The health system in Limpopo faces challenges due to shortages of medication in clinics and too few staff. Moreover, assistant nurses are no longer being appointed.
Treatment Action Campaign, a DWF partner organisation in its CSPPL Programme, monitors the services rendered by the Department of Health in clinics and hospitals. TAC identified a shortage of contraceptive medication in clinics in the Greater Giyani area, which heightens the risk of a high rate of teenage pregnancy in schools and of unwanted pregnancies in the community. Having collected pregnancy statistics in schools in the area, TAC believes the lack of contraceptives contributes to the increase in the rate of teenage pregnancies in the area. The statistics show that there is a high number of pregnant learners in schools due to a shortage of contraceptive medication. The situation also puts women at risk of unwanted pregnancies in the affected areas.
TAC field workers, monitoring clinics in Greater Giyani, report that the Department of Health is struggling to provide the clinics with a consistent supply of contraceptive medication and that the clinics sometimes have no medication for long periods. This lived experience is contrary to Section 27 of the Constitution of South Africa, which states that everyone in South Africa has the right to access health services. More specifically, it contradicts South Africa’s National contraception and fertility management policy which aims to ensure that “comprehensive quality contraception and fertility management services are available and accessible for all people in South Africa as part of a broader reproductive and sexual health package”.
TAC’s evidence is collected by their 15 field workers who visit clinics and monitor the services, using a TAC monitoring tool to check the availability of medicine in clinics. In so doing, the field workers found medicine was unavailable in clinics around Giyani. As a result, TAC increased its focus on teenage pregnancy and found that the Department of Health is also failing to provide services in other areas: long queues, too few staff, and too little medication for chronic diseases. This is contrary to the expectations of the community. Moreover in Greater Giyani, the TAC has found that the community is not informed or consulted about this challenge.
Having identified the problem, the TAC arranged a meeting with the clinic committee. This did not identify a solution. The TAC arranged a meeting with Mopani District Department of Health Manager, who indicated they were still waiting for medication to be delivered from the province so there was nothing they could do. They also met the provincial department through the MEC`s office but were told that this is a national problem. Unhappy with this response, the TAC decided to take the issue to the legislature, assisted by training from DWF on how to engage with provincial parliament, and help to submit the petition After the TAC Limpopo had attended the CSPPL collaborative workshops, their communication with Government improved. They started to engage with the Limpopo Provincial Legislature in writing and managed to submit a petition on the shortage of contraceptive medication in local clinics. The petition requested that the issue of medication be addressed by the Health committee within the Provincial legislature.
This approach was more effective than their attempt to communicate directly with the MEC, whose office did not provide solutions. Through the assistance received from DWF, TAC took a further step of going the legislature to submit a petition. The organisation is still waiting for a response, with the length of time taken to respond compounding the challenging situation. TAC also managed to meet the provincial legislature in a meeting arranged by DWF during which they got contact numbers for the petition officer in order to make follow-up calls.
Former TAC provincial secretary Booster Chauke was responsible for supervising the team of workers collecting evidence in clinics to proves the problems with medication in most clinics in the Giyani area. Booster, with the TAC team from Nwadzeku-dzeku village in Greater Giyani local Municipality, led the decision to submit a petition to Limpopo Provincial legislature on 3 October 2019, encouraging the legislature, through the health committee, to ask the MEC of Health to resolve the shortage of medication in clinics. He has left TAC and is now employed by the department of health as a health promoter, but remains the Provincial Secretary of the TAC.
The TAC is still waiting for a response from the Limpopo Provincial Legislature.
TAC has done great work by collecting evidence that was used to prove that the Department of Health is failing to provide services as expected by the community. They submitted the petition about the shortage of medication to the legislature. Though they did not receive a response, the medication was delivered within two months in the clinic and people are receiving the medication.
Through the DWF’s intervention, both TAC and Ritavi VEP were invited to travel with DWF to the legislature for a meeting. Because they had submitted a petition, the TAC could use this opportunity to enquire about the progress of the petitions. Moreover, the group met the Public Participation Manager to discuss the petition submitting process. The Manager of Public Participation advised TAC to call the legislature and ask the petition officer about progress, providing the TAC with cellphone contacts which could be used to do the follow-up calls. These were not needed because the problem was resolved and people are now receiving medication.
The action taken by Treatment Action Campaign was a powerful demonstration that civil society organisations have a role to play within a community. In this case, they have taken issues affecting the people within the health sector to the Limpopo provincial legislature which had a positive impact on the lives of the people in the area.
The action taken was also positive for the organisation and CSPPL Programme, showing the impact that DWF is making in the community. CSOs and the community are now aware that they can communicate with the Provincial Legislature when they want to raise concerns or address issues affecting the community. They are also aware of the process of submitting a petition. Even if the Provincial Legislature did not respond to their petition, they are aware of the situation and should bring it to the attention to the health committee so that it is addressed. On following up, TAC received no response from the legislature but will keep calling the petition officer to find about progress in handling the petition.