Bandile Masuku rebuilding Gauteng provincial health, one dose at a time

Despite good work by community health workers, Gauteng Health MEC Bandile Masuku was told their work was often compromised by a lack of support. Another problem Masuku stumbled on at Sebokeng Zone 13 clinic on Wednesday was the lack of uniforms for community health workers:

“It would be nice if we provided a standard uniform so they are easily recognisable as they move around the community. That will make their work easier.”

Another issue that surfaced was that of stipends. Masuku said:

“We need to work on it. We spoke about it and had a few calculations. I think it’s something that we can be able to do to accommodate all of you, somehow a living wage.”

Masuku asked for two years to effectively address the issue of stipends.

He said the interaction between health workers and the community was a good experience which affirmed what he believed about the importance of community health workers in the country’s health system.

“Its one of those good things that we don’t talk about too often when we talk about health,” he said.

“We always focus on all the negative stuff which dampens the spirits of all the others who are doing well. It was a good affirmation that they play a good role. They must be professionalised and provided (with) enough equipment and enough resources. We will ensure they are part of our health system”.

District Health Services chief director Meisie Lerutla, said community health workers were an important part of the health system:

“The community health programme in Gauteng is being implemented in all the five districts, including Sedibeng. We have a total of 8,719 community health workers across the province. In Sedibeng there are 1,012 community health workers. Zone 13 clinic has 20 community health workers, divided into three teams. They are the people doing the work here in Sebokeng.

“They are a very important component for the health system to function and they are one of the streams of primary healthcare re-engineering that is being implemented across the country.”

Masuku emphasised that Gauteng should be at the forefront of the full installation of community health workers.

Masuku encountered a number of other problems. Pre-eminent was the shortage of equipment at the clinic. Both nurses and other health workers emphasised the lack of equipment at the clinic.

Community Health Worker Tsepiso Dingalo, 44, said:

“It’s not easy, we hope the MEC hears our cries. We have a good number of elderly people who were diagnosed with high blood pressure in the area. But what happens is that we have to share the BP (blood pressure) testing machines because they are not enough.”

However, the problem does not end there. Even if one of the clinic centres has BP machines, a health worker has to walk to that centre to fetch them. Patients at the clinic were divided according to their ages with designated centres for people over 65 and clubs for those who are younger. The centres are where patients collect their medication and are screened. The clubs are run from the clinic and other centres in the community.

Masuku lauded the system of centres and clubs and said the idea greatly impacted on queues at the clinic. He encouraged schools and churches to share their space with the clinic to accommodate more centres.

As the MEC was on a visit to one of the local homesteads, 77-year-old Martha Motloung showed up, barely able to stand on her own as she leaned on her walking stick.

Motloung said it was all lies that the clinic functioned properly. She said the nurses were rude and had no humanity.

“They will just stare at you. They don’t care if you have been waiting for long,” Motloung said.

She was not aware she was talking to the MEC and said she had brought her complaint to the health workers, who she said she knew.

Motloung told Masuku she could no longer walk to the designated centre for those over 65 as her feet were constantly sore and she had high blood pressure.

Health workers, including the clinic’s clinic staff, assured her they would ensure that next time she could collect her medication closer to where she stays.

However, many people, mostly resident in the area, told Daily Maverick that service was fairly good at the clinic. Mirriam Mamatela, 97, who suffers from chronic hypertension, said she collected her medication at the clinic in Zone 13.

“The service is getting better. It was bad — they were just too slow. It’s really much better now.”

However, adding to the problems at the clinic, health worker Dingalo said the clinic also had no office equipment. She said they had to document their visits to patients, but the clinic did not have the necessary equipment, or even essential office material such as paper. In the absence of paper, health workers have to keep stock of everything without any documentary proof.

The clinic said the reason it established centres for the elderly to collect their medication was to avoid long queues. The system ensured they collected their medication closer to where they lived.

“One of our major problems is the shortage of medication such as Amlodipine and Metformin. Broken equipment is not repaired and community members throw municipal waste near the clinic,” one nurse told Daily Maverick.

In light of the problems, Masuku said the provincial department was “on top of the plan — hopefully it will work.”

Masuku said most of the planning will be revealed at the end of his first 100 days in office, in early September.

When Daily Maverick asked Masuku if he had achieved what he set out to do in his first 100 days in office, Masuku said:

“It’s not yet complete, and I think when we report back on the 6 September, which is the day on which the 100 days lapse, we will be able to give you a sense of what is going to happen in the next five years”.

Despite his many visits to health centres since he took over as MEC, many did not seem to know who Masuku was, but given his spirited, unannounced visits to health centres across the province, soon people might know exactly who Bandile Masuku is. DM