TAC Electronic Newsletter

Contents

• More on Delmas diarrhoea outbreak story
• Letter sent to Minister of Health on 17 September 2005
  
• Response to MEC of Health Mpho Gabashane's misrepresentations
• AIDS Law Project/TAC submission on government's draft Strategic Framework for the Human Resources for Health Plan

TAC National Congress Details

• Date: 23-25 September
• Venue: Cape Town Ritz Hotel, Sea Point
• The Opening Rally is open to the public and takes place from 18h30 to 20h30 on Friday 23 September.
  
• Links to important National Congress documents
  
• TAC audit for year ending February 2005
• TAC annual report for year ending February 2005
• Congress Documentation
• Media interested in attending should call Molly on 021 788 3507
• For media comment, please call deputy-chairperson Sipho Mthathi, national organiser Linda Mafu or spokespersons Denis Matwa and Nokhwezi Hoboyi on 021 788 3507.
  

More on Delmas diarrhoea outbreak story

Letter sent to Minister of Health on 17 September 2005

• Two workers at Delmas Hospital have independently indicated to the TAC delegation that the number of official deaths is substantially underreported, and that the epidemic began in June. Apparently a number of deaths that have occurred at Delmas's Bernice Samuel Hospital have not been included in the official death toll, as well as deaths that have occurred at people's homes.
• A worker for the local home-based care forum has informed TAC that the number of deaths among HIV-positive people for whom the forum provides care has gone up since June due to the outbreak of diarrhoea.
• Sydney Masinga, a member of the TAC delegation, personally met the families of six people who died due to the epidemic. He has personally seen three death certificates stating typhoid. One of these was a 33-year-old woman who died on Wednesday night in Delmas Hospital. We cannot reconcile her death with the official figures. It further seems that the official death toll is not considering excess deaths to diarrhoea.
• The TAC delegation visited Sizuzile Primary School. It was clear that the 32x20 litres of water they receive daily from Rand Water is inadequate, or delivered at an inappropriate time. There was no water left when the delegation arrived at the school in the early afternoon on Wednesday. Children were therefore left with no choice but to drink tap water, which is a possible source of contamination. The delegation had previously met seven children from this school, who were being treated in the tents at Delmas Hospital.
• It was also brought to TAC's attention that residents of Delmas town were supplied with bottled water, but residents in the township were supplied with tanks of water.
• A number of community members have complained that the tents established next to Delmas Hospital are cold. Either better premises are needed or heating needs to be installed in the tents.

• Collect and make publicly available up-to-date, accurate statistics of excess deaths due, or probably due, to the epidemic. Deaths occurring in all health-facilities and at private homes must be included.
• Provide safe heating in the tents established to handle the overflow of patients from Delmas Hospital. Alternatively, provide more suitable premises than tents to manage the overflow.
• Provide a much larger supply of safe and clean water to all residents until all possibility of contamination of the water-supply is removed.
• Ensure that sufficient doctors and nurses are sent to Delmas to handle increased patient loads.
• Ensure that enough medicines are available to manage the extra need.
• Determine whether infectious diseases in addition to typhoid are causing the diarrhoea outbreak.

Mpumalanga Health Department's Misrepresentations

• Gabashane asked TAC to present the evidence for increased deaths. We urge Gabashane to read the report we published on Sunday (available here). We also urge Gabashane to spend time in Delmas talking to community members who will present him with further evidence.

• TAC's investigation found evidence to support the allegation that the number of typhoid and diarrhoea deaths is being underestimated. Of course not all deaths due to diarrhoea can be confirmed as typhoid. Other pathogens might also be causing the diarrhoea outbreak. It is the excess deaths due to the diarrhoea outbreak that government is not reporting honestly (and possibly also some confirmed typhoid deaths). If government is unsure of the death toll, then it should not attempt to create false complacency by reporting only the confirmed typhoid deaths; it should at least acknowledge that there are very likely many more deaths linked to the diarrhoea outbreak.
  

• Gabashane has accused TAC of being irresponsible and causing alarm. But it is irresponsible to underestimate the seriousness of a diarrhoea outbreak. TAC had a duty to publish what we discovered as truth in the public interest. We have not caused any alarm in the Delmas community because it was the community that drew our attention to the underestimated deaths not vice versa. A large demonstration in Delmas turned violent on Thursday; TAC neither organised nor participated in that demonstration. Clearly the Delmas community was alarmed and upset before TAC broke this story.

• The National Department of Health has consistently spurned TAC's attempts to work with it. This is a consequence of the Minister of  Health's attitude to TAC and her HIV-denialism. We contacted the Mpumalanga Department of Health when we found evidence of underreported deaths in Delmas (and unsuccessfully tried to contact the national department), but the response was what we have sadly come to expect: denial and defensiveness. The Delmas crisis is exacerbated by this same attitude of the health department in most of its dealings with civil society and communities.
  

AIDS Law Project/TAC submission on goverment's draft Strategic Framework for the Human Resources for Health Plan

• It is not a national [human resource for health] (HRH) plan;
• It fails to recognise the relationship between HRH planning and health sector transformation, and to give substantive meaning to the concept of national stewardship of HRH planning;
• It fails to deal with emergency and short-term needs as integral parts of HRH planning;
• It is devoid of priority setting; and
• It fails to address other key issues such as:
• Inter-sectoral cooperation;
• The setting of health care worker (HCW)/patient ratios;
• Why many HCWs are leaving the public sector;
• The impact of HIV/AIDS on individual HCWs and the health system as a whole;
• The financing of HRH planning;
• Determining an appropriate role for the private sector; and
• Monitoring, evaluating and ensuring the proper implementation of a national HRH plan."