Latest developments in drive for Health Care in Chintsa - Pt. 11 in the Chintsa For Better Health Care story

This is Part 11 of a series of posts on the drive for Health Care for our community.
For Parts 1 through 10 please click on these links to take you straight to each one:

part 1  part 2  part 3  part 4  part 5 part 6  part 7  part 8  part 9  part 10 

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Latest developments in the drive for Health Care in Chintsa

Villagers waiting at the Chintsa East Village Health Outpost for one of two monthly visits from the BCM Mobile Clinic.  On this particular day there were 100 people waiting with 3 nurses seeing patients. At 14:20 the mobile left – not everyone had been seen and the mobile had to promise to come back the following week. This is a disaster for patients on chronic medication. ARVs are only provided once a month as a health outreach from Kwelera – this means that patients with HIV in Chintsa do NOT have access to health care in our area. 

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Some developments this week in the Chintsa Health Care activism pushing government to keep its promises:   

Dr. Madeleine Muller and Ward Councillor Ngabayena were contacted at 9am on Monday 10^th February by Councillor Billie who informed them that a new mobile clinic was going to be launched at Emjojweni Centre, Chintsa East, at 10am that very morning.   

Excited by the (very late) notification of what sounded like a ground-breaking  advance in government’s response to the call for better health services, Dr. Muller contacted as many community stakeholders to provide witnesses to this event.  This included Friends of Chintsa staff, who rushed to the village centre to give local support, only to find that the DoH and Amahlati District Municipality (who were 1 ½ hours late in arriving) were visiting Chintsa to make promises that a mobile clinic from Amahlati (King Williamstown district!) would be servicing outposts in a ridiculously huge area, and that Chintsa might get a visit once a month.   

Amahlati had brought a brand new mobile clinic vehicle (without any medication on board and no intention to do a health visit that day) and a new nurse to Chintsa East village to try win over  a crowd of locals who looked, on the whole, quite fed up with the renewal of promises while they are already dealing with shockingly poor services. The speeches went on for quite a while, and many of the villagers simply got up and walked out of the meeting.

Below is a letter from Dr. Muller responding to Councillor Billie about the events of that day, as well as resolutions reached by a newly formed community health organisation in a meeting held the next day, Tuesday 11^th February.  

This is followed by a response from the community to Amathole District Municipality council about what happened in both meetings.

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Dear Councillor Billie

I am afraid the meeting on Monday, 10 Feb did not go very well in Chintsa East. I think Amahlati meant well – but they do not know the community at all and seemed unaware of the long process we have already engaged in for better health services in Chintsa. 

They came to announce that a mobile clinic will be coming once a month – which is a further reduction in services – and understandably caused much unhappiness. We CANNOT accept the taking away of the rights of our community to health services, as it has been happening progressively since 2010. We lay the responsibility for this at the feet of the Amathole District Municipality.

We had a community meeting on the 11^th of February and I include an overview of that meeting. I have added in the resolutions below here so you can see what we have decided. 

We need your help to arrange a stakeholder meeting for Chintsa with the community. I have to say that it is hard to get good community participation if a meeting is arranged during the day – if we are given enough notice we can make sure that all the stakeholders are represented including SANCO, Friends of Chintsa, local political parties, the health committee etc.

Resolutions

1. The Chintsa East Community will elect a Chintsa East Health Committee at the next Committee meeting (already planned to discuss housing). It will be one evening in Chintsa during the week. Several nominations have already been put forward and more nominations will be accepted that evening. This committee will consist of 5-7 motivated community members who will interact with DOH. We recommend additional Health committees to be established in other areas of the ward where there is not clinic (such as Haga Haga)
2. It is unacceptable to reduce health care services in Chintsa. According to our constitution the government should work towards “access for all to basic health care”. Since 2010 services have been reduced and now plans are to reduce it even further. This is unconstitutional. We lay full responsibility for the restoration of our health care services with the Amathole District Municipality and will demand that Mrs Gede address this issue urgently.  We will continue to advocate for the resolutions of the meeting held in August 2013. 
3.  We urgently demand a stakeholder meeting in Chintsa, attended by relevant managers from ADM and Amahlati, to discuss a plan forward for Chintsa. 
4.  Ward 6 needs transparency on the handover of Great Kei from BCM to Amahlati. Has an adequate budget been transferred? How will funding of health care services change? What is the organogram and who is responsible for clinics and mobiles in Great Kei now? 
5.  Chintsa East Community now has several TAC (Treatment Action Campaign) members and once we have more than 15 members we will form a branch. The TAC will support the Chintsa East Health Committee with training and support on advocacy and how to engage with DOH through the appropriate channels.

I look forward to hearing from you on how we can get this stakeholder meeting with ADM off the ground as a matter of urgency.

Dr Madeleine Muller

RuDASA National Secretary

Rural Doctors Association of Southern Africa

Inspiring others to Rural Health

Tel: 0741028137

Remember to spread the word about how to get in contact with the ECHCAC and stay informed about our work:

Facebook: www.facebook.com/EChealthcrisis (please like the page!)

Website www.echealthcrisis.org (please sign the memorandum!)

Phone: Kwazi Mbatha: 0780599309 or Anele Yawa: 073 555 8849 

Email: echealthcrisis@rhap.org.za

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Chintsa Health Community Meeting

11 February 2014 2pm

Present: Sandy Jaji, Dr Trudy Thomas, Nokuphumla Pakamile, Koleka Roloma, Luvuyo Seyisi, Noxolo Mantyisi, Yamkela Siswana, Nomoyi Liza Maponono, Barbara Muller, Carol Tannock, J Tannock, N Slinger, Dr Madeleine Muller (RuDASA), Thabang Maseko

Minutes: Follow up since stakeholder meeting of 31^st August 2013. Dr Muller gave an overview of what has happened since the stakeholder meeting. Summary below.

