S.Africa: Eastern Cape hospitals run out of needles and battle other critical shortages
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The busiest Eastern Cape hospitals have run out of syringe needles, leaving doctors struggling to resuscitate patients, draw blood and get medicine from ampoules. Desperate managers have been scrambling for needles and obtained some supplies from rural hospitals, but this puts these facilities at risk of running out as well.
Eastern Cape health MEC Ntandokazi Capa’s office confirmed on Monday morning that the province has been hit by a shortage of surgical consumables including needles.
Medical personnel in busy tertiary hospitals like Livingstone Hospital in Nelson Mandela Bay have been scrambling to find needles, and in some cases have been unable to draw blood, struggling to resuscitate patients because they have no syringes, and unable to use medicine in ampoules.
“There is indeed a shortage of certain surgical consumables including needles. This is a provincial challenge which relates in part to suppliers not able to fulfil our order on time and some import challenges as some of these items are imported by contracted suppliers into the country,” Capa’s spokesperson, Sizwe Kupelo, said.
“The department is working with her counterparts in the national department and neighbouring provinces to find a lasting solution that will assure availability of these essential items.”
He confirmed that hospital managers were “borrowing” needles from rural hospitals.
“In the meantime, the department is redistributing stock from those facilities with low consumption to the high-consumption facilities. This is the reason some stock was moved from Cradock to Livingstone. In addition, small quantities are procured on a quotations basis from alternative suppliers, but unfortunately they also do not have the full line of consumables and cannot fulfil the quantities we require,” Kupelo said.
“The department is seized with this matter and we are committed to ensuring that there’s no negative impact on patient care due to these supply chain challenges.”
Sources in the department said one of the problems it was encountering is that suppliers are not paid within the stipulated 30 days after delivery.
There is also a shortage of syringes, nappies, nebuliser masks, adult oxygen masks, oxygen regulators, special plasters, ECG electrodes and ECG paper.
Kupelo confirmed that this was the case in some of the contracts, but that it was due to administrative issues, not a shortage of funds.
“The reasons vary and cannot be reduced to just one issue. Some suppliers are citing delays in payment. This is payment after 30 days of delivery. Again with this, at this time of the financial year it is less about availability of money but more about the administrative process that takes long,” he said.
“The department is in a comfortable position in terms of budget to pay suppliers, so therefore this cannot be blamed on suppliers being owed money.”
In a document setting out cost containment measures for the department, published in June, management stressed that funds for medicines, food for patients, laboratory services, medical supplies, property payments, emergency services, contractors, chemicals, fuel, oil, gas, wood and coal, consumable supplies, fleet services (including government motor transport) had to be protected at all cost and the bills for these services must be covered.
Earlier this year (in the previous financial year) the department’s emergency medical services were plunged into crisis when their lines were cut by Telkom because the phone bill hadn’t been paid.
Read more in Daily Maverick: EC Health Department scrambles to set up new emergency numbers after not paying the phone bill
The hospital – which is spread over two facilities, Livingstone Hospital and Port Elizabeth Provincial Hospital – has not had a permanent CEO since 2018 when unions literally ran the high-performing and head-hunted CEO Thulane Madonsela out of the facility. On no less than five occasions in the past two years the Department of Health said the appointment of a CEO was “imminent”, but it hasn’t happened yet. The department as a whole also has an acting head of department since the highly acclaimed Dr Rolene Wagner was moved to the Office of the Premier. It doesn’t have a chief financial officer either since the resignation of Msulwa Daca, nor an acting human resources director.
In June, premier Oscar Mabuyane said that fixing the Health Department would be one of his top priorities. According to documents seen by Daily Maverick, a shortage of gloves at the hospital is caused by a hold-up at the Provincial Cost Containment Committee that is linked to Mabuyane’s office.
In 2021, at the height of the Covid-19 crisis, the department had to send senior personnel to rescue Livingstone Hospital from collapse. At the time, Mtandeki Xamlashe – the acting CEO, now the director of hospital services in the department – said the situation at the hospital was allowed to deteriorate to such an extent that it will take five years to recover.
“We monitor the performance of our facilities from head office. [Around September 2020] we realised that things were really collapsing at Livingstone Hospital. Not that we wanted things to be perfect, but things were really going down in a spiral. We decided that I should come here, and contribute with the local team, obviously – at least to keep it afloat, otherwise it almost had to close,” he said at the time.
In July 2020, at the height of the first wave of coronavirus infections in Nelson Mandela Bay, desperate doctors fearing for their own health and safety and that of their patients temporarily closed the hospital’s casualty unit after it had not been cleaned for days because of labour disputes. Nurses had left the ward and doctors could not access medicine. Health and safety inspectors found a warehouse full of rotting linen that had not been washed for weeks.
“Facilities management had collapsed. There were areas of serious incompetence in that space. This began to demoralise the clinicians. They did their utmost best under the circumstances,” Xamlashe said at the time.
After Wagner’s appointment the situation stabilised, but it is now deteriorating fast. Doctors confirmed that they were told to be “innovative”, after complaining about the lack of consumables.
“The office of the MEC takes this matter seriously and has asked top management to find an urgent solution to it. Patient care is a priority to us,” Kupelo said, indicating that the MEC will visit Livingstone Hospital soon. DM
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