Tuesday, 17 September 2013

Chintsa Mobilises For Better Health Care Pt.3 - the March from Bisho Stadium to MEC offices

Report by Dr. Madeleine Muller, RuDASA National Secretary:
 

Friday, the 13th of September, turned out to be a beautiful, sunny hot day in Bhisho. An ideal day for the 2km march from Bhisho Stadium to the MEC offices. The turn-out was amazing, with organisations such as HOSPERSA showing up on the day to join the coalition and Zwelinzima Vavi pitching up as a concerned citizen J.

There was something extraordinary about a united group of people that represents such a variety of citizens, all concerned with health care. This was not a march just promoting the interests of one aggrieved group – this was an inclusive coalition that represented all the people who work in or use the health care services in the Eastern Cape. Hats off to TAC (Treatment Action Campaign) for excellent organisation and the whole event went like clockwork. The report compiled by Section 27 and TAC formed a clear focus point and I think really helped pull it all together and give these issues a personal face.





It was significant that the new HOD (Head of department) of Health, Dr Mbengashe, arrived and received the memorandum with good grace and the kind of supportive response that should be expected from a savvy politician. The MEC of Health, Sicelo Gqobana, was not there (and is yet to meet with any of the coalition) and the march sent a clear message that he can run but not hide. 
 
So where are we now? Now that the memorandum has been delivered the MEC has 30 days to come up with a workable plan on addressing the various issues facing the Eastern Cape health service delivery. Unfortunately he has yet to own up that there is a problem! I think we all expect an uneventful 30 days, at which point the coalition, with Section 27 support, must decide if we up the game and go the route of legislation. There is a small sliver of hope with the new HOD and if we are very lucky he might just try and pull something out of the hat… this would indeed be a miracle and one worthy of hoping for. 

Chintsa-East was part of this amazing province-wide initiative and at 9.30 on Friday morning 35 Chintsa residents set of in a Quantum and 5 taxis for Bhisho stadium Friends of Chintsa very kindly provided the taxi, a driver and lunch in support. It was a merry bunch who took the 2km in the heat in their stride. The reason why the march was such a success is because of the multitude of small, motivated villages that have sent a group of residents to support this cause. Chintsa can be proud to have formed part of the civil society movement for better health in our province.


The process has begun. We do not expect it to be quick but we do know that it will be sure, for we will make it so!

John Stephens has also posted an excellent album on the Section 27 Facebook page.

Best wishes

Madeleine Muller

Friday, 13 September 2013

Chintsa Mobilises For Better Health Care Pt.2 - the March to Bisho, today, Friday 13th Sept.

Yesterday's headline:



In the last few weeks there has been great movement to rally the communities of our area into a coherent organisation that can effectively tackle the challenge of failing health services in the Eastern Cape.  It started with a public meeting, held on Saturday 31st August (see blog below), to address this issue in our own village (lack of clinic and very sporadic visits from a poorly equipped mobile clinic) and hear from the Treatment Action Campaign (TAC), local ANC Provincial Health Committee, and the Rural Doctor's Association of SA (RuDASA) as to their roles, responsibilities, and respective visions for a clinic in our village.  This was followed up with a press conference this last Wednesday releasing a special SECTION27 and TAC investigative report into the collapsing health system in the Eastern Cape, and this movement has now culminated in a full protest march to Bisho today to present these findings and a memorandum to the MEC of Health, Sicelo Gqobana stating the problems that have been identified and what we, as concerned Citizens, insist the MEC do about it, namely respond to these requests and formulate a plan to improve these services in a timeous fashion.  

There has been quite an aggressive outburst and accusatory defensiveness on the MEC's part so far, so it is clear that somewhere, someone is on the back foot.  However this matter is not intended to be a fight - the matter is simple: people are suffering and dying in the most appalling circumstances, and nurses are working with dismal resources and conditions, when there are adequate funds and resources that are simply not being allocated, and where there is rife corruption and mismanagement in a system that otherwise could be working really well.  So, our comrades are on the March, as we speak, and we'll give a full report of that with photographs as soon as we have them.  But for now, keep informed, and take a look at some of these press reports we've picked up today after the two press conferences held on Wednesday 11th Sept - one in Johannesburg, and one in East London (and Dr. Madeleine Muller of RuDASA will be doing some live reports on Wild Coast FM straight from the March!):   

Eastern Cape health access made to look like a privilege http://mg.co.za/article/2013-09-11-eastern-cape-health-access-made-to-look-like-a-privilege  

