Manguzi Hospital Crisis

Hi All
Another urgent matter is about to affect our community. If leaders and citizens of kwaTembe do not urgently intervene is we will very soon have a hospital without any doctors. There are two issues at stake .

1) The one being the dual therapy for mother / child HIV transmission prevention . This issue is now already in the international & local media . I have pasted copies of two articles to this mail. This issue is self explanatory.

2) The second issue has not hit the press and goes about the recent visit of the KZN Minister of Health to KwaNgwanase. From what I am told she addressed a large gathering of community and leaders.. She alledgedly made a number of defamatory false statements about the doctors at the Manguzi hospital which of course the doctors deny as being untrue.
Apparantly no one at the gathering came out in support of the Docs who care for us and let these defamatory / derogotory / false statements go unchallenged.

The result is that our Docs are now depressed , demotivated , feel unwelcome in the community in which they serve. We don't have enough Doctors as it is to fill the vavant posts and now as a result of this we are about to loose not some but all of our Docs.

I spoke with some of them this weekend . I don't wish to go into who said what ,,, but the reality is that they are being offered posts elsewhere are are likely to accept. The reality exists that very soon we may have ( as in other parts of RSA ) a hospital with no Docs

Ernest






South Africa: KZN Targets Doctor But Shoots Itself in the Foot
(Cape Town)
15 February 2008Posted to the web 15 February 2008
Kerry Cullinan
By targeting Dr Colin Pfaff for disciplinary action, the KwaZulu-Natal health department risks alienating rural doctors and causing more to leave
The KwaZulu-Natal health department has chosen to identify a quiet rural doctor as a troublemaker, charging him for misconduct for "wilfully and unlawfully without prior permission of [his] superiors rolling out prevention of other-to-Child HIV transmission dual therapy to pregnant mothers and newborns".
But in charging Dr Colin Pfaff, the department has poked a hornet's nest of discontented public service doctors who are tired of being punished by bureaucrats for putting patients before process - especially when dealing with HIV/AIDS.
There has been a flurry of condemnation from medical organisations and doctors countrywide are currently signing a petition in support of Pfaff and demanding that the charges against him are dropped immediately.
Dr Francois Venter, on behalf of the SA HIV Clinicians Society, said that disciplining Pfaff "for doing his ethical duty is disgraceful".
"We call on KZN to immediately implement dual therapy across the province with the same energy they have expended on his case," said Venter.
Pfaff, a deeply committed Christian decribed by friends as a "humble visionary", raised money from overseas donors to supplement his hospital's nevirapine-only treatment programme for HIV positive pregnant women with another antiretroviral drug, AZT.
These donations were channelled through the Manguzi Mission fund, not the hospital.
The Western Cape has been using AZT and nevirapine since 2004 and has cut the mother-to-child HIV transmission to 8%. In KZN, which still uses nevirapine only, 22% of HIV positive mothers infect their babies.
Dr Victor Fredlund, the medical manager of Mseleni Hospital, also in the Mkhanyakude district in the far north of KZN, explains what drove Pfaff to seek donations to buy AZT for his patients.
"Our nevirapine programme was reaching nearly all pregnant mothers. Yet still more than 100 babies a month were still being born infected with HIV," said Fredlund.
"All the scientific literature, and the Western Cape experience, suggested that we could further reduce the transmission to a quarter of that, saving 75 or more babies a month, by introducing AZT during pregnancy."
Fredlund has written to Dr Sandile Buthelezi, head of HIV/AIDS in KZN, to express support for Pfaff and to say he will also do the same unless the department speeds up the introduction of dual therapy.
However, far from backing down, this week health spokesperson Leon Mbangwa confirmed the charge against Pfaff and added another: that he "acted beyond his authority in accepting a donation".
Mbangwa also declared: "We will not allow anyone to pull vulturistic theatrics to mystify this matter for their own political gains (sic). We will continue to put the interest of our people first."
Ironically, far from being in the interests of KZN's people, the department's decision to charge Pfaff is likely to impact badly on health service delivery in the province.
A number of doctors who did not want to be named said this week that they felt "demoralised" and "angry" about the incident, and one said he was suspending a major health initiative at his hospital that involved donor funds until there was clarity about the use of donations. - Health-e News Service.




