Friday 12 July

He could have lived

When a woman goes into a labour, she has a little time to contemplate how she will access healthcare services. Her immediate concern is for the safe delivery of her infant but for Nomqibelo Mfengu and her father, Friday, the arrival of little baby (insert name), triggered memories of the tragedy that had befallen their family three years ago.

Nomqibelo went into labour in the early hours of what day in what year. Her father called the ambulance base in East London 100 kilometers from their village Nier in the Eastern Cape.

“We started calling the ambulance around 6am in the morning,” says Mr Mfengu. “We called the ambulance and they said they are broken and there aren’t any. We were told that it would not come.”

Fortunately, Mr Mfengu’s home is not far from the local clinic and so he told his daughter to make her way to the clinic to seek help. Nomqibelo was accompanied by a young lady from the village. She had difficulty walking as her contractions increased in frequency and intensity. They finally made it to the clinic around 10am in the morning.

“When they arrived at the clinic my daughter had started to give birth,” explains Mr Mfengu “The nurse called the ambulance number and again was told that there were no ambulances available. The child was delivered at the clinic.”

Though he finds it difficult to articulate, Mr Mfengu’s worry for his daughter stems from concern over her HIV status. He understands that she needed to take precautions not to transmit the virus to the child. In addition, he relives the trauma he suffered when he watched his brother Zinzile die at home while they waited for an ambulance that would never come.

Mr Mfengu speaks haltingly about that day.  He recalls with pain how Mrs James the local community health worker who often intercedes on behalf of people in the village when they have medical emergencies called the ambulance based over and over but no ambulance arrived. Mama James, as she is fondly referred to, was there on the day that Zinzile died.

Contemplating death

“I called the ambulance one afternoon, it was June 2015,” says Mr Mfengu. “My brother Zinzile suffered from diabetes and his blood sugar levels were very low.”

“We called to ask them to take him to hospital because on many occasions we had called the ambulance because of his illness and each time, he would be taken to the hospital,” explains Mr Mfengu.

On that occasion, the ambulance failed to arrive.

“On the following day, I asked Mama James to call because I had not succeeded in getting an ambulance to come,” says Mr Mfengu “Just as my brother’s spirit left his body, the woman from the emergency services line called to ask if she should still send the ambulance, Mama James told them not to bother because my brother was already gone.

“All the woman on the line said was sorry.”

“The issue of ambulance has been discussed for a long time,” says Mr Mfengu who was one of the families that gave testimony at the Human Rights Commission hearings held in East London in March 2015. “When we have community meetings, we are promised that the ambulances will come and for a short while after these meetings it seemed that there was some improvement but after a time things went back to the way they were.  My brother would be alive now if that ambulance had arrived.”

Since the hearings the Eastern Cape department of health has promised to improve ambulance service in the province but Superintendent General, Dr Thobile Mbengashe reported to the parliamentary portfolio committee on health in June 2018 that ECDOH did not have 416 ambulances on the road — it only had a 254.

He said that department had 2 185 EMS staff, but that this was insufficient.

He explained that challenges in delivering EMS services included geographical coverage and terrain, uneven salary scales when people moved from a local municipality to the province, poor infrastructure for EMS, and scarcity of EMS skills.

The action plans in these areas included the recruitment of 100 additional accident emergency assistants (AEAs) by 31 March 2019, and training and upgrading of 96 basic ambulance assistants (BAAs). He said that ECDOH also planned to implement EMS regulations and to appoint a task team to provide advice on the regulations.

In August 2019, the ECDOH announced that it would handover of 129 new emergency medical services (EMS) vehicles to provincial health facilities. These comprised 49 ambulances, 40 response vehicles and 40 Patient Transport Vehicles (PTVs). This brings the total number of ambulances in the province to 303; woefully short of the 660 the ECDOH said it requires to meet the needs of the population.



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