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Chris Ellis on the strike in South Africa

23 Aug, 10 | by BMJ Group

A nationwide strike of  government employees started last week here in South Africa and looks to have serious repercussions for the health care sector. I am a semi-retired general practitioner but have sessions looking after three of the psychogeriatric wards at our local psychiatric hospital.  The patients are mostly very vulnerable elderly patients on long term medication.  

On arrival at the hospital gates this morning there was a large mob of striking staff singing and toyi toying in front of the gates and preventing staff from entering. It is said that the custom of toyi toyi, which is a rhythmic stomping dance was used in the old days in Africa when the people had a grievance. They would collect outside the chief’s compound and would dance and make a noise to get the chief’s attention.

As it was early in the morning and I must have been the first doctor to arrive they allowed me to enter in my pickup truck. They know me as a daft elderly white man so I think they judged me to be fairly harmless. It was quite eerie inside as there were no cars in the ward car parks and the curtains were all drawn and the wards were locked down. I managed to get a staff nurse in one of the two assessment wards to let me in as she had been threatened by the strikers not to answer the phones. She and another helper had managed to feed the patients and give them their medications. They were both afraid that the strikers would find them and label them as igundane, which is an isiZulu word for a “rat” and is the equivalent of a scab in English. Some of the nursing staff in other hospitals have been sjambokked (a sjambok is a leather or plastic whip stick) by the strikers for going to work.

The situation was worse in my long term female ward, which is in an isolated part of the grounds of the hospital. I found the patients milling around outside the ward as the night nurse had been threatened and had left the hospital and there was no staff at all in the ward. They had managed to find food but had had no medication for two days and one elderly patient was lying in front of the door having had a fit. She was now conscious and had a haematoma on her forehead but otherwise was unscathed so two of the other patients helped me get her into bed. 

It is a challenging situation to be in a hospital psychiatric ward with no staff and no medications and no keys to open the medication cupboard so I decided to go down to the gate and talk to the union officials to try and persuade them, at  least, to let one of the nurses, who knew the ward, to come in to help me give out the medicines. The union officials refused adamantly to let any more staff in so I returned to find some of the other doctors had been let in and were helping feed and wash the patients and give out medicines.

We then heard that a mob of strikers had entered the hospital grounds through the gate and were looking for igundanes. We have advised the staff who are in the wards to lock themselves in and await developments. I really appreciate the courage of these few women who are continuing their work in very difficult circumstances.

Chris Ellis is a semi-retired general practitioner from Pietermaritzburg, KwaZulu-Natal, South Africa.

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  • Thinus

    I recall this type of strike when I was still a student at Kalafong in the early 1990s. My wife and I often discuss returning to SA once our kids leave home but I doubt if I would be able to cope with this on an emotional and physical level after more than a decade in the “docile” Australian system

  • Eprinsloo

    Chris

    Thank you for his inside report of the real situation. We are concerned about deterioration of Health services in South Africa and ask ourselves why young doctors do not want to stay and work in South Africa.

    The minister of Health has indicated that he and other members of the community are willing to help extend a caring hand. However his hands are bound by the situation. It is high time that the Department of Police supports him and arrest criminals that attack and bar personnel from working and cause death and suffering to vulnerable communities. This is “robbing” the sick and “high jacking” the health care providers.

    Engela Prinsloo

  • ExSAdoc

    I have collated some reports and blogs from around the country:
    Johannesburg: A doctor has to break into work. Intimidation and threats by strikers:
    http://www.thoughtleader.co.za/readerblog/2010/…
    Durban:
    http://dpotpourri.blogspot.com/2010/08/fyi.html
    Groote Schuur hospital blockade:
    http://bushradionews.blogspot.com/2010/08/strik…
    Strikers labelled as murderers:
    http://bushradionews.blogspot.com/2010/08/strik…
    http://www.bloomberg.com/news/2010-08-20/south-…
    The army’s response:
    http://www.bbc.co.uk/news/world-africa-11057690
    The politicians' response:
    http://www.mg.co.za/article/2010-08-28-zuma-cri…
    Striker arrested for assaulting doctor:
    http://bushradionews.blogspot.com/2010/08/publi…