South Africa: Outrage Grows At KZN's Misconduct Charge Against Doctor
(Cape Town)
12 February 2008Posted to the web 12 February 2008
Kerry Cullinan
SA HIV Clinicians Society and the SA Medical Council join voices in support of Dr Colin Pfaff, the rural doctor charged with misconduct for introducing 'dual therapy'
Outrage is growing in the medical fraternity about the KwaZulu-Natal health department's decision to pursue charges of misconduct against a Manguzi doctor for introducing "dual therapy" for pregnant HIV positive mothers.
The Southern African HIV Clinicians' Society (SAHCS) yesterday joined the Rural Doctors Association of SA in calling for charges against Dr Colin Pfaff to be dismissed.
Meanwhile, the SA Medical Association (SAMA), which represents three-quarters of the country's public health doctors, said it was "perturbed by the principles involved in the case".
Over 100 babies a month get infected with HIV by their mothers in the Mkhanyakude district where Manguzi Hospital is situated.
Pfaff raised money from donors to add another antiretroviral drug, AZT, to the hospital's nevirapine-only programme. This dual therapy has been recommended by the World Health Organisation as being far more effective treatment regime than the single dose nevirapine in preventing mother-to-child HIV transmission.
Yet 10 days ago, Pfaff was sent a letter from the Manguzi Hospital CEO asking him to respond to the charge that he "wilfully and unlawfully without prior permission of (his) superiors rolled out [prevention of mother-to-child HIV treatment] dual therapy to the pregnant mothers and newborns".
The matter was taken up by the AIDS Law Project on behalf of Pfaff, but hope that the department would drop charges faded last Friday when spokesperson Leon Mbangwa described Pfaff as having "contravened policy" as the department had neither the capacity nor the budget to implement dual therapy.
The Southern African HIV Clinicians' Society (SAHCS) said yesterday (Mon) that many of its members had expressed "outrage" at the disciplinary action and were "demoralised by unnecessary and ongoing attacks on the integrity of people who try to do their best for their patients.
Pfaff has worked in Manguzi, a hospital on the border with Mozambique, for 10 years. "Despite lip service to supporting these [rural] areas, reports from medical staff of continued departmental bureaucratic incompetence and obstruction continue to surface," said the SAHCS.
"The institution of disciplinary action against Dr Pfaff for providing better therapy than that advised by the department is symptomatic of the lack of initiative and crude politicking that still seems to plague our country's response to HIV."
Meanwhile, SAMA Chairperson Dr Kgosi Letlape said: "We can't comment on the specifics of the case because it is ongoing. But we find it very disturbing that a doctor who is doing his ethical duty and helping his patients to get better treatment is considered to be committing a crime by this government.
"At the last meeting of the SA National AIDS Council [held in November] we were given an assurance that any area that was ready to go ahead with dual therapy could do so and nothing would happen to them," added Letlape. "We are now wondering whether this assurance meant anything."
Pfaff has been advised not to comment on the case, and his lawyer is still waiting for the department to inform him of the exact charges being faced by his client.
The KwaZulu-Natal health department, said yesterday it had charged Pfaff with misconduct "after he allegedly acted beyond his authority in accepting a donation and implemented a Prevention of Mother-To-Child Transmission (PMTCT) dual therapy to pregnant mothers and newborn babies without prior permission of his superiors".
Condemning "certain opportunistic politicians" for using "this matter as a political pawn to score points", departmental spokesperson Leon Mbangwa claimed . "we will continue to put the interest of our people first, unlike these opportunists". - Health-e News Service.