TAC Electronic Newsletter

10 December 2004


TAC Lusikisiki and student nurses demonstrate against unacceptable housing conditions of student nurses, who are expected to live in tents

TAC Gauteng members challenge Natalspruit Hospital CEO, who responds by suing the TAC for defamation

Provincial health summits held in Gauteng, Limpopo and Mpumalanga

Today is International Human Rights Day and the TAC's sixth birthday.

Demonstration against unacceptable student nurse housing in Lusikisiki - student nurses expected to live in tents!

Today in Lusikisiki, a rural village in the Eastern Cape, TAC members and student nurses are demonstrating against the unacceptable conditions of student nurses - who are expected to live in tents. Student nurses perform life-saving work in St Elizabeth's Hospital, the main hospital in Lusikisiki which serves many surrounding villages. They were recently threatened with eviction from their residence and were promised by the MEC for Health that they would be accommodated in park homes (not an ideal form of accommodation either, but one accepted by the student nurses as a temporary measure). This promise has been broken and the students are to be accommodated in tents. Twice in the last week, some tents have been erected but have blown down, fortunately before nurses had moved in. In the meanwhile, many students have sought private accommodation far from the hospital and many have consequently been victims of crime because of the long journey to the hospital and lack of security at their private accommodation.

It should also be noted that the accommodation for many qualified nurses working at St Elizabeth's is sub-standard, with some living in informal houses.

Date of Demonstration: 10 December 2004

Time of Demonstration: 11am

Route of march: From town hall to St Elizabeth's Hospital

The letter below was sent yesterday by the student nurses SRC and the TAC to the Lusikisiki Magistrate's Court.

The Presiding Magistrate

Lusikisiki Magistrates' Court

Jacaranda Street



9 December 2004

Dear Justice Sir/Madam


In June 2004, nurse students (students) and their representatives (SRC) of the Lilitha Nursing College - Lusikisiki Main Campus (nurses' college) received information from the Department of Public Works (Umtata) that students residing in ad-hoc accommodation at the Lusikisiki District Offices would be evicted from these premises.

Prior to this, students were allowed to reside on these premises with the endorsement of the management of St Elizabeth Hospital, the Department of Health and the Department of Education. The Department of Education was the previous manager of the facility which was being used by students for their accommodation during their studies.

Nurse students contribute in providing health care services to the communities of the Qaukeni Local Service Authority by performing nursing services as part of their training. Students perform nursing duties by day and night at St Elizabeth's Hospital. These student nurses played a critical role in reducing morbidity and mortality associated with the outbreak of cholera in 2003 in the neighbouring health sub-district of Libode. The management of the epidemic resulted in commendation by the World Health Organisation to the National Department of Health for the manner in which the cholera outbreak was managed. This is an indication that the students continue to provide health care services in the Qaukeni Local Service Authority communities.

As a result of the threat of eviction, many students sought private accommodation in surrounding villages (e.g. Ngobazana). In the interim, the SRC estimates that 30 student nurses have been victims of criminal activity including rape, rape and assault, assault, robbery and burglary. The Treatment Action Campaign (TAC) was approached by the SRC to assist with the problem of negotiating safe and decent accommodation for student nurses affected by this threat of eviction. This was done on the principal that TAC supports the development of a people's health service for all and has been active in supporting community initiatives since 2003 in Lusikisiki/Qaukeni and since 2000 in the Eastern Cape.

Both the SRC and the TAC had communicated formally and informally the state of affairs regarding nurse students' accommodation at Lilitha Nursing College to the provincial department of health. On 17 August 2004, at the launch of the Lilitha Nursing College, the current member of the provincial executive (MEC) for health, Dr Monwabisi Goqwana stated publicly that the nurse students should remain accommodated in the Lusikisiki District Offices based on an "agreement with the MEC for public works". This was received by the community in good faith.

However, on 20 August 2004, a communication from Mrs Magwentshu (Department of Public Works - Umtata) addressed to the President of the SRC of the Lilitha Nursing College, Mr Songezo Madyibi, stated that a security company had been authorised to evict students from the Lusikisiki District Offices on 23 August 2004. This happened three days after the MEC for Health had publicly committed to the security of tenure of the student nurses at the Lusikisiki District Offices and left student nurses with three days to make arrangements for accommodation.

An emergency meeting was arranged with Dr. Monwabisi Goqwana. This occurred at St. Elizabeth's Hospital on 26 August 2004 where an aggreement was reached that park homes would be erected to accommodate student nurses.

In a subsequent meeting held on 31 August 2004 involving a representative of the office of Dr. Monwabisi Goqwana, the director-general for infrastructure, Dr. Kotze, the provincial superintendent general, Mr Boya, the principle of hte Lilitha Nursing College, Mrs Ngele, the chief executive office of St Elizabeth's Hospital, Mrs Mnguni, nurse educators and the SRC, an agreement was reached that adequate tents would be provided to accommodate students on a temporary basis until the establishment of park homes as a medium term solution to be followed by the establishment of a permanent building for the purpose of accommodating student nurses.

