Death and a Funeral
By Melissa Meyer
4 September 2009 | AIDS Denialsm | Healthcare | AIDS Politics
The newly appointed Minister of Home Affairs, Nkosazana Dlamini-Zuma’s public grieving over the suicide of a young man who took his own life after the Department of Home Affairs refused to issue him with an ID, has made for truly moving copy this week.
The sincerity of her actions aside, considerable credit is due to the minister for her level of involvement. At a time when some cabinet members are alienating themselves from the general population, splurging government funds on luxury cars, Dlamini-Zuma has shown her ability to identify with ordinary citizens when she attended Skhumbuzo Mhlongo’s funeral.
But there is something disconcerting about this ministerial display of empathy. If only Dlamini-Zuma had been this moved by the deaths of the many South Africans who perished from AIDS-related illnesses under her watch as Minister of Health, the South African epidemic may have taken a much less dramatic toll.
Opportunities for her to show empathy and bereavement in this context have certainly not been lacking. During her tenure as health minister from 1994 to 1999 there were more than 180 000 AIDS related funerals at which she could have announced:
“He was a sacrifice, but how many more do we have to bury before we can turn around this department and make it what is expected of it? Why do we have to meet under such circumstances before we can say something has to be done?”
And yet she only uttered these pensive, crucial words this week, at the funeral of Mhlongo. Regrettably, the department she was referring to was the Department of Home Affairs, not Health.
According to a 2006 study, the cumulative AIDS death toll rose from 10 133 in 1994 to 194 620 in 1999. As then Minister of Health, Dlamini-Zuma could choose from over a hundred funerals a day to give a tearful “never-again” speech of this nature.
Yet the minister was quiet. And the press, whilst dutifully taking the government to task for its bewildering policy and treatment lethargy, only rarely spoke about the death and the dying. There were no dramatic headlines with last words from the deceased or captivating photos of a crying minister that drew public attention to these deaths.
The health system failed these people the same way the Department of Home Affairs failed Mhlongo, yet they were never declared “a hero” in the struggle against AIDS the way he was made out to be a hero in the struggle for an Identity Document.
Whilst the minister’s tears this week may have been moving, her emphatic display was too little, too late.
Melissa Meyer is a researcher at the HIV/AIDS and the Media Project.
Will our nurses ever come home?
23 September 2005 | Government Policy | Healthcare | The Media and HIV/AIDS
South African nurses are deserting our shores in search of a monetary shot in the arm due to poor pay and working conditions, several media reports have noted recently.
According to a City Press article on September 4, getting ill nowadays could be more serious than ever, especially if you're from the Eastern Cape. About 5000 nursing posts lie vacant there alone, with many more across the country, as South African nurses go overseas in pursuit of financial first aid.
You might visit a hospital but never lay eyes on a nurse, especially at night when the nursing staff is in even shorter supply than during the day.
Countries like the United Kingdom, Canada, Australia and Saudi Arabia are the targets for underpaid nurses and other medical professionals, providing better working conditions and more money.
The City Press article states:
“The number of vacancies could be close to 20000 countrywide … Eastern Cape is the hardest hit with 5000 vacancies according to the provincial health department. Limpopo needs 1767 nurses, Mpumalanga 650, while Northern Cape and North West each has 1500 vacancies.”
Most of the nurses who are going abroad are from public health institutions, where the workload is heavy and the meagre reward doesn't provide much motivation.
The Health Systems Trust reports that nurses are unevenly distributed, especially in rural areas where there are fewer qualified nurses compared to urban areas.
Health Minister Manto Tshabalala-Msimang met with about 200 South African nurses in the UK recently to try lure them back home, according to a Sapa report. In the meeting, she apparently told them that South Africa would be employing a lot more nurses. But it's rather easy to doubt the minister's powers of persuasion regarding this issue. “ How will the short-sighted captain flog her trip to our runaway Florence Nightingales? What crew will agree to sail this sinking ship?” asked Maureen Isaacson in Sunday Independent.
Limpopo health department spokesperson, Phuti Seloba, told City Press: “One nurse usually does the work of three or four nurses. Imagine what the situation is like when she goes on leave or attends a course. It means the remaining nurses will handle the workload of eight people.”
The situation is bleaker when that nurse is permanently lost to an overseas employer. City Press reported that one nurse who had been working at Chris Hani Baragwanath for 30 years took home only R5500.
And poor pay is coupled with terrible working conditions. Nurses often have to do menial tasks such as pushing patients on stretchers. Chris Hani Baragwanath Hospital human resource director, Thulane Madonsela, told City Press that even though menial positions such as cleaners, messengers, porters, and ward and linen attendants are vacant, there isn't much which can be done without contravening rules laid down by a public sector clause.
“We are restricted by the ‘Resolution 7′ adopted in 2002. It says the public sector is bloated and as such we must get people who are in excess in the entire public sector and place them where they are needed.”
So no-one from the outside can be hired. It's a logistical stalemate which has forced many public hospitals to run on empty.
South Africa isn't alone. Poor and developing countries all over the world are experiencing the brain drain, too. In Asia, according to a Sapa report carried in News24, the hardest hit appear to be Nepal, Bhutan, Papua New Guinea, Afghanistan, Cambodia and Indonesia. News24 notes that a recent article in the British medical journal The Lancet focusing on the problem.
