JOHANNESBURG - Gauteng's public health service has run out of essential lifesaving drugs and its laboratory services are about to collapse.
In the latest development concerned doctors have met with senior officials from the national and provincial health departments demanding concrete steps to urgently address the restoration of laboratory services, access to essential medicines, an end to critical staff shortages and the rationalisaton of hospital budgets.
"We have an ethical duty to provide quality health services to the public...we are unable to do so," the group said.
The clinicians, including senior academics, specialists and professors, working at three academic hospitals, on Monday sent a desperate letter to the national health and finance ministers, the Gauteng premier and health MEC and the head of the provincial health department, inviting them to an urgent meeting yesterday (Subs: Tuesday).
Sources have confirmed that the situation has reached a point where health minister, Dr Aaron Motsoaledi, has intervened over the past 48 hours to avert the collapse of laboratory services in Gauteng, due to non-payment, and restore the supply of drugs.
"We trust you understand the urgency. Each day that goes by, patients are put at risk," the doctors said in the letter.
It is understood that a meeting did take place yesterday between the senior clinicans and representatives from the national and provincial health departments, including the deputy health minister and Director General.
It is understood that an undertaken was given by officials to work around the clocks and restore the drug supply and laboratory services by the end of this week.
Spokesperson for the Gauteng premier Simon Zwane confirmed that the province was working with national government and that they were committed to clearing all their health-related debts by end of June.
Specialist paediatrician at Rahima Moosa Mother & Child Hospital Professor Ashraf Coovadia confirmed that the drug stockouts had become more chronic towards the middle of last year.
"Before that we had good alternatives when we ran out of one drug. Now we are finding the stockouts of essential drugs to be more protracted and directly linked to the non-payment of suppliers," said Coovadia.
He said the final straw for him was last week when he was told the pharmacy had run out of a first line drug to treat bacterial meningitis, a potentially fatal condition.
Coovadia said the latest pharmacy list at the hospital showed that among others there were no first line drugs to treat seizures, meningitis, diabetes and high levels of potassium - all life threatening conditions.
"As far as the National Health Laboratory Services (NHLS) are concerned, I can't even get a simple urine test done to determine if a baby has an infection," said Coovadia.
Treatment Action Campaign Chairperson Nonkosi Khumalo said they were aware of widespread stockouts of antiretroviral drugs in Gauteng with some patients being overdosed on available drugs and underdosed on those that were out of stock or scarce, especially tenofovir and lamivudine.
"This is a sure recipe for drug resistance," she warned, adding that some patients had resorted to halving their dosages as they were fearful of running out.
Other patients living with HIV have been waiting since last year for TB results. "Our information is that these patients have been duped into believing that their specimens had been lost, while they had not been sent away in the first place," said Khumalo.
She said several clinics and some hospitals had run out stationary and did not have files or pens, sending patients away.
Others had no gloves or bottles to collect TB sputum.
Some of the hospitals and clinics she listed include Kaalfontein, Ebony Park, Edenvale, Lenasia, Vosloorus, Kempton Park and Alexandra.
"Gauteng is not coping, things are collapsing," she said.
In another development, it has emerged that the NHLS was unable provide any courier services from Monday. This means that specimens from clinics and hospitals could not be transported to the laboratories.
There is a very real possibility that laboratory services will only be provided at the four central hospitals in the next two weeks, unless there is urgent intervention in the form of payment.
In-house laboratories have already been closed at Kopanong, Yusuf Dadoo, Germiston, Rahima Moosa, Edenvale, South Rand and Pretoria West. Several other laboratories would only operate between 8am and 7pm with the big hospitals taking on the bulk of the load after hours.
The latest developments are likely to severely affect turnaround times.
NHLS CEO Dr Sagie Pillay said the courier were "likely to shut us off by Monday" due to non-payment.
"If the status quo continues we will have to make even more unpalatable interventions," said Pillay, adding that he could not continue to run services on promises.
A junior doctor who spoke on condition of anonymity for fear of losing his job, said the academic hospitals including Helen Joseph were running out of food, clean linen and drugs on a daily basis.
"It is heartbreaking. A couple of weeks ago, against great odds we saved a guy who had a blood clot and a heart functioning at 10 percent of capacity. Once we pulled him through he lay naked in a bed for a week because there was no linen. It's a basic dignity issue as well," he said.
The doctor said in another incident they had to "play God" when two young patients had to be ventilated.
"The only two available machines had been out of order for months, we fiddled with them and got the one going. We had to choose who to save, it's not right," he said.
"We have seen in Limpopo how the national government can respond to a crisis. Gauteng is much more urgent and dire, we need the same response," he said.
Mark Heywood of SECTION27 said: "The inequality and injustice is sickeningly glaring. Most middle class people in this country are unaware and unaffected by the crisis. We can afford to keep our families healthy. If it weren't for the concerned doctors speaking out about what they are witnessing, this would go on indefinitely."