Staff, including nurses, at RK Khan Hospital in Chatsworth, Durban, picketed on Wednesday over poor working conditions at the facility. Photo: Tsoanelo Sefoloko
Nurses, administration staff and general workers brought parts of RK Khan Hospital in Chatsworth, Durban, to a standstill for about an hour on Wednesday. They protested outside the hospital to highlight what they say are poor working conditions.
Protesting nurses say they are forced to perform cleaning duties in addition to patient care because the hospital has not employed enough cleaners. Other workers complained of staff shortages in the administration and general units.
Workers say they met with the management in February. Union leaders had asked the facility to commit to resolving their complaints.
Nurse Zizakele Ndlovu said they were told by the union leaders that working conditions would improve. But nothing changed, she said.
“The conditions we work under at the hospital are not good. We end up having to work more hours, and we don’t get paid for overtime. Sometimes I even work as a clerk,” she said.
“The department treats us as if we don’t know our job, and we don’t deserve what we are asking for. We lost many workers to Covid; some retired and others resigned. Those vacancies have not been filled. Even at top management there are lots of vacancies and this leads to poor service.”
Chairperson at the hospital of the National Education, Health and Allied and Workers’ Union (NEHAWU) David Mpongose said they had engaged management and had been promised that the situation would improve.
“Our bosses are arrogant. They really don’t take us seriously. Each time they make empty promises, so we decided to protest for the provincial government to assist us,” said Mpongose.
Xolani Mnguni, a cleaner, said he earned R7800 per month under the hospital’s previous contractor, but now only earns R3000 under the current contractor. He also said he has to do jobs other than cleaning.
Hospital CEO Linda Sobekwa accepted the workers’ memorandum and signed it on behalf of the provincial health department. She promised to ensure that the department responded within ten days as requested.
Agiza Hlongwane, spokesperson for the KwaZulu-Natal Department of Health, said officials would consider the workers’ demands and respond to them.
By Vincent Lali, Chris Gilili, Liezl Human, Tariro Washinyira, Nombulelo Damba-Hendrik, Thamsanqa Mbovane, and Mkhuseli Sizani
“You have shown the power of the people by closing all the hospitals,” National Education Health and Allied Workers’ Union (NEHAWU) Western Cape provincial secretary Baxolise Mali told striking union members on Wednesday. “The employer says people are dying. It is not our responsibility to keep people’s lives.”
Mali was speaking to strikers outside the Khayelitsha District Hospital in Cape Town, as NEHAWU members continued a wage strike which has disrupted hospitals and government offices across the country. The government considers the wage negotiations for 2022 to be settled but NEHAWU and several other unions are still demanding up to 12%.
Police presence outside the hospital had kept protesters away, said hospital CEO David Binza. He said the situation was “better than yesterday”, when “things were bad”.
Binza said services at the hospital had been severely affected by the strike on Monday.
Protesters had prevented people coming in and out of the hospital. Staff had ended up working 24 hours because there were not enough nurses to relieve them, and there was a shortage of nurses in childbirth wards. “Yesterday they prevented night staff from gaining access into the facility. It was mostly doctors that they allowed in. Doctors alone can’t work properly,” he said.
Today things had been better, he said, as the police had arrived early and kept protesters away from the hospital.
Western Cape health spokesperson Mark van der Heever said shift changes at the hospital were being closely monitored after patients in critical condition had to be transferred to other hospitals such as Helderberg, Tygerberg, Mitchells Plain and Karl Bremer.
Striking workers outside Khayelitsha District Hospital on Wednesday. Photo: Vincent Lali
“On Tuesday night, 7 March, protesters disrupted services and blocked staff from entering Khayelitsha District Hospital until 11pm. The ongoing disruption has directly resulted in staff shortages as they are prevented from entering, backlogs building up and other operational challenges.”
He said protests had been reported at Karl Bremer and Tygerberg hospitals, but services had not been disrupted.
Mali said NEHAWU’s intention was to “collapse the provision of government services” to force the government to the negotiating table. “Our tactics involve closing workplaces, to force workers to get out and switch off their computers.”
