/ MEDIA STATEMENT / The content on this page is not written by Polity.org.za, but is supplied by third parties. This content does not constitute news reporting by Polity.org.za.

The National Office Bearers [NOBs] of the National Education, Health and Allied Workers’ Union [NEHAWU] undertook a fact-finding site-visits in selected public healthcare facilities in the wake of the outbreak of the novel coronavirus and rising cases of COVID-19. 

The purpose of the visits was to asses the conditions under which healthcare workers were working including the availability of PPEs, compliance with the OHS Act and the state of the institutions in terms of government’s criteria of the National Core Standards (NCS). Since the announcement of the first infection in the country on the 5th March 2020 NEHAWU has been at the forefront in sharply raising the lack of sufficient protection for its members and healthcare workers in general. 

Our fight to protect members started by approaching the Public Service Co-ordinating Bargaining Council [PSCBC] on the 15th March 2020 for deliberations on employers’ state of readiness and preparations for return back to work of public servants. On the 8th April 2020, the National Office Bearers (NOBs) of NEHAWU met with Minister of Health, who was accompanied by the Minister of Employment and Labour, the Minister of Trade and Industry and the then Acting Director General of the NDOH. This meeting took place in the midst of a legal dispute in which NEHAWUsought relief from the court that would compel the NDOH and provincial departments to adhere to the prescripts of the OHS Act including the provisions of PPEs in order to protect the lives of frontline workers. 

In that meeting assurances on the adequate Personal Protective Equipment [PPEs] were given and measures were to be put in place to ensure safety of frontline workers and this led to NEHAWU dropping its court action. However, after analysing the data presented by government on PPEs, we immediately submitted our own analysis as a response to departmental data analysis to Ministers present at the meeting which exposed the fact that what was available in stock was inadequate when measured against the headcount numbers of different categories of healthcare workers per institution and provincially.

The rising numbers of infected frontline workers and fatalities prompted the national union to deploy all its NOBs to workplaces to check the following:

Compliance to the Occupational Health and Safety [OHS] Act

Available stocks of Personal Protective Equipment [PPEs]

The establishment and functional workplace health and safety committees

The impact of the shortage of staff in hospitals 

Training of workers and frontline workers in dealing with COVID-19

The NOBs programme focused on epicentre provinces such as Eastern Cape, Gauteng, KwaZulu-Natal and Western Cape which helped us to empirically verify the information and complaints we received already from members in branches and regional structures. It provided an opportunity for the union’s leadership to probe for more information and answers from responsible officials in the visited institutions as well as to express the union’s solidarity and support for frontline workers. The programme also included the donation of PPEs and immune boosters by NEHAWU as part of its contribution in the fight against the virus to frontline healthcare workers. 

KEY FINDINGS FROM SITE-VISITS

The lack of adequate provision of PPEs

In almost all healthcare institutions that were visited, our teams found that there were generalised shortages of PPEs - four months after the union was told by government that there were enough PPEs in stock and that it was undertaking additional procurement to replenish what was in its inventories or warehouses. Almost all managers did not have an idea as to how long these PPEs would last and had no plan in place to avoid stock depletions. 

We also found that there were challenges in relation to PPEs distribution to frontline workers. In some institutions cleaning staff and porters are left unprotected because of the misconception that PPEs are only for clinical staff when they regularly have to clean and clear contaminated areas. 

In fact, in an institution like Charlotte Maxeke Johannesburg Academic Hospital, our team found that workers had to resort to using refuse bags to protect themselves. 

The bottom-line with regard to PPEs is that they were never adequate in the first place, the available PPEs are still not adequate in terms of what is experienced by our members at institutional level and for the projected peak of the epidemic, especially when measured according to the requirements of the full complements of different categories of staff.

Lack of compliance with the Occupational Health and Safety Act

In all healthcare institutions that were visited, there is generally non-compliance with the OHS Act. This is despite the fact that at the national and provincial departmental levels, as well as at institutional level, there are officials that have been appointed specifically to deal with health and safety imperatives. In fact, some of our teams have found that the authorities at institutional level shockingly demonstrated complete ignorance of this legislation as well as the departmental guidelines that have been issued since the outbreak of the COVID-19. Thus, from the inquiries of our teams in their engagement with the responsible authorities, none of the institutions were able to show or present to our teams the following:

When and how they have embarked on Risk Assessments.

How the Infection Prevention and Control measures that have been implemented are informed and linked to the Risk Assessments that were undertaken, and whether there is a process of active monitoring and review to improve.

That the Occupational Health and Safety Committees have been established according to the legislation and are accordingly operational. In fact, to underscore the pervasive disregard of the law and its regulatory requirements, in all institutions there are no regular briefings to the labour representatives on the infections, cases of self-isolation, recovery and fatalities.

Across the board, we have found no branch of the union that expressed satisfaction with the managers’ consultation process, where it is practiced. Actually, at the Tygerberg Hospital labour was not even allowed to participate in the established ad hoc COVID-19 structure, despite the fact that it is healthcare workers that are more practically informed about what is happening and are most exposed to the contagion.