• 31^st August 2013  Chintsa East Community Meeting. At this meeting several resolutions were drawn up, identifying the health care needs of the Chintsa Community. Chintsa East needs primary health care services at least three times a week – either via mobile clinic or the health post - until a permanent clinic can be built in the area. Ambulance services need to be addressed. We were particularly concerned that the handover from BCM to Amahlati does not lead to a reduction in current services and that a plan will be in place for scaling up health services. 
• 18 September 2013 The resolutions were given to Ms Ngabayena, the ward councillor for ward 6. Ms Ngabayena said that she will hand the resolutions to Great Kei Municipality – in a particular to Councillor Mali 
• October 2013 Loyiso Tshetshe said he will follow up with Mr Mali to discuss a response to the resolutions. He met with Mr Mali on the 29^th October 2013 
• 22 November 2013: Mr Mali presented the resolutions at the Amathole District Health council 
• 4 December 2013: We contacted Councillor Billie, from the DHC, who recommended a stakeholder meeting in Chintsa with Mrs Gede, the Amathole District Manager to discuss the needs in Chintsa. 
•  6 January 2013: We sent a letter to Mrs Gede and Councillor Billie, requesting the Stakeholder meeting. We have not yet had a reply from Mrs Gede 
•  27 January 2013: We called Councillor Billie who said he will try and arrange stakeholder meeting with Mrs Gede (ADM) and Dr Nkohla (BCM) attending. 
•  5 February 2013: Councillor Billie called to say that a meeting about the mobile clinic will happen on the 10^th of February. He told me that we as a community will be able to give input. Mr Mali will contact us with details but I was unable to get hold of Mr Mali to set a date and agenda 
•  10 February 2013: the community and councillor Ngabayena was informed at 9am on the Monday morning that Amahlati will be presenting on the mobile clinic services to the community at 10am that morning. Dr Muller was working and we tried to inform as many stakeholders as possible but it was very late notice.

Feedback of meeting of 10 February

Three Chintsa East community stakeholders were present at the meeting on the 10^th of February. I have compiled an overview from everyone’s contributions on how we understand that meeting. 

The meeting was arranged by Amahlati sub-district and GKM to let Chintsa Community know what health services will be provided by Amahlati in the area. They brought with them a nurse and a mobile clinic but it was not functioning on that day.  It was not intended as a stakeholder meeting and had not undergone any public participation. There was no notice of the meeting that made some stakeholders feel that the meeting was undemocratic. There was a strong ANC presence and only a few members of the community. 

Speeches were made by Amahlati sub-district (we are still trying to find out who that was) and by Mr Mali from GKM. We were told that Chintsa will fall under Amahlati and that Amahlati will provide ONE mobile clinic to provide services to the whole Great Kei area with possibly one stop a month in Chintsa. 

This would mean a reduction in our already meagre services, which caused great unhappiness among community members present at the meeting. We have tried to engage with DOH about the lack of services and now it felt that the reply from DOH was a further reduction in services! The meeting has left a great feeling of dissatisfaction in Chintsa.

Discussion

 

We had a lively discussion about the implications of this meeting and the strategy forward. 

The mobile clinic comes twice a month. With the last mobile visit there were 100 people waiting with 3 nurses seeing patients. At 14.20 the mobile left – not everyone had been seen and the mobile had to promise to come back the following week. This is a disaster for patients on chronic medication. ARVs are only provided once a month as a health outreach from Kwelera – this means that patients with HIV in Chintsa do NOT have access to health care in our area. 

Dr Thomas felt it essential to take action to ensure the rights of community members to health care access. She has the ANC National health plan, under which Chintsa East qualifies for a clinic. We need a clinic built this year.

Luvuyo Seyisi suggested the forming of a Chintsa East Health committee as we had no clinic committee in our area (having no clinic). Thabang Maseko, from the TAC, presented on how TAC could support that process. Several community members have joined the TAC. TAC will help us mobile community.

We will elect a Chintsa East Health Committee at the next Committee meeting. The following nominations were put forward: Dr Trudy Thomas, Nontsikilelo Slinger, Sandi Jaji, Yamkela Siswana. Nokuphumla Pakamile, Noxolo Mantyisi and Dr Madeleine Muller. 

Resolutions

·      The Chintsa East Community will elect a Chintsa East Health Committee at the next Committee meeting (already planned to discuss housing). It will be one evening in Chintsa during the week. Several nominations have already been put forward and more nominations will be accepted that evening. This committee will consist of 5-7 motivated community members who will interact with DOH. We recommend additional Health committees to be established in other areas of the ward where there is not clinic (such as Haga Haga).

·      It is unacceptable to reduce health care services in Chintsa. According to our constitution the government should work towards “access for all to basic health care”. Since 2010 services have been reduced and now plans are to reduce it even further. This is unconstitutional . We lay full responsibility for the restoration of our health care services with the Amathole District Municipality and will demand that Mrs Gede address this issue urgently.  We will continue to advocate for the resolutions of the meeting in August 2013.

·      We urgently demand a stakeholder meeting in Chintsa, attended by relevant managers from ADM and Amahlati, to discuss a plan forward for Chintsa.

·      Ward 6 needs transparency on the handover of Great Kei from BCM to Amahlati. Has an adequate budget been transferred? How will funding of health care services change? What is the organogram and who is responsible for clinics and mobiles in Great Kei now? 

·      Chintsa East Community now has several TAC (Treatment Action Campaign) members and once we have more than 15 members we will form a branch. The TAC will support the Chintsa East Health Committee with training and support on advocacy and how to engage with DOH through the appropriate channels.

Once the Chintsa Health Committee has been established, they will formulate the next meeting.