Home Affairs offices in Khayelitsha were closed. Disappointed, Luthando Tiso said he has been going to Khayelitsha Home Affairs to collect his ID since Monday. “I can’t get a job without an ID,” he said.
In the city centre, the Home Affairs office in Barrack Street and the offices of the Department of Labour were closed and there was a strong police presence.
One man said he had been to the Mitchells Plain Labour Department offices on Monday and Tuesday only to find them closed because of the strike, and had come to Cape Town hoping for help. “I desperately need to claim from the Unemployment Insurance Fund. I lost my job in January. My rent and children’s school fees are already behind,” he said.
Eastern Cape
In the Eastern Cape, Department of Health spokesperson Yonela Dekeda said hospitals were being run by skeleton staff.
“We had an incident early in the morning where striking workers blocked the Cecilia Makiwane Hospital’s entrance in East London. But police were called to remove them.”
Dekeda said unions which were not supporting the strike action had raised concerns that their members were being intimidated and denied access to workplaces.
“We do appreciate responsible shop stewards who have called their members to order, where necessary, and ensured that critical services continue and that our patients receive necessary care,” she said. “However, we take very seriously those employees who intimidate others, and cause services to be affected negatively.
“Appropriate action will be taken in all such instances, and law enforcement agencies are being deployed.”
At Laetitia Bam Day Hospital in KwaNobuhle, Kariega, Eastern Cape deputy secretary of NEHAWU, Busiswa Stokwe told about 100 striking workers: “We know we will be attacked even in the community, accused of not caring for patients. But the same community when you are doing the work of ten people, whilst you are four, would insult you, saying you are lazy. We must put ourselves first.”
A patient who did not want to give his name said he had arrived at 5am to have three teeth removed but had been ordered out by striking workers at 7am. “They came by car and on foot and sang in the corridors. We realized that we should go back home, with aching teeth.”
“We were about ten and have no money to remove teeth at a private doctor, who charges R350 per tooth,” he said.
Gauteng
In Tshwane, striking workers closed down the offices of the Department of Public Service and Administration, shouting and insulting some workers who were inside the offices.
There was a stand-off between the striking workers and police, as the workers closed off Hamilton and Edmond Streets with huge stones and turned cars away. Police moved the workers away.
Phumuzo Malahleni, a registry clerk at the Department of Agriculture, said his R12,000-a-month salary was too low to cope with the soaring cost of living. “As public servants we can’t afford anything. Violence and going to the streets is the only language our government understands.”
NEHAWU Gauteng provincial chairperson Mzikayise Tshontshi told GroundUp that the battle for a wage increase was far from over.
He said NEHAWU had been called to the Public Sector Bargaining Council on Thursday. “Our negotiators will be there, but the rest of us will continue shutting down public services.
“We believe our strike has been resoundingly successful. From Monday to today, the numbers have been growing. Tomorrow we want to intensify the strike,” said Tshontshi.
Addressing the crowd outside the department, Tshontshi called out those who were still at work.
“We are also aware of ‘amagundwane’ (rats). Some are sitting in cosy offices, and then when we win this battle they are going to be first in the queue because they think they deserve what we have fought for. There have always been traitors in every struggle; this is no different.”
At Tembisa hospital, striking workers blocked the entrance with burning tyres and debris while chanting slogans. Calm was later restored.
Free State
Free State health spokesperson Mondli Mvambi said the province had obtained an interdict on Wednesday morning to prevent strikers from disrupting services at hospitals and clinics. “The order does not stop the strike but stops acts of intimidation, violence, disruptions and instigating.”
Mvambi said hospitals hardest hit were National District Hospital, Universitas, Pelonomi and Medical Depot in Bloemfontein. “There were no nurses at work and patient care was seriously compromised.” Mvambi said calm had been restored but services remained strained as nurses were still not at work.
“At Manapo in QwaQwa they are not allowing nurses into the hospital. At Boitumelo in Kroonstad, picketers were singing at the gate but services are said to be continuing. At Pelonomi Hospital, nurses in ICU were forced out by the strikers.”
