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"contents": "<i><span style=\"font-weight: 400;\">After the release of the report by Professor Malegapuru Makgoba, the Health Ombudsperson, of the findings and recommendations of his investigation into allegations concerning quality of care at Rahima Moosa Hospital, Dr Tim De Maayer received numerous requests to comment from the media. He declined most of them. </span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">However, after careful consideration, consultation with colleagues and because his Open Letter is acknowledged in the Ombud’s report (see pp 37-38), he has prepared the response below. He believes this is necessary for the public record and to close the circle on his original decision to speak out about conditions at his hospital. As the Ombud’s report notes:</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">“</span></i><i><span style=\"font-weight: 400;\">Dr T De Maayer said he would remain in the public service. He indicated that he is often invited to work in the private sector but felt it would take away from his full-time job. He said he chose not to go to the private sector and hopes never to go to the private sector. He confirmed that he would stay in South Africa.”</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">We therefore publish it in the interests of the constitutional rights of everyone to have access to healthcare services and information and bona fide comment that advances that right. – Mark Heywood, Editor, </span></i><span style=\"font-weight: 400;\">Maverick Citizen</span>\r\n\r\n<b>Read more in Daily Maverick:</b> <a href=\"https://www.dailymaverick.co.za/article/2023-03-15-it-is-criminal-what-is-happening-to-patients-says-rahima-moosa-whistle-blower-tim-de-maayer/\"><span style=\"font-weight: 400;\">It is criminal what is happening to patients, says Rahima Moosa whistle-blower Tim de Maayer</span></a>\r\n\r\n<i><span style=\"font-weight: 400;\">Read the Ombud’s report </span></i><a href=\"https://healthombud.org.za/publications/reports/investigation-report-into-allegations-against-rahima-moosa-mother-and-child/\"><i><span style=\"font-weight: 400;\">here</span></i></a><i><span style=\"font-weight: 400;\">. </span></i>\r\n\r\n<span style=\"font-weight: 400;\">I welcome the release of the report into allegations at Rahima Moosa Mother & Child Hospital (RMMCH), released on 14 March 2023.</span>\r\n\r\n<span style=\"font-weight: 400;\">The findings of the report are accurate, and its recommendations, if brought to fruition, will bring the hospital some necessary relief. </span>\r\n\r\n<span style=\"font-weight: 400;\">Nevertheless, the Ombud was not tasked with investigating the rot in Gauteng’s hospitals in general. RMMCH is far from unique in its failure to uphold the constitutional rights of South Africans. A report in any of the other Gauteng hospitals will likely reveal similar dysfunction.</span>\r\n\r\n<span style=\"font-weight: 400;\">The motivation behind my original letter was to highlight the plight of our patients, who are still receiving second-rate care because of the dire circumstances public hospitals function in. </span>\r\n\r\n<b>Read more in Daily Maverick:</b> <a href=\"https://www.dailymaverick.co.za/article/2022-05-22-a-wake-up-call-for-health-department-heads-children-are-dying-because-of-horrendous-state-of-our-public-hospitals/\"><span style=\"font-weight: 400;\">A wake-up call for Health Department heads: Children are dying because of horrendous state of our public hospitals</span></a><i><span style=\"font-weight: 400;\"> </span></i>\r\n\r\n<span style=\"font-weight: 400;\">After the public outcry many delegations from the likes of GDoH and NDoH came to see how to help. Despite these many meetings and plans, very little has changed on the ground.</span>\r\n\r\n<span style=\"font-weight: 400;\">On the positive side, we are not receiving regular load shedding, and the sewerage situation mentioned in the report appears to be improved. Gift of the Givers sank a second borehole, and there is a better relationship between hospital management and staff at all levels. Current management has shown itself to care about patients, and not just public image.</span>\r\n\r\n<span style=\"font-weight: 400;\">But most other problems persist; nothing has been done to address the crumbling infrastructure, stock-outs of essential items continue, the CT scanner which passed its sell-by date a long time ago is broken again, we still are not reclassified as a tertiary hospital, overcrowding is a daily reality. </span>\r\n\r\n<span style=\"font-weight: 400;\">Most importantly, patients are still suffering as they were before. To hear that R200-million was returned to the fiscus by GDoH last year as they had failed to spend it, is not only a slap in the face for public-sector patients, but also typifies the incompetence and poor management in the health sector. </span>\r\n\r\n<span style=\"font-weight: 400;\">Imagine, the hospital with probably the second-busiest maternity unit in the country has not had a head of obstetrics for close to two years!