The State of South Africa Health Care

Susan S. Johnson

(Bloomberg) — The death of a 34-year-old man with Covid-19 who wasn’t fed for 100 hours or attended to by a doctor for almost three days has shown the dire state of some of South Africa’s public hospitals.



a person sitting in a room: A hospital worker walks amongst patients with COVID-19 in the COVID-19 ward at Khayelitsha Hospital, about 35km from the centre of Cape Town.


© Photographer: RODGER BOSCH/AFP
A hospital worker walks amongst patients with COVID-19 in the COVID-19 ward at Khayelitsha Hospital, about 35km from the centre of Cape Town.

Tembisa Provincial Tertiary Hospital near Johannesburg was accused of gross negligence by the country’s health ombudsman after an investigation.

“The problems I have at one of your facilities continues, it is becoming unbearable,” the patient, Shonisani Lethole, told Health Minister Zweli Mkhize in a Tweet two days after his admission to the hospital. “And they don’t seem to care.”

His death sparked outrage on social media in a country where there’s a marked gap in the quality of health care afforded to about 15% of citizens who have medical insurance and the rest of the population. Thousands signed a petition to demand justice. Mkhize, who didn’t see the Tweet until it went viral, ordered the investigation last year.

Lied Under Oath

Lethole was brought to the hospital in June and suffered from stage 4 renal failure after contracting the coronavirus. He wasn’t informed about the test results before his death six days later.

Video: WHO experts leave Wuhan quarantine to start virus probe (AFP)

WHO experts leave Wuhan quarantine to start virus probe

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Lethole got no food for 43 hours before he was sedated and didn’t receive a feeding tube for another 57 hours after sedation, according to the investigation. Overall, it took 69 hours before registered medical practitioners assessed his condition. Upon his death, it took another 10 hours to remove his body from the bed.

While his parents brought him food, it wasn’t delivered to him because cleaners were afraid to enter the ward without personal protective equipment.

The ombudsman concluded in a report published Wednesday that the hospital shouldn’t have been used as a Covid-19 facility and provided substandard care. It put patients with and without Covid-19 in the same ward, was guilty of “appalling record-keeping” and failed to move bodies to the mortuary timeously.

“The severity and change in Mr. Shonisani Lethole’s condition could have been detected earlier and would have resulted in a different management process and pathway with probably a different outcome,” the report said.

Authorities should take disciplinary action against the facility’s chief executive officer and some staff, including those who had lied under oath to investigators or tried to mislead the probe, according to the report. The provincial health department said Thursday it would implement the ombudsman’s recommendations.

(Updates with provincial health department’s comment in final paragraph)

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