Doctors, nurses and paramedics protest their unemployment

Gathered at the entrance of the national treasury in Pretoria on Friday, the 31st of January, over 1,000 unemployed doctors, dentists, pharmacists, and other healthcare professionals handed over a memorandum to demand employment. Marches like this have recently been taking place all over the country, in provinces like Mpumalanga, Limpopo, and Eastern Cape, as young unemployed healthcare professionals reach the end of their tethers waiting for job placements by the state.

“Imagine you are on call, and you are the only doctor for that department. You must cover all the wards, handle your own admin, see new patients coming in who have been sitting in cubicles all day. By the time you realise that a patient needs urgent care, it is too late,” recollected Dr Glenna Selaka about her experience serving at a big hospital in Tembisa last year.

She has seen how the shortage of doctors in public healthcare facilities affects patients and patient health outcomes. “It is disappointing, and if this continues, where we see more doctors year after year protesting for jobs, our healthcare system is going to fall apart,” said Selaka.

Leading the march was the South African Medical Association Trade Union (Samatu), that has urged government and members of the public to see the unemployment of healthcare professionals as an urgent crisis. “Our government is not taking our health, safety, and security, seriously. There is no way that we can be a country riddled with diseases, have more than 1,500 doctors unemployed and shortages in the clinics, yet we are told that there is no money. It means that we have leadership that does not plan, or even worse, care about its people,” said Dr Cedric Sihlangu, general secretary of Samatu.

He continued: “We thought that we should stay away from the department of health who is our primary employer, and talk to the source that they always defer to. They always say that there is no money because treasury did not give them enough money. Treasury must tell us if that is true and if it’s true then treasury must have a plan to shift funds.”

A crumbling healthcare system

National chairperson of the Treatment Action Campaign (TAC), Sibongile Tshabalala said that it was important to remember that the issue of unemployed doctors and healthcare professionals has been ongoing for years, and has only worsened with time. “The public healthcare system has been unable to cope for a long time. This has directly affected communities’ access to healthcare services, especially when patients need to go to the hospital to be attended to. You find that the few doctors who are there are overworked and unable to keep up,” she said.

Tshabalala added that the reports they get from communities show that many people are reluctant to go to the hospitals. “This is because they get there during the early hours of the morning, sit the whole day, and leave at night, sometimes without being seen by a nurse or doctor. This is not because doctors don’t want to see you but it is because they are limited and overstretched.” She said that the frustration of doctors and other health professionals is observable in all public health facilities.

Dr Buntu Mdodana passed the first part of his specialist exam and up-skilled to go into paediatrics after his community service last year, with the hope that his passion for this scarce area of medicine would be valued in the public healthcare sector. “After going through all of that, my expectation and desire was that after community service I would be placed in a facility where I can go and apply those skills and continue my training in the area of paediatrics. It seems like for me, this is not an opportunity that is available in public healthcare,” said Mdodana.

He added that unemployed healthcare professionals don’t know what direction to take because even though there was an interview process, they were still told that there is no funding for them. “Posts came out in some provinces and I applied. We all applied. Then the posts got frozen citing the issue of a lack of funding for these posts. So it’s not that there is no need for us, but there is no money to fund vacancies to fill the need.”

The protesters also demanded that parliamentarians and members of the executive be compelled to utilise the public healthcare system.

A ripple effect

With the same concern as the TAC, the Democratic Nurses Organisation of South Africa (Denosa) expressed anger that the shortage of nurses in hospitals is further deteriorating the standard of services in public facilities. Mogomotsi Seleke, general secretary of Denosa in the City of Tshwane, said that the shortage of nurses is aggravated by unemployment and the closure of nursing colleges: “The production of nurses is very low, and we find that the government continues to impose austerity measures which makes it difficult for nurses to be hired. They [nurses] end up having no choice but to leave the country, further disadvantaging people living in South Africa who use public healthcare services.”

Denosa said that they fear the shortage of nurses in the country may only get worse. A secondary challenge deepening this crisis is the government’s refusal to absorb community service nurses. “Our lasting hope is that the government will lift all austerity measures and hire more nurses. We also hope that community service nurses will be absorbed because their contract ends today and we want to see them in the system, patching the gap brought about by the unemployment of healthcare professionals,” said Seleke.

Emergency healthcare workers like paramedics, emergency nurses, and emergency medicine doctors, were also present and in support of the march. “Most of the transfers that we do happen because there is no doctor. Sometimes we drive extremely long distances of over three to four hours, especially when transferring a patient from a rural area, all while the shortage of ambulances and staff continues to affect us,” said general secretary of the South African Emergency Personnel Union (Saepu), Ntsapo Mhlauli.

Mhlauli said that the long transfers take a toll on the vehicles and become a higher expense to maintain, leading to the poor maintenance of the vehicles and their breakdown for prolonged periods of time.

“We even transfer to other provinces, from Eastern Cape to KwaZulu-Natal and Western Cape. If each province, each district, each rural areas, can have enough working, healthcare professionals, then the department will save a lot of extra costs that goes to the excessive transfers,” Mhlauli argued.

Health department responds

In response to our request for an interview, the spokesperson for the national department of health, Foster Mohale, said that the department understands the plight of unemployed doctors and other healthcare workers. “We will continue to make efforts to mobilise resources to recruit as many healthcare workers, including doctors to contribute in the public health system as the country is implementing the NHI to ensure equal access to quality and affordable health care for all, regardless of their socioeconomic status,” he wrote.