    Standerton Hospital ward’s seriously ill patients rushed to private house: public servant strikers threw them out…
    2010-08-24 Standerton – A private home in Standerton has been hastily equipped to serve as a hospital ward after striking workers threatened to throw seriously ill patients out of the local state hospital.The protesters arrived at the hospital on Saturday morning and gave staff until just after midday to remove all the patients, said Pieter van der Westhuizen, owner of Jeria trauma care and ambulance service.“At least we were able to convince the protesters to give us time until 15:00.” The house in Paarl Street belongs to Van der Westhuizen and is currently being used by the Generation Changers church as a place of ministry. With the help of private organisations and nursing staff who are not participating in the strike, Van der Westhuizen’s ambulance service moved 13 patients to the house.“We were forced to smuggle beds, medication and other equipment from the hospital so that we could equip the house properly.”The only wards which are still open at the Standerton hospital are the maternity and paediatric wards. However, protesters threatened on Monday afternoon that these wards will also have to be closed by Tuesday afternoon.http://www.news24.com/SouthAfrica/News/Ward-moves-to-private-house-20100823
    No ICU beds in Pretoria – medics Police fire rubber bullets at strikers, Addington Hospital, KZN
    On Monday, August 23 2010, police fired rubber bullets at a large group of strikers who were blocking access to Addington Hospital in KZN. And a critically-injured woman had to be airlifted from an accident scene in Pretoria to Johannesburg after it was found that due to the public sector’s refusal to work and their blocking access to hospitals’ emergency rooms, there were no ICU beds available in Pretoria… http://www.news24.com/SouthAfrica/News/No-ICU-b…
    While they strike, people die… Comatose Joburg Hospital patient Bobby Turner, 68, above, nearly died because nurses and doctors were not allowed at his bedside to replace his feeding tube, his drip and clean his bedding. His family had to rescue him, and rushed the urine- and faeces soaked, dehydrated patient to a private hospital just in time. http://www.news24.com/SouthAfrica/News/While-th… Also, while the government has announced with much fanfare that they deployed members of the SADF-medical service, no troops will be patrolling the state hospitals to prevent any violence nor to protect patients: http://www.news24.com/SouthAfrica/News/Soldiers…
    KZN hospitals blocked Monday, worker’s car burnt: On Monday August 23, 2010 – A car was burnt and the Mangosuthu Highway in Umlazi in KZN – the access road to a local public hospital – was blocked off with a fridge and car-wrecks. Violent protestors barged into the Prince Mshiyeni Hospital in Umlazi and burnt a car belonging to a worker at the hospital,” said SAPS LtColonel Vincent Mdunge. http://www.news24.com/SouthAfrica/News/Proteste…
    Durban: King Edward Hospital, Monday: – A group of striking workers defied a court order when they prevented non-striking workers and patients from entering King Edward Hospital in DurbanThe five striking workers wearing National Education, Health, and Allied Workers' Union (Nehawu) T-shirts prevented workers and patients from entering the hospital. They only allowed entry to people who wanted to collect antiretroviral drugs…

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
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  • ExSAdoc

    I am appalled at the ethics of the South African Medical Association (SAMA, the doctors' trade union)! (http://www.iol.co.za/index.php?set_id=1&click_i…)

    If SAMA can say that the government is putting 1.6% above the lives of patients then
    they should also point out that so are COSATU (the main trade union involved in the strike) and SAMA by their members' actions.

    The South African Medical Association (Sama) has put the blame on government
    for the loss of lives and harm to patients in various state hospitals across
    the country. It accused government of putting money before people's lives.

    Poppy Ramathuba of SAMA says the ongoing strike has compounded the challenge
    of the shortage of doctors and nurses in the public sector.

    “We believe that government still believes that the 1.6% extra is much more
    important to them than the people that are dying. If government really cared
    as they claim to care – they would resolve this matter. It is innocent
    people who are dying – it is children of the ordinary working class that are
    not going to school,” says Ramathuba.

    When will we take full responsibility for our own inhumanity to our
    neighbours?

  • dpayne

    I will be out of the office starting 26/08/2010 and will not return until
    13/09/2010.

    For urgent bmj.com queries, please contact Birte Twisselmann or Juliet
    Walker, and for doc2doc.bmj.com, please contact Sabreena Malik

    _______________________________________________________________________
    The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients group.bmj.com. This email and any attachments are confidential. If you have received this email in error, please delete it and kindly notify us. If the email contains personal views then the BMJ Group accepts no responsibility for these statements. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. Emails sent or received by the BMJ Group may be monitored for size, traffic, distribution and content. BMJ Publishing Group Limited trading as BMJ Group. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.
    _______________________________________________________________________

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