North West
In the North West, services at least six hospitals were disrupted by the strike: Klerksdorp-Tshepong, Potchefstroom, Taung District, Moses Kotane, Ganyesa District, and Gelukspan. There were pickets outside several other clinics and hospitals.
Mpumalanga
In Mpumalanga, spokesperson Christopher Nobela said that all health facilities had been affected and hospitals were working with skeleton staff in hospitals.
Limpopo
Limpopo health spokesperson Neil Shikwambana said, “We do not have reports of disruptions in any of our facilities so far.”
KwaZulu-Natal
Workers stopped work at Inkosi Albert Luthuli Central Hospital in Durban for several hours on Wednesday morning, singing outside the hospital. Patients were allowed to enter.
NEHAWU branch secretary Sikhumbuzo Gumbi said workers decided to go back to work at midday so they could assist patients. “As workers we decided to protest in the morning then attend to patients around lunchtime.”
Gumbi said the staff would continue protesting in the mornings until the strike ends.
Prince Mthalane, Durban NEHAWU regional secretary, said clinics had been closed in KwaMashu and at Polyclinic workers had burned tyres. Police had been called but workers had talked to them and no-one had been arrested.
“The aim is to have a peaceful strike,” he said.
GroundUp was unable to reach the health department spokespersons in KwaZulu-Natal or the Northern Cape.
Police
“Innocent patients have been caught in the crossfire and inconvenienced by something which has nothing to do with them,” said Department of Health national spokesperson Foster Mohale. He said the Minister of Health had asked the Minister of Police to strengthen the police presence in areas affected by the strike.
“Skeleton staff has also been available to give care to patients who could not be discharged,” said Mohale.
South African Police Union spokesperson Lesiba Thobakgale said the union had joined NEHAWU in the protest. “As SAPU, from today we have served a strike notice and we are joining the other unions,” said Thobakgale.
Striking members of the National Education, Health and Allied Workers Union (NEHAWU) blocked the department of Home Affairs offices in Cape Town on Tuesday. Photo: Thomas Kachere
Patients were turned away from some hospitals as members of the National Education, Health and Allied Workers Union (NEHAWU) and other unions pressed forward with their wage strike, in spite of a court interdict.
Many government offices were closed for several hours.
NEHAWU has approached the Labour Appeal Court to appeal against a decision to enforce the interdict against the strike granted by the Labour Court to the Department of Public Service and Administration.
In Cape Town, police intervened after a scuffle broke out after a member of the public who was queuing for service at the Department of Home Affairs office in Cape Town called protesters names.
The police warned the protesters not to engage in any violence.
Provincial General Secretary of NEHAWU, Baxolise Mali said, “Today we have escalated matters”. He said hospitals including Khayelitsha Day Hospital and Somerset Hospital had closed, and the offices of Home Affairs and Labour were closed. “SASSA offices will close soon for social grants,” he said.
NEHAWU served the department with a notice to strike on 24 February after wage negotiations deadlocked. The department offered a 4.7% increase while unions demanded between 10% and 12%.
Ronald Ruiters had queued at the Home Affairs office in Cape Town for hours for a temporary ID, without getting help, he said. “Yesterday I was here at 4:30am. I am an old man. What about people who are suffering now including sick people in hospitals? There should be a better way of dealing with these issues.”
“Since morning the police were here but they could not control the protesters, nothing is working here.”
Mali said workers were angry at a statement by acting Public Service Minister Thulas Nxesi who had described the strike as reckless.
“The acting minister called people reckless and said they need to go back to work … go back to work on what basis? Come with an offer: we are willing to negotiate.”
“It is reckless for the government to impose salaries on people. It is reckless for the government to expect the people who have been praised during the time of Covid for having to work hard in very difficult conditions to serve our people to get peanuts.”
“The ‘no work no pay’ principle is not a new thing. Let them deduct the money, we are used to poverty. “
Mali said members of the public did not understand. “They stand in long queues because the government is refusing to employ more people to work for Home Affairs, [Department of] Labour and SASSA. Instead they increase the cabinet. Too many deputy ministers and what work do they have to do?”