Shortage of staff

In all healthcare institutions that were visited by our teams, the shortage of staff was one of the primary factors that were raised, not only by workers but also by some managers as well. 

Our own experiences, which were confirmed by these site-visits, is that these shortages do not just involve the categories such as specialists, doctors, allied professionals and nurses, but all different non-clinical staff as well. This generates an unbearable environment and experiences for patients and visitors, not to mention the extreme work overload imposed upon to the current workforce in the face of the COVID-19. Resultantly, the public health institutions are chronically suffering from unsanitary conditions, long queues, exhausted and irritable workforce, amongst other negative factors. 

In fact, the question of the shortage of staff is so pervasive across public healthcare institutions that were visited and in other hospitals our teams found that nurses are being forced to do the work of cleaners and potters without necessary designated PPEs. 

Authoritarian and destabilising management

Our team discovered that members and workers are victimised on a daily basis and nothing is done to have a cordial working environment including the dropping of disciplinary measures as announced by the Minister of Health. Moreover, we also found out the following:

When a member has tested COVID-19 positive, some managers would refuse to carry out fumigation (microbial fogging) to disinfect the affected institution or section thereof. Such behaviour endangers the rest of the workforce as well as other patients.

We have a number of members, especially shop stewards, that have been victimised in one form or another just because they have raised questions about the lack of PPEs, the absence of daily screening of healthcare workers, and the refusal by managers to allow workers to go on self-isolation if they reasonably suspected that they have been exposed.

Our shop stewards have been forced to sign confidentiality forms, which means that they are not supposed to report or raise concerns about how the institution is managing the COVID-19 issues, otherwise action would be taken against them.

Managers regularly issue written warnings to workers who refuse to work under the conditions that they deem unsafe (because of the lack of PPEs), despite the provision of the OHS Act which protects workers under such circumstances. For instance, two members of NEHAWU were given final written warnings by management for refusing to perform their duties without PPEs at the Tygerberg Hospital.

In a province such as the Western Cape, managers have rejected reports of infection in the workplace from workers and they would even go as far as to compel such workers, who may even have already been diagnosed COVID-19 positive, to work as long as they did not have or present symptoms.

At the General Justice Gizenga Mpanza Hospital – our team found that about two workers have been suspended after the management refused to provide a report to them on the rising infections within the facility. 

Lastly, it is hardly surprising that under such circumstances depicted in the above examples such institutions are characterised by unnecessary hostilities towards NEHAWU, that in the course of the site-visits our leadership found themselves having to deal with protest actions that had erupted. In fact, there have even been some strikes in institutions such as Livingstone Hospital, iNkosi Albert Luthuli Hospital, Kopanong Hospital and Helen Joseph Hospital – and have largely been caused by  managers.

Dysfunctional district healthcare system

Our team also noted that most of the problems that engulf the public healthcare facilities are as a result of the dysfunctional district healthcare system. Across all health districts nationally, there are problems of coordination, complementarity and a broken referral system. For instance, as part of the site-visit in the Eastern Cape, our team found an unfolding disaster at the centre of which was the maternity ward at Dora Nginza Hospital. The hospital is supposed to work with about 7 feeder clinics, three of which were closed. This resulted in overcrowding at the hospital, which exposed the already ailing people to the danger of the COVID-19. Numerous of such similar incidents have been experienced by our members and reported in the media previously. 

Also our members in the institutions are questioning the authenticity or accuracy of the stats supplied by government on infections on a daily basis. Almost in all institutions, it was commonly held by the frontline healthcare workers that there was deliberate under-counting, especially with regard to the incidents and causes of deaths. In fact, the challenges faced by the National Institute for Occupational Health [NIOH] Health Care Workers’ DATCOV Surveillance System in gathering data validates this view in that there seems to be no uniform or standardised method of recording across the institutions. Furthermore, only 18 public healthcare institutions are cooperating with the NIOH in submitting their data on weekly basis, whereas the private healthcare institutions are generally cooperative.

The decentralised response to the epidemic

Linked to the fragile district health system, is the fact that over the past quarter of the century since the advent of democracy and freedom, government has woefully failed to develop a systemically coherent and coordinated cooperative governance and management of the public healthcare sector. So far, the response to the outbreak of the COVID-19 underscores this. Instead of centrally coordinating the procurement of PPEs and the deployment of human and material resources to ensure that intensive and high care requirements and facilities are available where they are most needed, these planning and resources imperatives were largely left to the discretion of provinces. Hence, there was a shambolic and competitive scramble amongst provinces for PPEs and other essential requirements - which led to the maldistribution of these already inadequately gathered resources.

NEHAWU DEMANDS AND PROPOSALS FOR THE PROTECTION OF THE PUBLIC HEALTHCARE WORKERS

Having assessed the outcomes of the visits we hereby demand the following:

The full compliance of the OHS Act by all workplaces including ensuring that risk assessment and infections control and prevention measures are put in place and demand for the establishment of OHS committees in all workplaces. The Occupational Health and Safety Act must be implemented in full to protect workers.

