Unpaid overtime seems to be the main spark for the strike by healthworkers in the Free State that has spread from Monapo Hospital to others in the Free State.

“We are receiving reports of entire hospitals being shut down, patients being turned away from full and overcrowded facilities, maternity wards filled with women on floors, shut down in overfull casualty and trauma units. The situation is untenable and must be addressed as an emergency,” the Treatment Action Campaign and SECTION27 stated, after first hearing of the growing crisis.

By late Friday tensions had eased and an uneasy truce was underway. Night shift workers agreed to go back to work that same day, and an agreement was reached that saw the strike action lifted for the weekend.

Threat of continued strike

But the unions have said that if the Free State’s MEC for Health, Dr Benny Malakoane, does not meet with them to negotiate a satisfactory solution to their demands very soon, the strike will continue again.

The difficulties began when most staff at Monapo Hospital embarked on a strike last Monday co-ordinated by the National Health, Education and Allied Workers Union (Nehawu), and has continued ever since. Critically ill patients had to quickly be transferred to other hospitals.

Tsoleli Mosikili, head of communication for Monapo Hospital, said there were several reasons for the strike action. These included the fact that kitchen and security staff were insourced, there was a general staff shortage and staff were not paid for overtime worked, with nurses and doctors who have worked up to 16 hours on a shift only being paid for 10 hours. There were also complaints against the appointment of Buthelezi Ambulances which are suspected to have been acquired irregularly.

Tensions over overtime unresolved

Complaints of overtime payments for hospital staff have been an ongoing problem at many government hospitals for over a year.

Recently the Free State Health MEC, Dr Malakoane, said in a public statement that he would cut overtime by a third – yet ongoing tensions suggest this has not been resolved. Many doctors in the Free State have worked more than 80 hours of overtime each month this year. Yet because this was not approved, they have not been paid for the time worked.

Nehawu is also demanding that more fulltime staff to be permanently appointed at Monapo, and that money used for mobile toilets at the hospital is instead be used to pay staff. The temporary toilets have been stationed at the hospital because ongoing drought conditions in QwaQwa mean that there is no water, and so toilets in the hospital are not working.

Staff shortages lead to crisis situation

Only about 30 percent of Monapo Hospital staff have been working – only the staff who are not members of Nehawu, and all those on leave have been called back to help with the crisis situation.

Patients at Monapo Hospital were battling as they were not receiving enough food as kitchen staff had joined the strike.

“It’s a sad situation. Our lives depend on nurses and now there are no nurses around to help us, we don’t know what to expect next,” said one patient.

“We do have a shortage of staff,” Mosikili said, explaining that these were due to issues like staff being transferred to other hospitals, some going on pension and some dying.

Mosikili said the hospital was anxious to see all the challenges raised by the union resolved, and called on staff to return to work while negotiations continued.

All emergencies were being redirected to the already overcrowded Dihlabeng Hospital in Bethlehem, more than 50 kilometers away.

N0 staff available to transfer patients

“It’s a sad situation. Our lives depend on nurses and now there are no nurses around to help us, we don’t know what to expect next.” – patient

.Sibongile Mtimkulu, CEO of Manapo Hospital, said there were currently no nurses, no cleaners and no porters available to to transport patients. No emergencies could be handled, the hospital was dirty and about 70% of staff had failed to report for duty, she said. This was despite a request by health officials for staff to report to work.

Nehawu regional secretary Maurice Mopeli said workers would continue striking until their demands were adequately met.

Their action has since stepped up, with other QwaQwa hospitals now also going on strike.

“We are receiving reports of entire hospitals being shut down, patients being turned away from full and overcrowded facilities, maternity wards filled with women on floors, shut down in overfull casualty and trauma units. The situation is untenable and must be addressed as an emergency,” claimed a joint statement sent out by the Treatment Action Campaign (TAC) and social justice organisation SECTION 27.

Surrounding hospitals struggle with extra patients

By late last week Dihlabeng Hospital was almost full, the maternity wards were over capacity and women were lying across the floors. The casualty and trauma unit was unable to respond to at least one road accident due to lack of capacity as nurses were in discussions about striking.

Monapo’s district hospitals – Thebe Hospital and EL Ross Hospital – are both over-full. Thebe Hospital reported being unable to accept any caesarians due to no theatre lights and too few doctors on call to operate. More beds were having to be made for patients on the floor.

At Reitz Hospital, only the maternity and emergency wards were open, meaning that the spreading dysfunction was impacting on the Reitz catchment area and the functioning of Bethlehem Hospital.

Specialists at Bongani Hospital were reportedly also threatening to resign and nurses were in discussions to decide about imminent strike action and the hospital clinic was shut down.

Calls for President Zuma to intervene

“We have no faith in the provincial department to address this emergency adequately or rapidly. We demand urgent intervention by President Jacob Zuma and Premier Ace Magashule to fix the Free State health system, to pay people for outstanding overtime, and to fire the Health MEC,” said the TAC.

“In the upcoming weeks TAC and SECTION27 will engage in a fact finding mission in the province. We will be mobilising communities affected by these crises, collecting testimonies, and visiting affected facilities. All evidence will be shared publicly with the media,” the organisations said.

In the meantime, the crisis situation rages on, and the worries of those most in need of healthcare deepen. – Health-e News.

An edited version of this story first appeared on the Daily Maverick