“What needs to be done is to create employment so that people get served quickly. That is all we are fighting for. We are not going to compromise.”
In Pretoria, striking workers occupied the Department of Labour Head office, singing and shouting at workers inside to come out. They also closed entrances to the offices of the Department of Higher Education and Training, and disrupted traffic on Francis Baard Street.
A striking cleaner at the Department of Labour, Boitumelo Motaung said she earns R6000 a month and supports a family of four people. She says she spends about R1000 on transport from Ga-Rankuwa to Pretoria for work.
“We are suffocating, and we are earning peanuts. I have three kids that are attending school and their father is unemployed. I am taking care of everything and a few days after payday, I am left without a penny and survive off loan sharks. We need government to recognise our value as people. Sometimes I am forced to do the work of three people where I work because they are not employing enough cleaning staff. That is why I am supporting this NEHAWU strike,” said Motaung.
Motaung said she has been working as a cleaner for seven years.
In a statement, DPSA director general Yoliswa Makhasi said work stoppages and pickets by NEHAWU and its members would be contempt of court.
“We will strike until our demands are met”
NEHAWU deputy secretary-general December Mavuso
Spokesperson for the department Moses Mushi said the minister had called on unions to return to the negotiating table.
NEHAWU deputy secretary-general December Mavuso said the strike had expanded. He said the union’s lawyers and government lawyers were in discussion about an appeal to the Labour Appeal Court. “We don’t know when an outcome will be available . In the meantime, our workers are on the picket lines,” said Mavuso. “We will strike until our demands are met”.
Department of Health spokesperson Foster Mohale said the department was working with provincial health authorities and law enforcement agencies to monitor the situation to ensure rapid response and if necessary urgent intervention.
In Fort Beaufort in the Eastern Cape, community health care workers were ordered to stop their services at clinics and hospitals. Striking NEHAWU members blocked the entrance of the Fort Beaufort Provincial Hospital and turned away patients. Top management was allowed to enter but other staff were locked outside the gates.
NEHAWU also shut down several government offices in the Eastern Cape.
Mphakamisi Shooter, regional NEHAWU treasurer, told GroundUp the union had used its resources to put President Cyril Ramaphosa in power. “But now he is failing to give us what we deserve.”
“We have over 5,000 members in this region. Today we made sure that we shut down all government departments in this region until Ramaphosa gives us a decent wage.”
MEC for Health Nomakhosazana Meth condemned the unprotected strike. “We understand that workers have a right to demonstrate but when they do they cannot infringe on the rights of others. We cannot afford to have a situation where the lives of patients and staff not on strike are in danger as a result of the action of those who have embarked on this action.”
She said there were reports of disruptions and acts of intimidation in some areas.
In Makhanda, clinics were closed as were the offices of the departments of Home Affairs, Labour, and Social Development by a group of about 80 protesters.
Madoda Toni, who was part of the protest, said the government cannot continue to pay workers low salaries while prices of food and other items were rising so fast. “We need permanent jobs, decent wage increases, and contract workers should be absorbed to be full time government employees and paid decent salaries,” said Toni.
In Qonce (King Williams Town) it was also reported that SASSA and Home Affairs offices were closed down by the protesters.
In Durban, patients were prevented from entering Prince Mshiyeni Memorial Hospital by NEHAWU members. The protest started about 6am and ended just before lunchtime when workers dispersed and returned to work. By 1pm, everything was back to normal.
Health activists demonstrating in Cape Town for a rise in the tax on sugary drinks were disappointed by Finance Minister Enoch Godongwana’s announcement in his Budget speech that the tax would be frozen for two years. Godongwana said this was “due to the difficult operating environment for the sugar industry from the impact of flooding and social unrest.”
The tax on sugary drinks was first introduced in 2018 to reduce consumption. The tax is imposed on drinks with more than 4g of sugar per 100ml. Research from the University of the Witwatersrand in 2021 showed that it has been effective in reducing the consumption of sugar-sweetened drinks.