Infected workers may only return to work on the following conditions: They have completed the mandatory 10 days of self-isolation, they have undergone a medical evaluation confirming fitness to work if they have had moderate or severe illness, they strictly adhere to personal hygiene, wearing of masks and social distancing. Managers at institutional level must closely monitor symptoms of such workers returning to work. Furthermore, we therefore call on the NDOH to issue a circular, explicitly prohibiting managers from preventing workers to go on quarantine if they believe they have been exposed, whether at home or at the workplace. The circular must explicitly prohibit managers from issuing or communicating any kind of threats or intimidating notices or letters to workers in such a way that they are forced to work when they have been diagnosed COVID-19 positive but without symptoms or when they have been in contact with individuals diagnosed COVID-19 positive.

We call on the NDOH, to mandate the daily screening of healthcare workers and that it must roll-out a national testing programme of None-Communicable Diseases, as many of the frontline workers actually live with such underlying diseases without being aware, which causes complications and deaths when such NCDs are only discovered at a later stage.

We call on the Department of Health to engage with the Health Professions Council of South Africa [HPCSA] to expedite the applications and to review the postponed arrangements for the board exams for the foreign-trained doctors and other healthcare workers, whether South African or not. Similarly, we call on the South African Nursing Council [SANC] to review its decision on the registration of the foreign-trained nurses.

We call on government to abandon the current decentralised and fragmented approach in the procurement of PPEs, as determined by the Guidelines on the Management of the Coronavirus (COVID-19) in the Public Service issued by the Department of Public Service and Administration.  

We demand that the NDOH must review the process of reporting on COVID-19 fatalities in all institutions to ensure adherence with uniform standards as recommended by the WHO. In this regard, we also call on the NDOH to compel all institutional managers to regularly update NEHAWU and other trade unions on all Coronavirus and COVID-19 data especially pertaining to the healthcare workers in the institutions. 

Government must fill all vacant posts in the public healthcare sector and ensure that we start to build building blocks for the implementation of the National Health Insurance [NHI]. 

We call on government to implement a Risk allowance for frontline workers for the hard work and sacrifice of their lives and families during this fight against this invisible enemy. This include honouring the salary adjustment for public servants by implementing the last leg of Resolution 1 of 2018 as is.

PROGRAMME OF ACTION TO PROTECT WORKERS FROM THE VIRUS  

The recent stats by the Department of Health indicates that as of the 23rd July 2020 about 13, 174 healthcare workers were infected with COVID-19, while 107 workers had lost their lives. Out of the 13, 174 infected workers more than 10 275 of those workers are our members which they account for 78% of the reported numbers. However, the statistics from the Department of Public Service and Administration [DPSA] report that there are 22329 public servant who are currently infected which is contradictory from the number from NDOH. This makes to further doubt the veracity of the statistics communicated by government. 

These statistics paint a very bleak picture and prompted the national union to adopt a national programme of action that will be implemented to protect all members in all sectors it organises. 

The national union refuses to sit idle while members are infected on a daily basis. The national programme will be implemented as follows:

From provinces will continue with workplace visits and do assessments to establish state of readiness and compliance particularly as it relates to the safety of workers.

30th July – 11th August 2020 the national union will meet workers in all sectors where we organise especially those in public healthcare, private healthcare, South African Social Security Agency [SASSA], Lancet and Ampath, National Health Laboratory Service [NHLS], Department of Employment and Labour inspectors, Community Healthcare workers, Special Investigative Unit [SIU], the higher education sector, social development as part of mobilisation towards the implementation of the plan of action. 

10th August – 15th August 2020: In the same period the national office will be meeting strategic partners of the union such as SASCO, YCLSA and other progressive organization relevant to sectors where we organize and also meet the following Ministers and Director Generals, Public Service and Administration, Health, Employment and Labour, Trade and Industry, Social Development, Higher Education and Training, Science and Technology, SASSA CEO and SARS Commissioner including CEOs of BIG 3 Private Health Companies (NETCARE, MEDCLININC and LENMED) and local private hospitals. 

21st August 2020: “Tsaya le tsatsi la Leave” all our members in all the provinces will on this day flock to the offices of the employer and all apply for a day leave. 

24th August – 27th August 2020: Lunch Hour Pickets across all sectors.

28th August 2020: Siyahlala Day of Action, all workers across all sectors shall lockdown themselves at home and not go to work on this day.

31st August 2020: Work to rule campaign by all members across all sectors.

1st – 2nd September 2020: Hoot in support of Frontline Workers motorcade in all provinces and regions in recognition and appreciation of the good work and sacrifice demonstrated in saving lives of South Africans at the expense of their own lives.

3rd September 2020: National Day of Action in a form of demonstrations across provinces where memorandums shall be handed over targeting the National Parliament, Presidency Office and Premier’s Offices. The National Office Bearers will be deployed in these office and Provincial Office Bearers to address these demonstrations and submit memorandums.

10th September 2020: Full Blown Action – Complete withdrawal of labour in all sectors if there is no response favourable to our interests until all our demands are met. 

Issued by NEHAWU Secretariat