After asking health minister Zweli Mkhize for help in a province not coping with the Covid-19 pandemic, Eastern Cape premier Oscar Mabuyane is taking advice from a support team sent to the province to assist.
In a statement on Friday evening, the provincial government said a support team — led by Dr Sibongile Zungu and including Prof Ian Sanne, Theo Lighthelm, Albert Jansen, Dr Dorman Chimhamhiwa and Wendy Ovens — had conducted an assessment of the province’s health system, administrative processes and capabilities at hospitals in Nelson Mandela Bay and in Buffalo City.
Mkhize deployed the team.
The statement said the team had recommended that the provincial government address the inadequate co-ordination between tertiary, regional and district hospitals through a revised command and control structure.
Ensuring there was a Covid-19 project manager — who could fast-track the necessary action — was one of the team’s main recommendations.
The team found that while the metros had mobilised reasonable infrastructure to meet the surge, attention to service delivery requirements such as the adequate provision of oxygen, equipment, human resources and medicines was needed.
“One of the findings is that procurement delays are hampering the surge capacity commitments,” the statement said.
“The support team recommended that government urgently address problems in hospitals like Dora Nginza in the Nelson Mandela Bay metro which is being overwhelmed by the patient demand, lack of infrastructure, equipment and human resources to meet the clinical care demand.
“The support team also found that labour relations is an overwhelming issue that requires a dedicated action plan.
“They also found that historic arrangements for drainage areas, resource allocation, and referral routing are not addressing the significant surge in patient numbers, particularly in under-served, vulnerable populations.”
In their report the team also said emergency medical services and patient transport services required intervention to ensure continued function.
The assessment found that all oxygen separation plants were located in the Nelson Mandela Bay area, making distribution of oxygen to hospitals problematic.
Mabuyane’s spokesperson Mvusi Sicwetsha said: “Premier Mabuyane accepted recommendations of the report as an independent expert solution to the challenges facing the department of health and, to some extent, affecting its ability to provide quality health care to the people of our province.
“At the instruction of premier Mabuyane, the provincial government is establishing a project management unit (PMU) at the department of health that will be responsible for leading the health intervention of our Covid-19 containment and mitigation strategy.
“The PMU team being assembled has the necessary authority to fast track actions, decisions to address each of the findings in the report of the support team, issues being raised by communities to government through customer care platforms, complaints from workers and matters reported by the media.
“The PMU is tasked with strengthening effective scientific based interventions to reduce the transmission of person-to-person of Covid-19, maintenance of low levels of community transmission and to mitigate and protect the functioning of the health system of the Eastern Cape Province.”
Sicwetsha said as a result, Mabuyane had appointed Zungu head of the PMU.
“Dr Zungu’s responsibilities will be to lead the rapid response team co-ordination focusing on the operational needs of the regional co-ordination to suppress and contain the spread of Covid-19, strengthen the PMU support for the operational clinical support units for all district and sub-district for Covid-19 response.
“She will work closely with the tracking, tracing and testing teams, hospital support teams and directly with regional co-ordinators to ensure that the tracking, testing, isolation and quarantine interventions are strengthened.
“Dr Zungu will provide technical and clinical support for case management of hospitalised patients including the availability of oxygen, clinical protocols for patient management and rational use of ICU beds.
“Mabuyane has also appointed Dr Monde Tom who will design and drive an integrated organisation-wide intelligence and information system that supports the decision-making process, resource allocation, operational efficiency, effective interventions and impact of health systems to improve the health status of the people of the Eastern Cape province,” Sicwetsha said.
The third member of the PMU is Laurence van Zuydam, a human resource management specialist who is currently employed as the head of transversal human resource management at the office of the premier.
His responsibility is to focus on redesigning the organisational structure, functions and critical process of the department of health to create a central governance structure designed for rapid decision making, reorganising the teams into work streams made up of a variety of knowledge skills and competencies across functional units of the department of health, Sicwetsha said.
The team will include experts from universities in the Eastern Cape that are developing the province’s integrated psychosocial support strategy and framework aimed at guiding operations, resource mobilisation and recruitment of personnel to provide clinical psychosocial services to Eastern Cape residents.
The PMU team will report to Mabuyane on a weekly basis.