HEALA, a coalition of organisations focused on nutrition, organised a flash mob in the Cape Town city centre ahead of the Finance Minister’s Budget Speech on Wednesday, advocating for an increase in the sugary drinks tax. They want the tax to be increased from 11% to 20%, following the guidance of the World Health Organisation.
The flash mob was part of HEALA’s “Less Sugar, More Life” campaign, and featured school pupils from Cape Town in a dance.
“We don’t even notice how much sugar we are drinking in sugary drinks and it’s harmful to our health. I want other young people to know that it’s dangerous,” said one of the dancers, Enkosi Stofile.
“The announcement by the Finance Minister, coupled with ineffective increases on other health taxes such as alcohol and tobacco, is a direct attack on the lives of millions of people at risk of serious health conditions such as diabetes, cardiovascular diseases and cancer,” said Nzama Mbalati, HEALA’s Programmes Manager.
Mbalati said there was no rationale for the decision to maintain the rate of tax on sugary drinks. “This decision is not in the interest of ordinary people. Instead, it puts profits ahead of people.”
About 10 000 new cases of diabetes are reported in South Africa each month, according to the International Diabetes Federation. Up to 70% of women and 39% of men are obese or overweight. Sugar is a cause of obesity and tooth decay, and is linked to a range of other non-communicable diseases. The national budget for 2023, tabled by Godongwana in parliament today, includes a R200-million reduction in health spending this year.
Before the budget speech, News24 reported that the South African Sugar Association said 6000 jobs could be lost if the tax was increased. SASA also said 9,000 jobs had already been lost since the levy was introduced.
However, in the aftermath of a fraud scandal at Tongaat Hulett, South Africa’s largest sugar producer, in 2018, 5,000 workers were served with retrenchment letters.
Disclosure: Community Media Trust does work for HEALA. GroundUp was once a project of Community Media Trust and still has a close relationship with Community Media Trust.
People living in Atlantis, Cape Town, say they are struggling to access healthcare. There are two clinics run by the City – Saxon Sea and Protea Park – offering limited care, concentrating on family planning, child health, basic antenatal care, and HIV care. For any other health issues, residents have to go to Wesfleur Hospital. People queue for treatment as early as 5am.
In 2017, we wrote about the long queues and other problems at Wesfleur Hospital.
Community activists have set up the Atlantis Community Health Organisation (ACHO), which submitted a memorandum of grievances in August last year to Western Cape MEC for Health Nomafrench Mbombo, and resident Allison Adams, (not part of the ACHO) set up an online petition that has garnered over 1,275 signatures.
Adams and ACHO want the two City clinics taken over by the province so that they can be upgraded to offer primary and not just general healthcare. This would take pressure off Wesfleur.
“Clinics would serve as a conduit to relieve the hospital from everyday attendance. The hospital can’t cope. We have limited number of doctors available every day,” says Ashley Poole of ACHO.
Adams says the doctors can’t cope with treating patients, doing ward rounds and conducting medical assessments for residents seeking disability grants. It takes days for people to get help at the hospital, she says, and everyone with even a minor illness has to go to the hospital.
“We have people traveling to Dunoon Community Health Center to seek medical attention,” she says.
ACHO wants a new hospital built in Atlantis, which in the 2011 Census already had nearly 70,000 people.
Mayoral committee member for health Patricia van der Ross said the City is open to transferring the clinics, but “the Western Cape health department must have the requisite budget available to continue running the clinics”. Then a handover agreement can be concluded.
She said a task team was established and “numerous meetings” were held explaining to the community the challenges involved in doing such a transfer.
One interim measure is that stable, chronic patients are seen at Protea Park three days a week on Mondays, Thursdays and Fridays between 8am and 4pm, and at Saxonsea clinic on Mondays between 8am and 1pm.
Provincial health department spokesperson Natalie Watlington said since receiving the memorandum in August 2022, the department’s district team has implemented short and medium-term interventions to improve matters at Wesfleur Hospital.