Baby dies at hands of healthcare

A tale of rural health

Collapse of health services will continue to cost lives

South Africa: Timeline of a troubled province http://allafrica.com/stories/201309111119.html

Fix Eastern Cape health system or face action, government warned http://www.citypress.co.za/news/fix-eastern-cape-health-system-face-court-action-government-warned/  

NGOs report details of EC health crisis



My open letter to South Africa

Motsoaledi forms task team to probe shocking E Cape health care http://mg.co.za/article/2013-09-12-motsoaledi-forms-task-team-to-probe-shocking-e-cape-health-care


Govt. dismisses E Cape health crisis report http://www.sabc.co.za/news/a/0b0e2480410f180a96e7b7434f2981a1/Govt-dismisses-E-Cape-health-crisis-report 

Kudos to Dr. Madeleine Muller, Dr. Trudy Thomas, Nokuphumla Pakamile and the other valiant members of our community who are mustering up the courage and numbers to take this challenge, through all the right channels, to the doorsteps of those who have the power to do something about this.

Saturday, 7 September 2013

Chintsa Mobilises For Better Health Care

Welcome to this week's blog!  Today we are proud to publish the findings of the meeting that was held this time last week, to call for a clinic or a similar health service in our area:


Chintsa East Public Meeting

Health Access for Ward 6 residents

31stAugust 2013, Chintsa East Public School


The table of speakers, from left: Thabang Maseko of TAC, Dr. Trudy Thomas, co-chair, Dr. Nozipho Jaxa, member of EC ANC Provincial Health sub-committee, Dr. Madeleine Muller, National Secretary of RUDASA (see below for more photographs from the meeting)




Present: 67 members from Ward 6
Supporting organisations: RuDASA (Rural doctors associations of South Africa), TAC (Treatment Action Campaign), ANC, Friends of Chintsa, SANCO, CERPA (Chintsa East Ratepayers Association), Buccaneers Backpackers, Angels School, Chintsa East Public School, Acacia Tree Nursery School, Yekelela Play and Guest Farm, Wild Coast FM.
Chairperson and Co-chair of meeting: Nokuphumla Pakamile and Dr Trudy Thomas
Speakers:
·         Mr Thabang Maseko: EC Provincial secretary of the Treatment Action Campaign
o   Gave an overview of the history and activities of the TAC in supporting civil society in communicating with the government. If Chintsa has 15 interested members a branch can be started
·         Dr Madeleine Muller National Secretary of the Rural Doctors Association of South Africa
o   Gave an overview of current health care services in the Great Kei and the health care needs in the area.
·         Dr Nozipho Jaxa: Member of EC ANC Provincial Health sub-committee

o   Gave an overview of the ANC Health plan including NHI and primary health care engineering. 


Background

Ward 6 is a geographical challenging area as it spans over a large area. The three semi-urban villages – Chintsa, Haga Haga and Kei Mouth & Morgan Bay are more than an hour’s drive from each other.  Members of the community have noted the lack of easy access to preventative, routine and emergency medical services especially in Morgan Bay, Haga Haga and Chintsa:


Clinic access for Chintsa:

·         Kwelera Clinic is 28km away and will be part of Buffalo City Metro when the handover happens. Since 2010 it has provided a NIMART (ARV) nurse that initially visited the clinic twice a month with the mobile clinic and currently comes once a month on a Wednesday. The nurse from Kwelera provides HIV and TB care but has missed visits when there were staff shortages or lack of transport.

·         Mooiplaas clinic is 27 km away and will form part of Amathole District from 1 September.

To reach either clinic residents of Chintsa has to first catch a taxi to town and then another 1-2 taxis to reach the clinic. In practice these clinics are therefore out of reach for the average citizen and residents usually attend services at Gateway Frere, DVDH or Empilweni Gompo CHC.  

Mobile clinic services:

·         The Great Kei area was traditionally serviced by 3 mobile clinics that provided basic health care services. The mobile clinic that visited the East Coast resort road stopped at a multitude of stops along this road including Crossways, Bulura, Glen Eden, Chintsa West, surrounding farms etc. Since provincialisation of health services this has been reduced to one mobile clinic and service to this area have been cut to one mobile clinic point visit (Chintsa East) twice a month. The other mobile vehicles were written off and condemned by the traffic department during the transfer of assets from Amathole health district to Buffalo City municipality. Currently the visits are usually on the 2nd last Wednesday and last Thursday of the month. No timetable has been distributed and many residents are uncertain when to expect the mobile clinic.

