According to the Quarterly Labour Force Survey, unemployment in the province stood at 47.8% in the first quarter of 2024.
Mashego takes over a portfolio that for the 2024/25 period has a budget that increased by just over 3% from the previous year (a below-inflation increase). It stands at R24.6bn, which is made up of R20.3bn from the province’s equitable share, R4.1bn conditional grants and R220.6m from the department’s own revenues.
Every cent will be needed. The province is battling with a high number of unfilled posts, crumbling infrastructure and the challenge of delivering services to rural communities.
Another mounting concern for the Limpopo government is food insecurity. In a July 2023 paper, researchers estimated that 52% of Limpopo households do not know where their next meal will come from. Persistent malnutrition exposes children to health risks including stunting, wasting and immune weakness, according to the World Health Organization.
Health system challenges
At a clinic level, there are challenges too. Ritshidze is a multi-partner project focused on community-led data collection and analyses of healthcare services at clinics across the country. They surveyed 303 users of Limpopo clinics in the first quarter of 2023 — 78% of clinic users said waiting times at clinics were too long. Based on their data Ritshidze estimates the average clinic waiting time is 2.38 hours per visit.
They also found that the province lags in giving stable HIV-positive patients multi-month scripts. Multi-month scripts save patients time in queues and transport money. It also eases congestion in facilities. Ritshidze found that only 12% of patients are on the preferred three-month script refill. It also found that only 56% (compared to the national average of 94%) of people living with HIV were in the past year given a viral load test (an important monitoring test that measures the amount of HIV in a person’s blood).
The Treatment Action Campaign (TAC) is one of the partners of the Ritshidze project. Daniel Mathebula is TAC Limpopo provincial manager. He says that TAC would have preferred to have an MEC who has a healthcare background. He says: “Since 1994, we have had a bad history of MECs who are not doctors in the province. With Ramathuba, she had professional experience being a doctor so she understood the challenges better.
“We are not sure whether the new MEC will deliver. We at TAC had never heard of her before her appointment. But we’ll give it time, try to meet her and see what happens going forward.”
Mathebula says the priorities for Mashego should be to address staff shortages and to fix infrastructure at clinics and hospitals. Added to this, he says, the MEC should be sorting out glitches that have seen lab services through the National Health Laboratory Services result in patients not getting their test results timeously or at all, in some instances.
He also says TAC is receiving complaints about mobile clinics that exist but are seemingly not offering a proper service. He says: “We are hearing from rural communities that the mobile clinics stay for only a few hours each visit but we see many mobile clinics parked in town when they should be delivering services.”
Mathebula adds: “We need an MEC who is committed and transparent. She must be able to work with all stakeholders and civil society because we are the people who know what’s happening on the ground.”
‘Too many vacancies’
The Democratic Nursing Organisation of South Africa (Denosa) in the province says a priority for Mashego should be to make acting positions permanent, including that of chief nursing officer in the province.
Jacob Molepo, the union’s provincial secretary, says: “The issue of staff vacancies must be resolved. We have high staff turnover in the province; some of this is due to natural attrition, but we also see people leaving for greener pastures in other provinces or the private sector.
“Each month we are seeing about ten staff go on retirement, so we also need to prioritise nurses training.”
Molepo says there must be a strategy to support nurses working in rural communities. He says as the province has pushed to have more 24-hour clinics it has not matched this with adequate staff employed. He says: “Sometimes you’ll find there are only two nurses attending to 100 patients a day and the working conditions in a rural area has challenges; so nurses are exhausted and that’s why they leave.”
“We are prepared to work with the new MEC and we will not prejudge her. We will meet and put our expectations on the table,” he says.
Despite several efforts to get comment from Mashego over the last week and initial indications from her office that she would respond, questions Spotlight sent her have gone unanswered.
The MEC’s office was contacted for an interview, but director of communications Neil Shikwambana asked for written questions. Mashego’s spokesperson Samuel Modipane also received the questions. He said he would try to get Mashego’s responses and then redirected questions to Shikwambana. After several prompts and an extended deadline, there has been no response.
Questions put to Mashego included for her to outline her priorities for the health department; what she felt she would be bringing to the role; outlines of her background and personal management and leadership style; how she intends acting on corruption; staff shortages and optimising a shrinking budget. Mashego was also asked about her directorships, conflicts of interest and what bearing these have on her as a public official.
— This article was first published by Spotlight
Ufreida Ho
www.timeslive.co.za
