Health-e News Service - February 10, 2012
JOHANNESBURG - Gauteng's public health service has run out of
essential lifesaving drugs and its laboratory services are about
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
"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
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
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
"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
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
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
The latest developments are likely to severely affect turnaround
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
"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