On 8 September 2004, a site inspection was held to establish quantitites and positions of the tents. A subsequent meeting held by the senior management team of the department of health in Bisho discussed the resolutions of the meeting dated 31 August 2004. It was decided at this meeting that that the department would suspend the option of the park home solution. The SRC was not represented at this meeting and this decision was only communicated to the SRC on 11 November 2004.

On 15 November 2004, more than two months had elapsed before the first tent was ready to accommodate student nurses who had begun to prepare for end-of-year evaluations. before students occupied the tents, all of the tents had been destroyed by wind and rain. This meant that students had to remain in private accommodation in surrounding villages.

It has also been communicated to the SRC that the provincial department of health's request to the national department of health for funding the establishment of a permanent building to accommodate nurse students has been made. The national department of health has rejected this request stating that this is a provincial responsibility. The province has places this on its provisional budget for financial year 2005/6.

This left the three options for accommodation as resolved on 31 August as being unfulfilled at the end of 2004 and the crisis of accommodation not being addressed in the near future. As a result, the SRC met once again with Dr. kotze, Mrs. Ngele and Mrs. Mnguni as well as Dr. Thomas (Superintendent, St. Elizabeth's Hospital). It was resolved at this meeting that Dr. Kotze would take the responsibility of costing and assessing suitability of relocating the accommodation of students to Sigcau Teachers Training College. It remains to be seen whether this is an agreeable solution.

It is our opinion that tents do not comply with a generally accepted understanding of reasonable and dignified accommodation when offered by government representatives. Furthermore, community representatives consider the continued indignity suffered by the student nurses as a result of their lack of safe and decent accommodation, the increased exposure of student nurses to crime and the potential disruption of health care services to the community of Qaukeni Local Service Authority as contemptuous. The community of Lusikisiki and surrounds have struggled to establish and sustain vital this community institution and an apparent lack of concern and duty by various government representatives is largely undermining this community institution.

This happens in the backdrop of the enormous need of public sector health services, an absolute shortage of health-care staff and a "budget belt-tightening exercise" that will further undermine health services in this community and across the Eastern Cape. As a result of this, a mass community protest march will be held on 10 December 2004 to protest against a lack of concern, urgency and duty by government and to voice the frustration of the community. We the undersigned will continue to engage all stakeholders to resolve this crisis.

Mr. Mfanelo Mendwana

Deputy President SRC, Lilitha Nursing College

Ms.Nombulelo Rangana

District Co-ordinator OR Thambo Muncipality

Treatment Action Campaign

For further details, please contact Nombulelo Rangana on 083 9986 544



TAC challenges Natalspruit Hospital CEO, Daisy Pekane - She responds by suing the TAC for R500,000!

Natalspruit Hospital CEO, Dr. Daisy Pekane is suing the TAC for R500,000 for defamation of character. This follows a pamphlet and memorandum, distributed by TAC branch members who use the hospital, that made allegations against Pekane. Following the initiation of the defamation litigation, the TAC established an internal investigation to examine the allegations made against Pekane. The conclusion of the investigating team is that the allegations are substantially true. Therefore, if Pekane presses ahead with litigation, the TAC will defend against her claim and demonstrate in court her responsibility for the deterioration of Natalspruit Hospital.

The report of the investigation can be downloaded from:



Abridged and edited extract from the report:

Natalspruit hospital is situated in Ward 14, Katlehong and falls under the Ekurhuleni Health District. Natalspruit serves over 2 million people from Katlehong, Thokoza, Germiston, Standerton, Vosloorus, Heidelberg and Edenvale. It is a regional level 2 hospital with 21 general wards, one six-bed ICU, one three-bed neonatal ICU, an eight-bed High Care Ward, a psychiatric and a labour ward. It has seven operating theatres during the day and one theatre after hours. Surgical sub-specialities at Natalspruit hospital include urology, ophthalmology, spinal and rehabilitation. Natalspruit is part of the CHB cluster of hospitals.

Before June 2001, according to trade union representatives, there was a positive working relationship between the management of Natalspruit Hospital and NEHAWU, the trade union representing most of the hospital's health-care workers.

This changed in June 2001 when Dr. Daisy Pekane was appointed as acting CEO. Pekane’s appointment was controversial from the very beginning. She had only recently been "chased" out of her previous post as superintendent of Tembisa hospital – literally physically escorted from the hospital grounds - by NEHAWU members frustrated by her "arrogance, unbecoming behaviour, and for not respecting anyone". Pekane is accused by NEHAWU members of causing "massive unhappiness" at Tembisa hospital.

Under Pekane, Natalspruit Hospital's administration, cleanliness and management's relationships with NEHAWU and the communities served by the hospital deteriorated. The hospital has seen a spate of resignations of doctors and nurses over the last few years.



