South Africa’s health system is currently under pressure due to the coronavirus pandemic, with infections increasing drastically and hospitals running out of beds. Health workers are not only contracting and dying of the virus, but they also work irregular hours due to the shortage of staff. Is this an indicator that the health care system has collapsed?
The South African health system is made up of the public and private health sectors. The private sector provides health care for 20% of the population and is highly resourced, maintained and includes highly-trained personnel that caters mainly for rich and prominent citizens. Conversely, the public sector provides health care for 80% of the population and is poorly managed, under-resourced, poorly maintained and understaffed.
This situation hasn’t changed much since the advent of democracy and there is evidence that the public healthcare system has slowly declined since the advent of democracy. One of the most pressing challenges currently faced by public health care is the deteriorating infrastructure and small clinics, most of which are located in rural areas, that are poorly maintained. Most of the hospitals have severely cracked walls and leaking ceilings.
Most of South Africa’s hospitals are public hospitals – however, these tend to be overcrowded with long waiting times. The standard of medical care in public hospitals can range from acceptable to very low since they are plagued by problems such as old or broken equipment, medication shortages and poor hygiene.
There are damning reports that describe the collapse of the public health care system on which over 45 million depend on – the deaths of 144 psychiatric patients in the Life Esidimeni tragedy being one of them. The patients died after the Gauteng health department transferred them to ill-equipped NGOs.
Other reports detail how a two-year-old girl was allegedly raped while in a Covid-19 isolation ward at a hospital in George Mukhari hospital. The story of Martha Marais, 76-year-old woman, who was tied to a hospital chair and left to lie on the cold floor, allegedly by nurses at the Mamelodi Hospital in Tshwane.
There are few public clinics and hospitals that are performing well with a huge gap between a clinic that is in a rural area and one located in a suburb. Unfortunately, poor people have no other choice but to rely on these public health care institutions, since they don’t have the means to access quality healthcare through private healthcare.
All public health care facilities should offer quality services to all citizens, regardless of where they live, and the government needs to prioritise the upgrading and maintenance of health infrastructure in an effort to deal with the challenge of ageing and dilapidated infrastructure in public health facilities.
The government has a duty to focus on improving the overall healthcare system which involves placing an emphasis on public health as well as addressing the shortage of medication. As it stands, the public healthcare system seems to be on the verge of collapse with dark days ahead.