South African nursing colleges don't seem to be churning out graduates as fast as they should be, exacerbating the shortage. In places like the Eastern Cape , where the nursing crisis is worst, the department advertises posts monthly, but gets no more than 50 or so applications, according to News 24. The same article notes that in Mpumalanga, 40 nursing posts were advertised recently, but only one person applied.
Of course nurses are not the only medical professionals contributing to the trend: doctors, radiographers, dentists, social workers and physiotherapists are also part of the brain drain. For example, about half of all recent graduates of the Durban Institute of Technology's radiography department have already left, according to the student website, Dut.ac.za.
What's a cause for concern is who will be around to help with the ARV treatment rollout. The World Health Organisation had estimated that by December last year, about 840,000 people in South Africa needed antiretrovirals (ARVs), but that only 7% of them (between (47,000 and 62,000) were actually receiving the drugs. (See more about this in the Journ-aids treatment factsheet.)
What is going to happen to the millions of HIV-infected people who are waiting for ARV treatment, if no-one is there to distribute them?
At the same time, do we blame nurses for leaving, when it's clear that South Africa and many other Southern African countries don't have much to offer them, except swollen ankles, and a pat on the back – if they're lucky? – Lunga Madlala
Will our nurses ever come home?
16 September 2005 | Healthcare | Treatment
South African nurses are deserting our shores in search of a monetary shot in the arm due to poor pay and working conditions, several media reports have noted recently.
According to a City Press article on September 4, getting ill nowadays could be more serious than ever, especially if you're from the Eastern Cape. About 5000 nursing posts lie vacant there alone, with many more across the country, as South African nurses go overseas in pursuit of financial first aid.
You might visit a hospital but never lay eyes on a nurse, especially at night when the nursing staff is in even shorter supply than during the day.
Countries like the United Kingdom, Canada, Australia and Saudi Arabia are the targets for underpaid nurses and other medical professionals, providing better working conditions and more money.
The City Press article states:
“The number of vacancies could be close to 20000 countrywide … Eastern Cape is the hardest hit with 5000 vacancies according to the provincial health department. Limpopo needs 1767 nurses, Mpumalanga 650, while Northern Cape and North West each has 1500 vacancies.”
Most of the nurses who are going abroad are from public health institutions, where the workload is heavy and the meagre reward doesn't provide much motivation.
The Health Systems Trust reports that nurses are unevenly distributed, especially in rural areas where there are fewer qualified nurses compared to urban areas.
Health Minister Manto Tshabalala-Msimang met with about 200 South African nurses in the UK recently to try lure them back home, according to a Sapa report. In the meeting, she apparently told them that South Africa would be employing a lot more nurses. But it's rather easy to doubt the minister's powers of persuasion regarding this issue. “ How will the short-sighted captain flog her trip to our runaway Florence Nightingales? What crew will agree to sail this sinking ship?” asked Maureen Isaacson in Sunday Independent.
Limpopo health department spokesperson, Phuti Seloba, told City Press: “One nurse usually does the work of three or four nurses. Imagine what the situation is like when she goes on leave or attends a course. It means the remaining nurses will handle the workload of eight people.”
The situation is bleaker when that nurse is permanently lost to an overseas employer. City Press reported that one nurse who had been working at Chris Hani Baragwanath for 30 years took home only R5500.
And poor pay is coupled with terrible working conditions. Nurses often have to do menial tasks such as pushing patients on stretchers. Chris Hani Baragwanath Hospital human resource director, Thulane Madonsela, told City Pressthat even though menial positions such as cleaners, messengers, porters, and ward and linen attendants are vacant, there isn't much which can be done without contravening rules laid down by a public sector clause.
“We are restricted by the ‘Resolution 7′ adopted in 2002. It says the public sector is bloated and as such we must get people who are in excess in the entire public sector and place them where they are needed.”
So no-one from the outside can be hired. It's a logistical stalemate which has forced many public hospitals to run on empty.
South Africa isn't alone. Poor and developing countries all over the world are experiencing the brain drain, too. In Asia, according to a Sapa report carried in News24, the hardest hit appear to be Nepal, Bhutan, Papua New Guinea, Afghanistan, Cambodia and Indonesia. News24 notes that a recent article in the British medical journal The Lancetfocusing on the problem.
South African nursing colleges don't seem to be churning out graduates as fast as they should be, exacerbating the shortage. In places like the Eastern Cape , where the nursing crisis is worst, the department advertises posts monthly, but gets no more than 50 or so applications, according to News 24. The same article notes that in Mpumalanga, 40 nursing posts were advertised recently, but only one person applied.
Of course nurses are not the only medical professionals contributing to the trend: doctors, radiographers, dentists, social workers and physiotherapists are also part of the brain drain. For example, about half of all recent graduates of the Durban Institute of Technology's radiography department have already left, according to the student website, DITonline.
What's a cause for concern is who will be around to help with the ARV treatment rollout. The World Health Organisation had estimated that by December last year, about 840,000 people in South Africa needed antiretrovirals (ARVs), but that only 7% of them (between (47,000 and 62,000) were actually receiving the drugs. (See more about this in the Journ-aids treatment factsheet.)
What is going to happen to the millions of HIV-infected people who are waiting for ARV treatment, if no-one is there to distribute them?
At the same time, do we blame nurses for leaving, when it's clear that South Africa and many other Southern African countries don't have much to offer them, except swollen ankles, and a pat on the back – if they're lucky? – Lunga Madlala