Provincial People's Health Summits held in Gauteng, Limpopo and Mpumalanga

Gauteng Provincial People's Health Summit

The Gauteng People's Health Summit was hosted on 13 to 14 November 2004 by the Treatment Action Campaign (TAC), the AIDS Consortium, AIDS Law Project, South African Democratic Nurses Union (SADNU) and the Health and Other Service Personnel Trade Union of South Africa (HOSPERSA).

It brought together representatives from all areas of civil society and government officials working in and around the health sector and had the following objectives:

To provide a platform for health workers and users to discuss their experiences of working and using the public health system;

To provide a platform for a broader understanding to the extent of the implementation of the Operational Plan (ARV Programme), highlighting successes and challenges in implementation and the experirences of HCW, service users and People Living with HIV and AIDS;

To involve government, civil society at large, including health-focused organisations; HCW trade unions and communities in discussion and resolutions on improving the health care system and access in Gauteng.

Presentations by key speakers from various sectors highlighted the many challenges as well as a collective commitment to strive for improved working relations to deliver a people owned health system in the province. The summit was also addressed by MEC for Health, Gwen Ramokgopa.

Key issues that were identified included; the need for improved facilities management, both private and public, a need to ensure district driven interventions, an overwhelming need for efficient antiretroviral rollout, a need for a functional human resourcing strategy and implementation plan for the Department of Health and the realisation that civil society and government were jointly responsible for a working health system in Gauteng.

Limpopo Provincial Health Summit

The First Limpopo Province People's Health Summit took place on 13 November 2004 in Polokwane. Over 250 people representing churches, all the major health-care worker trade unions (including Denosa, Hospersa, Sadnu, Nehawu), NGOs, people living with HIV/AIDS and traditional healers gathered to discuss how to work together to improve the Limpopo health-care system. The delegates heard about the challenges facing the provincial health-care system and the particular challenges of the HIV epidemic.

The Summit delegates were disappointed that despite a concerted effort by the TAC to invite the Limpopo MEC of Health and his department to the summit, not a single official from the Limpopo Department of Health or government attended the meeting. Delegates also noted with concern the slow pace of the rollout of the Comprehensive HIV/AIDS Plan in this province and the failure of the Limpopo Government to provide detailed information on the antiretroviral rollout, despite their claims that they have a detailed plan. The summit also noted with concern the difficult conditions under which health-care workers in the province operate. This in turn affects patient-care and the sustainability of the public health system. One example that was noted was the situation in Tintswalo Hospital in Acornhoek. Despite having the capacity to immediately begin rolling out treatment, the hospital has not received antiretroviral medicines. This means that nurses have to watch many of their patients die unnecessarily.

The delegates resolved to campaign for Tintswalo Hospital and other health care facilities to start receiving the necessary support to rollout antiretroviral treatment. It was also resolved to campaign for the improvement of conditions of service for health-care workers. It is critical for national government to develop a Human Resources (HR) plan and for Limpopo Province to implement a provincial specific HR plan.

A challenge for all the delegates is that we do not know enough about the science, treatment and prevention of HIV/AIDS. Therefore delegates resolved to improve their own treatment literacy knowledge and to rollout treatment literacy programmes throughout Limpopo.

The Summit also noted the important role that traditional healers have in Limpopo society. Therefore, it is crucial that traditional healers not be marginalised, but that there should be a platform for the public health-care system, NGOs such as the TAC and traditional healers to work together to better understand each others' way of working. It was also noted that more funds need to be set aside to test traditional medicines so that safe and effective ones can be identified and attain the same status as other medicines registered with the Medicines Control Council.

It was also agreed that there is not enough information circulated about social grants and this needs to be changed. Many people living with HIV or AIDS still do not understand how the disability grant works. This has created a lot of confusion within the PWA community on who qualifies for the grant and how to access it. The summit also resolved to support the Basic Income Grant campaign.



Mpumalanga Provincial Health Summit


The Mpumalanga People's Health Summit was held on 20 November 2004. The atmosphere of the summit was so passionate, that a toyi toyi almost broke the wooden floor of the hall! Three hundred people, including all the major health unions, home based care organisations, support groups, and the media attended.

The Head of the Provincial Health Department spoke for an hour and stated that the Provincial Health service was in a difficult state due to the previous administration under Sibongile Manana and Rina Charles. He explained in detail what measures are being taken to correct matters (e.g. 2000 additional health workers and administrators will have been appointed by Janruary 2005). He explained that he had met with GRIP, an NGO that supplies antiretrovirals to rape survivors, to rectify a relationship that was destroyed during Manana's term. He also agreed to investigate the conduct of the head of the Provincial antiretroviral programme, gave his cell number out to everyone, and promised monthly or quarterly meetings with the TAC leadership in the Province.