor.  Unemployment is high and disease is rampant.  HIV, tuberculosis and other infectious diseases are all at pandemic proportions.  But the health care system is in chaos.  

Daygan Eager is a researcher for the Public Service Accountability Monitor.

"There isn't capacity there to deliver even the most basic services," said Eager.  "You're talking about rehydration packs for people with diarrhea.  Diarrhea is a major killer in South Africa."

In South Africa, each province has its own health care department.  Here in the Eastern Cape, this department has a long documented history of mismanagement and fraud.  Siva Pillay is the head of the department.

"We did investigations.  We found huge fraud.  I don't want to lie to you.  There's more than $200 million rand [$27million] of fraud and things like that," noted Pillay.

The biggest problem, though, is the increase in tuberculosis. Most of the patients here with TB are also HIV positive. Doctors, like Pillay, believe the increase in TB is because of the HIV epidemic.

"Our biggest pandemic today is the HIV pandemic, with the TB component which is complicating the issues," added Pillay.

Yet, reports say people often go untreated for both HIV and TB because the department does not have the capacity to handle them.   So this volunteer, who goes by the name Toyota, tries to deal with the HIV part of it by counseling women to be tested for HIV.  She is HIV positive, herself.  She got the disease when she fell in love with a man who was HIV positive.

"He helped me by lending me money to go to school," said Toyota.  "But, at the same time he hurt me, because he didn't tell me he was HIV positive."

The man died.  Today, she is on anti-retroviral drugs.  She says many women will not go in for testing, because being HIV positive carries a certain stigma.

"Meaning you are like a prostitute, you got it from selling your body.  So that's why people don't want to come out," added Toyota.

It is estimated that tens of thousands of people are walking around, untreated for HIV/AIDS.  And, that has just worsened the TB problem.  TB can be life threatening, if it is not treated. For those that can find the treatment, it is long.  Six months of pills taken daily.  But a volunteer named Duda says a lot of people stop taking their medication too early.

"They [are] feeling strong.  They are gaining weight.  Now they stay at home.  They think they are cured," Duda explained.

But they are often not cured.  The TB comes back and sometimes in more dangerous forms.  Again, researcher Daygan Eager.

"You talk about high level services like HIV and TB.  Very often the services are not there for people who need the services desperately," added Eager.

Health department head Pillay says he just does not have the money to improve the services.

"You have a budget that is insufficient to provide the necessary treatment to provide health care," he noted.

And Pillay says, if the number of ill continue to increase, he will have to consider denying treatment to some people, so he can give it to others - even for critical conditions like HIV. In effect, he will be rationing the care.

"We like to believe that there is none, because health care is a very emotional issue, but everywhere there is rationing of care. And, rationing of care is a reality we will have to face," added Pillay.

The United States, one of several countries providing aid to help African nations combat HIV/AIDS, has given more than one billion dollars, so far, to South Africa.  And it has pledged another $500 million, in the next two years. Yet treatment is not reaching thousands of people, either because they do not want it or because South Africa's strained health care services cannot deliver it.

You May Like

Video Five Patients Given Experimental Ebola Drug Said To Be Improving

Experimental drugs have been tried on six people: three Westerners and now, three African pyhysicians More

Video In Ukraine, Fear and Distrust Remain Where Fighting has Stopped

As Ukrainian military reclaims control of eastern cities residents rebuild their lives, but many say everyone is being treated with suspicion More

Video In Rural Kenya, Pressure Builds Against Female Circumcision

Girls learn to object; FGM practitioners face penalties from jail sentences to stiff fines More

This forum has been closed.
Comments
     
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Five Patients Given Experimental Ebola Drug Said to Be Improvingi
X
Carol Pearson
August 19, 2014 11:43 PM
The World Health Organization has approved the use of experimental treatments for Ebola patients in West Africa. The Ebola outbreak there is unprecedented, the disease deadly. The number of people who have died from Ebola has surpassed 1,200. VOA's Carol Pearson reports on the ethical considerations of allowing experimental drugs to be used.
Video

Video Five Patients Given Experimental Ebola Drug Said to Be Improving

The World Health Organization has approved the use of experimental treatments for Ebola patients in West Africa. The Ebola outbreak there is unprecedented, the disease deadly. The number of people who have died from Ebola has surpassed 1,200. VOA's Carol Pearson reports on the ethical considerations of allowing experimental drugs to be used.
Video

Video In Ukraine, Fear and Distrust Remain Where Fighting has Stopped

As the Ukrainian military reclaims control of eastern cities from pro-Russian separatists, residents are getting a chance to rebuild their lives. VOA's Gabe Joselow reports from the town of Kramatorsk in Donetsk province, where a sense of fear is still in the air, and distrust of the government in Kyiv still runs deep.
Video

Video China Targets Overseas Assets of Corrupt Officials

As China presses forward with its anti-graft effort, authorities are targeting corrupt officials who have sent family members and assets overseas. The efforts have stirred up a debate at home on exactly how many officials take that route and how likely it is they will be caught. Rebecca Valli has this report.
Video

Video Leading The Fight Against Islamic State, Kurds Question Iraqi Future

Western countries including the United States have begun arming the Kurdish Peshmerga forces in northern Iraq to aid their battle against extremist Sunni militants from the Islamic State. But there are concerns that a heavily-armed Kurdistan Regional Government, or KRG, might seek to declare independence and cause the break-up of the Iraqi state. As Henry Ridgwell reports from London, the KRG says it will only seek greater autonomy from Baghdad.
Video

Video In Rural Kenya, Pressure Builds Against Female Circumcision

In some Kenyan communities, female genital mutilation remains a rite of passage. But activists are pushing back, with education for girls and with threats of punishment those who perform the circumcision. Mohammed Yusuf looks at the practice in the rural eastern community of Tharaka-Nithi.
Video

Video For Obama, Racial Violence is Personal Issue

The racial violence in the St. Louis suburb of Ferguson is presenting U.S. President Barack Obama with an issue to which he has a deep personal connection. To many Americans, Obama's election as America's first black president marked a turning point in race relations in the United States, and Obama has made ending the violence a policy priority. On Monday he issued a new call for calm and understanding. Luis Ramirez reports from the White House.
Video

Video Clinton-Obama Relationship Could Impact 2016 Election

President Barack Obama and former Secretary of State Hillary Clinton have a long and complicated relationship. That relationship took another turn recently when Clinton criticized the president’s foreign policy. VOA National Correspondent Jim Malone reports there is renewed attention on the Clinton-Obama relationship as Hillary Clinton considers running for
Video

Video Iran Looks to Maintain Influence in Baghdad With New Shia PM

Washington and Tehran share the goal of stopping Syrian-based militants in Iraq. But experts say it's Iran, not the United States, that will most influence how the new government in Baghdad approaches internal reforms and the war in Syria. VOA State Department Correspondent Scott Stearns has the story.

AppleAndroid