TAC Electronic Newsletter
20 September 2005
- 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
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
- 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.
Note: TAC chairperson, Zackie Achmat, will receive an honourary
doctorate from the University of Western Cape on Thursday evening 22
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More on Delmas diarrhoea outbreak story
Letter sent to Minister of Health on 17 September 2005
Dr. M. Tshabalala-Msimang
Minister of Health
17 September 2005
By Fax: (012) 325 5526
Dear Minister Tshabalala-Msimang
DELMAS DIARRHOEA AND TYPHOID EPIDEMIC
We bring to your urgent attention details about the Delmas typhoid and
diarrhoea epidemic that we have learnt since Wednesday. The official
death toll due to this epidemic as of Friday 17 September was three. We
have found evidence inconsistent with this. A TAC delegation to Delmas
has also witnessed and received allegations of an inadequate response
to the epidemic. Furthermore, no interventions have been implemented to
deal with the special needs of people with advanced HIV disease who are
at higher risk of illness and death due to the diarrhoea epidemic.
A TAC delegation investigating events in Delmas has learnt the
The TAC team also found evidence of hard work by dedicated health-care
workers and NGOs supporting them. We also support the Department of
Health investing additional resources in Delmas during the epidemic.
But it is not enough.
- 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
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
- 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.
We urge the National Department of Health to take immediate action to
address the situation in Delmas. This would include the following
- 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
- 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
- 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
- Determine whether infectious diseases in addition to typhoid are
causing the diarrhoea outbreak.
We urge you to act urgently and consistently with your constitutional
cc: Premier Thabang Makwetla, Mr James Ngculu (MP) Health Portfolio
[END OF LETTER]
Mpumalanga Health Department's Misrepresentations
In radio interviews on 19 September, the Mpumalanga Health Department
spokesperson, Mpho Gabashane, responded defensively and disingenuously
to TAC's report. We present the following clarifications:
- 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
- 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.
[END OF DELMAS STORY - BACK TO CONTENTS]
AIDS Law Project/TAC submission on
goverment's draft Strategic Framework for the Human Resources for
Download the full submission here.
Extract from submission:
"Our key concerns relating to the substance of the Strategic Framework
can be summarised as follows:
- 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."
[END OF SUBMISSION - BACK TO CONTENTS]
[END OF NEWSLETTER]