·         In 2010 Friends of Chintsa, the community, supporting NGO and Department of health renovated a steel container in Chintsa East into a building that can be used as a health post. Buffalo City health district designated this as a health post that will be visited by a nurse from Kwelera clinic. Initially it was hoped that this could be a weekly service from Kwelera clinic with full primary health care services but unfortunately due to staff shortages it is currently only a monthly visit from the nurse providing ARVs.

Ambulance services:

·         One of the most often voiced complaints is the unreliability of the ambulance services to provide support with medical emergencies in the community. It can be difficult to get hold of the ambulance service, or the ambulance takes several hours to arrive or on occasion does not come at all.

Health care needs of Ward 6 Residents

Residents of ward 6 need health care access for the following reasons:

·         Family planning and condom provision

·         The support and provision of Youth and Adolescent services

·         Easy access to prevention services such as immunisations, pap smear, nutritional assessments, BP and diabetes screening and HIV testing

·         Early screening, detection and management of TB

·         Education on reduction of alcohol intake and smoking.

·         Education on the importance of exercise

·         Management and treatment of acute illnesses and minor accidents

·         Management of chronic illnesses such as diabetes, HIV, Epilepsy, HT, mental health etc.

Resolutions:

Health post and mobile clinic services


·         All areas in Ward 6 need at least 2-3 weekly access to primary health care services. In Chintsa this can be provided as follow:

o   The local clinic could provide a nurse with a stock of primary health care drugs to Chintsa Health post 2 or 3 times a week. When Chintsa falls under Amathole this could be Mooiplaas clinic. A similar arrangement can be made for Morgan’s bay with Cwili Clinic.

o   The Mobile clinic could increase its visits to weekly visit to Chintsa East Health post.

o   Doctors living in the area are willing to support this clinic with emergency health care when available to do so provided that the DOH supplies them with relevant medication and equipment.

·         Each Health post could be supported by a team of 3 - 5 Community Health care workers that can support the community based outreach teams. They will start by doing a baseline analysis of the disease profile of ward 6.

·         Infrastructure at the clinic could be improved by relevant authority or local NGO support to include a secure dispensary where emergency and chronic medication can be kept.

·         The community is aware that Kwelera clinic will be moving to the metro whilst ward 6 remains under Amathole District. THE COMMUNITY THEREFORE REQUESTS, AS A MATTER OF URGENCY, THAT THE CHINTSA HEALTH POST BE HANDED OVER TO MOOIPLAAS CLINIC AND THE NECESSARY EXTRA PROVISION OF NURSING STAFF BE PLANNED FOR TO PROVIDE STAFFING TO THE HEALTH POST.

·         For this interim measure to work it is essential the DOH works closely with the transport services to ensure that both mobile clinic and transport of nurses to the health post do not lapse.

Ambulance access:

·         Ward 6 residents need guaranteed ambulance access with reasonable response times. Relevant persons need to meet with the local ambulance services to determine the challenges in ambulance provision and to formulate a plan to address these. Emergency numbers and processes must be easily accessible to residents

A clinic for Chintsa

·         Ward 6 residents need to have easy access to a full set of primary health care services.

·         The Department of Health is requested to do a feasibility study on the possibility of building another clinic for Ward 6 in Chintsa.


The task team will present these resolutions to the ward councillor of ward 6, Mrs Nosipho Ngabayana, who will table them at the Great Kei Muncipality. The G/Kei Councillor for Health will then take the Great Kei recommendations to the Buffalo City Metro as a matter of urgency as the community is concerned that the handover from Buffalo City Metro to Amathole district may delay matters further.

Responsibilities of ward 6 residents

·         Residents of ward 6 wish to better and improve their own health and are requesting better health information. Local organisations and local health care professionals are interested to become involved in education on prevention programs, nutrition, HIV, TB etc. for the local community

·         Residents of ward 6 wish to be informed of the progress on the above resolutions and to monitor its implementation

·         Residents of ward 6 will support local initiatives that promote health and health care service delivery

·         Organisations in ward 6 can help support the training of CHWs if posts for CHWs are created by DOH in our areas


Drafted 31st August 2013



 
Dr. Madeleine Muller, Nokuphumla Pakamile (Friends of Chintsa Committee member) and Dr. Trudy Thomas consult before start of meeting












Meeting members are led in song by Nokuphumla Pakamile at commencement of the meeting














Meeting members fill in a register




 











Dr. Nozipho Jaxa talks about the ANC's Health Care responsibilities











- photos by Odwa Shaun Mtshini