The Supreme Court of Appeal (SCA) has set aside a controversial supervisory order, granted in April 2021, compelling the South African Health Products Regulatory Authority (SAHPRA) to report back to court every three months on access to ivermectin for use in the treatment of COVID patients.
The court has ruled that there was no evidence to justify the order made by Pretoria High Court Judge Cassim Sardiwalla, that affected parties had not asked for the order, and that they had not been heard before he made it.
The judge had also failed to provide his reasons for making it, the court said.
The issue has its genesis in four applications, one by the African Christian Democratic Party in 2021 against SAHPRA seeking access to ivermectin for the treatment of COVID.
At that time, SAHPRA, which was wary of its use saying there was no reliable research to prove its efficacy, had already put in place its “controlled compassionate use” programme in response to reports of illicit ivermectin-containing products entering the South African market. The programme was stopped in May this year.
In terms of that programme, permission was granted to five importers of unregistered oral solid dosage forms of ivermectin. Health facilities were permitted to hold bulk stock but individual applications were still required. SAPHRA said it would monitor its use.
The ACDP and others approached the court for orders directing SAHPRA to remove restrictions and do “all things necessary to regulate and ensure the manufacture” of ivermectin until such time as clinical evidence demonstrated that it was not effective in the treatment of COVID.
The matter was settled along the same lines as SAHPRA’s programme.
But Judge Sardiwalla, in making the settlement agreement an order of court, also granted a “supervisory order”, putting SAHPRA under his judicial authority in respect of ivermectin.
SAHPRA and the Minister of Health applied for and were granted leave to appeal the order to the SCA.
In heads of argument before the SCA, SAHPRA said its appeal concerned the propriety of the order directing an organ of state to report back to court and be subject to judicial supervision where the dispute had been settled and there was no evidence at all that SAHPRA and the minister would not comply with the settlement agreement.
“It was simply imposed without justification. The order constitutes a grave violation of the Constitution … it violates the rule of law, the right to a fair hearing and the principle of separation of powers,” it argued.
The judge, SAHPRA said, had improperly made findings on matters not in dispute and his written reasons for the supervisory order “do not constitute reasons at all”.
In the SCA ruling, Judge Clive Plaskett said Judge Sardiwalla had suggested to the parties that he “regarded himself as seized of all matters involving ivermectin” and had proposed the supervisory order.
Both SAHPRA and the minister indicated they would oppose this and filed further papers.
While the judge had indicated that he would hear the parties on 6 April 2021, his registrar had informed SAHPRA’s attorney that morning that he had made a decision, he would not hear arguments, and he would send his order to the parties shortly.
No reasons accompanied the order.
SAHPRA and the minister asked for reasons but when these were furnished, they made no mention of the supervisory order or why he granted it.
Judge Plaskett said the first difficulty with the order was that Judge Sardiwalla had not given SAHPRA and the minister a hearing despite knowing that they did not agree to it.
“He agreed to a hearing but inexplicably changed his mind. In these circumstances, an oral hearing was, without doubt, essential.
“Courts decide matters, particularly opposed matters, in open court and the exceptions to this rule are limited.”
Judge Plaskett said the fact that the order had not been applied for by any party required that it be set aside.
He said, further, there was a complete absence of evidence to justify it.
“Important as supervisory orders may be in appropriate cases, the granting of this type of relief must be carefully considered – and justified on the facts – particularly because of its separation of powers implications.
“In this case, not only was there no evidence as to the necessity of a supervisory order but the fact that SAHPRA and the minister had settled the matter and agreed to an order suggests that there was probably no necessity for one.
“Had he allowed the parties to argue the matter, he would have been informed of the separation of powers problem …
“Finally, it strikes me as telling that the reasons he furnished made no mention of the supervisory order – and this despite being pertinently asked to furnish reasons on this very issue,” Judge Plaskett said, upholding the appeal, and setting aside the order.
The ACDP originally opposed SAHPRA’s appeal but shortly before the SCA hearing, it withdrew its opposition on the basis that no cost order would be made against it. The SCA therefore did not order costs.
The ivermectin programme was stopped in May this year.