</span>\r\n\r\n<span style=\"font-weight: 400;\">Staff morale is low. It is difficult to motivate yourself to come to work every day to face the challenge and try to do your best for patients knowing you are fighting a losing battle. For example, as a paediatric gastroenterologist I’m still forced to treat inflammatory bowel disease patients with substandard treatment, while better drugs have been in existence for more than 20 years! </span>\r\n\r\n<p><img loading=\"lazy\" class=\"size-full wp-image-1623077\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2023/03/MC-Iam_1.jpg\" alt=\"\" width=\"720\" height=\"387\" /> <em>The Rahima Moosa Mother & Child Hospital in Johannesburg. (Photo: Denvor de Wee)</em></p>\r\n\r\n<span style=\"font-weight: 400;\">When specialists and subspecialists are not able to apply their trade effectively, frustration sets in quickly. Cynicism and depression ensue. These are key components of the burnout so many of us are experiencing.</span>\r\n\r\n<span style=\"font-weight: 400;\">A particular low point in the report is its findings against the nurse who had incorrectly mixed patient cleaning solution. While the error in her actions is irrefutable, the obvious question is why a busy hospital performing many Caesarean sections in one day, is allowed to run out of cleaning solutions in the first place? Making a plan with the limited resources available to us, even if we know we are not providing the best treatment, is a daily occurrence. Healthcare workers of all levels are doing as much good as possible with what we have. And if we were not to do so, many more would die.</span>\r\n\r\n<span style=\"font-weight: 400;\">In the wake of the report, I was asked to respond by the press. But the fear of reprisals for whistle-blowers remains stifling. The consequences of the punitive action against those speaking out in healthcare led to many South African healthcare workers joining the “I am” movement last year, speaking up against continued victimisation. Despite the initial acknowledgement and meeting, as a healthcare worker, I am still just as scared to speak out.</span>\r\n\r\n<span style=\"font-weight: 400;\">The report’s recommendations do suggest clear timelines though, and we hope these will be monitored and compliance checked. </span><b>DM/MC</b>\r\n\r\n<i><span style=\"font-weight: 400;\">Dr Tim De Maayer has asked us to convey that this will be his only public statement on the issue and that he will not be giving any further media interviews or comments. 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"description": "<span style=\"font-weight: 400\">Dr Tim De Maayer is a dedicated paediatric gastroenterologist who works at Rahima Moosa Mother and Child Hospital and serves as a lecturer at the University of the Witwatersrand. </span>\r\n\r\n<span style=\"font-weight: 400\">At Rahima Moosa Hospital, he established a specialised Paediatric Gastroenterology service, which provides care to children with complex gastrointestinal, liver, or nutritional diseases. </span>\r\n\r\n<span style=\"font-weight: 400\">In May 2022, he wrote an </span><a href=\"https://www.dailymaverick.co.za/article/2022-05-22-a-wake-up-call-for-health-department-heads-children-are-dying-because-of-horrendous-state-of-our-public-hospitals/\"><span style=\"font-weight: 400\">open letter </span></a><span style=\"font-weight: 400\">to administrators at the Gauteng Department of Health, which was </span><a href=\"https://www.dailymaverick.co.za/article/2022-05-22-a-wake-up-call-for-health-department-heads-children-are-dying-because-of-horrendous-state-of-our-public-hospitals/\"><span style=\"font-weight: 400\">published</span></a><span style=\"font-weight: 400\"> by Daily Maverick. His open letter was widely praised as he exposed the shocking state of children’s healthcare at the Rahima Moosa Mother and Child Hospital.</span>\r\n\r\n<span style=\"font-weight: 400\">Dr Tim De Maayer did what brave health workers have always done. Having done everything in his power to care for the desperately ill children at Rahima Moosa Mother and Child Hospital, he raised issues with management and, having seen no change, he went public. </span>\r\n\r\n<span style=\"font-weight: 400\">In June 2022, </span><a href=\"https://www.dailymaverick.co.za/article/2022-06-09-dr-tim-de-maayer-who-blew-the-whistle-on-shocking-state-of-childrens-healthcare-at-rahima-moosa-hospital-is-suspended/\"><span style=\"font-weight: 400\">he was placed on precautionary suspension</span></a><span style=\"font-weight: 400\"> with immediate effect after criticising the state of healthcare provided to patients at the hospital. The resulting public outcry saw him </span><a href=\"https://www.dailymaverick.co.za/article/2022-06-10-whistleblower-paediatricians-suspension-lifted-after-massive-public-outcry/\"><span style=\"font-weight: 400\">being reinstated.