The government is responsible for the failure of the country’s healthcare system says the South African Human Rights Commission (SAHRC). The commission launched a report entitled “Public Inquiry: Access to Health Care Services” on 16 April 2009 in Johannesburg.
Speaking at the launch of the publication SAHRC deputy chairperson, Zonke Majodina said the report was prompted by complaints received by the South African public regarding poor service delivery in the health care system across the country. These complaints overshadow the impact of the Department of Health’s hospital revitalisation plan, Majodina said.
The report found that poverty is a major cause for ill-health and is also a key barrier to accessing health care services. The report is based on visits to approximately 100 facilities across the country and submissions from the public. It found that medical and health personnel have poor or discriminatory attitudes towards vulnerable groups and this leads to poor access to health for them.
“These constraints amount to a denial of the right to access healthcare for some of the poorest and exacerbate existing vulnerability of marginalised groups and individuals within the country,” said Majodina. This view was reiterated by Brian Mazibuko, a consultant working on health issues. Mazibuko said that volunteers working in clinics complain about the attitude of nurses. He argued that despite the hard work that volunteers carry out at clinics, health workers are disdainful of them. As a result, their contribution to health services often goes unrecognised.
Centre for the Study of Violence and Reconciliation’s (CSVR) Nomfundo Mogapi, said: “It is our responsibility as a country to take care of our nurses.” She expressed concern at the fact that the report does not mention the specific experiences of unaccompanied minors and children from child headed households who at times, because of lack of documentation and expectation that they must be accompanied by adults, struggle to access health care services.
Majodina pointed out that even though the report focuses on challenges and problems related to the delivery of health care services, it also focused on children trafficked into the country.
Asked if the report considered the experiences of internally displaced people as a result of the recent xenophobic attacks in the country’s townships, SAHRC CEO, Tseliso Thipanyane, noted that the attacks occurred after the hearings, which took place in May 2007. Thipanyane said the report does make reference to the rights of non-nationals in accessing health care services.
The report recommends that the Department of Health should engage and liaise with the Department of Home Affairs on the different types of documents that non-nationals use and the timely issuance of permits for refugees, as possession of immigration documentation remains central to all foreigners in accessing health care services.
The report also found that rape survivors wait for long hours especially over weekends as many women do not have transport and depend on police where they first report the case. According to the report, police sometimes refuse to open cases for rape survivors and at times refuse to transport them to health facilities.
The following are some of the main findings of the report:
- Access to healthcare services, especially for the poor, is still severely constrained by expensive, inadequate or non-existent transport, by serious shortages with regard to medicines, emergency transport and long waiting times at clinics and other healthcare service facilities.
- Staff attitudes were discriminatory towards women wanting to access abortion facilities, rape survivors, refugees and members of LGBTI communities.
The report also explores a broad range of challenges such as the progressive realisation of the right to access to health care services, the public and private sector divide, management and implementation, infrastructure and accessing services at a district level.
Acknowledging that the shortage of competent and qualified health personnel contributes to inadequate health care, the report recommends that the department should focus on retention strategies that include improving working conditions for health personnel. It also recommends that there should generate greater awareness of the existence and the cost of services at district facilities to entice communities to use primary health care facilities.
Majodina is of the view that the report will go a long way in creating the opportunity for all stakeholders including the public and government, to debate the challenges and find solutions to the problems associated with access to healthcare services in the country.
- Butjwana Seokoma is the Information Coordinator at SANGONeT. Adam Mukendi is the Project Officer: e-Community and Content Services, responsible for the Citizen Journalism in Africa portal.