</span></a>\r\n\r\n<span style=\"font-weight: 400\">The consequences of the punitive action against those speaking out in healthcare led to many South African healthcare workers joining the</span><a href=\"https://www.dailymaverick.co.za/article/2022-06-21-i-am-movement-of-sa-health-workers-throws-down-the-gauntlet-to-health-minister-and-gauteng-premier/\"><span style=\"font-weight: 400\"> “I am” movement</span></a><span style=\"font-weight: 400\"> in 2022, speaking up against continued victimisation. </span>\r\n\r\n<span style=\"font-weight: 400\">The Office of the Health Ombud released </span><a href=\"https://healthombud.org.za/publications/reports/investigation-report-into-allegations-against-rahima-moosa-mother-and-child/\"><span style=\"font-weight: 400\">its report</span></a><span style=\"font-weight: 400\"> to minister of health Dr Joe Phaahla on Tuesday 14 March 2023, </span><a href=\"https://www.dailymaverick.co.za/article/2023-03-14-rahima-moosa-mother-child-hospital-is-a-filthy-and-neglected-mess-says-health-ombud/\"><span style=\"font-weight: 400\">noting</span></a><span style=\"font-weight: 400\"> that the health and dignity of patients and the wellbeing of healthcare workers were severely compromised.</span>\r\n\r\n<span style=\"font-weight: 400\">The investigative team spent close to a year investigating the allegations and concluded that there was incontrovertible proof that confirmed the complaints. The team obtained video footage that corroborated their findings, and whistle-blower Dr Tim De Maayer contributed significantly to the report.</span>",
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"description": "<i><span style=\"font-weight: 400;\">After the release of the report by Professor Malegapuru Makgoba, the Health Ombudsperson, of the findings and recommendations of his investigation into allegations concerning quality of care at Rahima Moosa Hospital, Dr Tim De Maayer received numerous requests to comment from the media. He declined most of them. </span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">However, after careful consideration, consultation with colleagues and because his Open Letter is acknowledged in the Ombud’s report (see pp 37-38), he has prepared the response below. He believes this is necessary for the public record and to close the circle on his original decision to speak out about conditions at his hospital. As the Ombud’s report notes:</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">“</span></i><i><span style=\"font-weight: 400;\">Dr T De Maayer said he would remain in the public service. He indicated that he is often invited to work in the private sector but felt it would take away from his full-time job. He said he chose not to go to the private sector and hopes never to go to the private sector. He confirmed that he would stay in South Africa.”</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">We therefore publish it in the interests of the constitutional rights of everyone to have access to healthcare services and information and bona fide comment that advances that right. – Mark Heywood, Editor, </span></i><span style=\"font-weight: 400;\">Maverick Citizen</span>\r\n\r\n<b>Read more in Daily Maverick:</b> <a href=\"https://www.dailymaverick.co.za/article/2023-03-15-it-is-criminal-what-is-happening-to-patients-says-rahima-moosa-whistle-blower-tim-de-maayer/\"><span style=\"font-weight: 400;\">It is criminal what is happening to patients, says Rahima Moosa whistle-blower Tim de Maayer</span></a>\r\n\r\n<i><span style=\"font-weight: 400;\">Read the Ombud’s report </span></i><a href=\"https://healthombud.org.za/publications/reports/investigation-report-into-allegations-against-rahima-moosa-mother-and-child/\"><i><span style=\"font-weight: 400;\">here</span></i></a><i><span style=\"font-weight: 400;\">. </span></i>\r\n\r\n<span style=\"font-weight: 400;\">I welcome the release of the report into allegations at Rahima Moosa Mother & Child Hospital (RMMCH), released on 14 March 2023.</span>\r\n\r\n<span style=\"font-weight: 400;\">The findings of the report are accurate, and its recommendations, if brought to fruition, will bring the hospital some necessary relief. </span>\r\n\r\n<span style=\"font-weight: 400;\">Nevertheless, the Ombud was not tasked with investigating the rot in Gauteng’s hospitals in general. RMMCH is far from unique in its failure to uphold the constitutional rights of South Africans. A report in any of the other Gauteng hospitals will likely reveal similar dysfunction.</span>\r\n\r\n<span style=\"font-weight: 400;\">The motivation behind my original letter was to highlight the plight of our patients, who are still receiving second-rate care because of the dire circumstances public hospitals function in. </span>\r\n\r\n<b>Read more in Daily Maverick:</b> <a href=\"https://www.dailymaverick.co.za/article/2022-05-22-a-wake-up-call-for-health-department-heads-children-are-dying-because-of-horrendous-state-of-our-public-hospitals/\"><span style=\"font-weight: 400;\">A wake-up call for Health Department heads: Children are dying because of horrendous state of our public hospitals</span></a><i><span style=\"font-weight: 400;\"> </span></i>\r\n\r\n<span style=\"font-weight: 400;\">After the public outcry many delegations from the likes of GDoH and NDoH came to see how to help. Despite these many meetings and plans, very little has changed on the ground.</span>\r\n\r\n<span style=\"font-weight: 400;\">On the positive side, we are not receiving regular load shedding, and the sewerage situation mentioned in the report appears to be improved. Gift of the Givers sank a second borehole, and there is a better relationship between hospital management and staff at all levels. Current management has shown itself to care about patients, and not just public image.</span>\r\n\r\n<span style=\"font-weight: 400;\">But most other problems persist; nothing has been done to address the crumbling infrastructure, stock-outs of essential items continue, the CT scanner which passed its sell-by date a long time ago is broken again, we still are not reclassified as a tertiary hospital, overcrowding is a daily reality. </span>\r\n\r\n<span style=\"font-weight: 400;\">Most importantly, patients are still suffering as they were before. To hear that R200-million was returned to the fiscus by GDoH last year as they had failed to spend it, is not only a slap in the face for public-sector patients, but also typifies the incompetence and poor management in the health sector. </span>\r\n\r\n<span style=\"font-weight: 400;\">Imagine, the hospital with probably the second-busiest maternity unit in the country has not had a head of obstetrics for close to two years!</span>\r\n\r\n<span style=\"font-weight: 400;\">Staff morale is low. It is difficult to motivate yourself to come to work every day to face the challenge and try to do your best for patients knowing you are fighting a losing battle. For example, as a paediatric gastroenterologist I’m still forced to treat inflammatory bowel disease patients with substandard treatment, while better drugs have been in existence for more than 20 years! </span>\r\n\r\n[caption id=\"attachment_1623077\" align=\"alignnone\" width=\"720\"]<img class=\"size-full wp-image-1623077\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2023/03/MC-Iam_1.jpg\" alt=\"\" width=\"720\" height=\"387\" /> <em>The Rahima Moosa Mother & Child Hospital in Johannesburg. (Photo: Denvor de Wee)</em>[/caption]\r\n\r\n<span style=\"font-weight: 400;\">When specialists and subspecialists are not able to apply their trade effectively, frustration sets in quickly. Cynicism and depression ensue. These are key components of the burnout so many of us are experiencing.</span>\r\n\r\n<span style=\"font-weight: 400;\">A particular low point in the report is its findings against the nurse who had incorrectly mixed patient cleaning solution. While the error in her actions is irrefutable, the obvious question is why a busy hospital performing many Caesarean sections in one day, is allowed to run out of cleaning solutions in the first place? Making a plan with the limited resources available to us, even if we know we are not providing the best treatment, is a daily occurrence. Healthcare workers of all levels are doing as much good as possible with what we have. And if we were not to do so, many more would die.</span>\r\n\r\n<span style=\"font-weight: 400;\">In the wake of the report, I was asked to respond by the press. But the fear of reprisals for whistle-blowers remains stifling. The consequences of the punitive action against those speaking out in healthcare led to many South African healthcare workers joining the “I am” movement last year, speaking up against continued victimisation. Despite the initial acknowledgement and meeting, as a healthcare worker, I am still just as scared to speak out.</span>\r\n\r\n<span style=\"font-weight: 400;\">The report’s recommendations do suggest clear timelines though, and we hope these will be monitored and compliance checked. </span><b>DM/MC</b>\r\n\r\n<i><span style=\"font-weight: 400;\">Dr Tim De Maayer has asked us to convey that this will be his only public statement on the issue and that he will not be giving any further media interviews or comments. 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