On the 15th of August 2017, the Rural Health Advocacy Project in partnership with the Canzibe Hospital Board held a Community Dialogue/Imbizo at the Canzibe Community Hall. Partner organisations that were present were TAC, One2One Enable Mothers, The Jabulani Foundation and RuDASA. The imbizo was attended by over 150 community members from Canzibe village and the surrounding villages and the chiefs and the indunas (traditional leaders) of the villages were also present.
The main agenda of the day was to engage, learn and understand the communities’ experience with the health system in Nyandeni Sub-District. The community members took the opportunity to voice their views, experiences and any challenges through the 5 Commissions. Challenges and proposed solutions are stated in the REPORT ON THE NYANDENI COMMUNITY HEALTH IMBIZO Aug 2017 and copied below:
ACCESS TO HEALTH CARE FOR VULNERABLE POPULATION
- No access to treatment for vulnerable population.
- Discrimination and ill-treatment of the vulnerable by the health care professionals.
- The waiting times in the hospitals are too long.
- The hospital structure is not designed for disabled people.
- The distance to the health facilities are too far.
- Financial implications on the vulnerable trying to access treatment.
- Lack of hospital transport such as ambulances, patient-transport and emergency medical transport.
- Lack of specialising doctors who can assist the disabled.
- Poor road structure that leads to the hospital.
- Clinics are closing too early and its disadvantaging the community.
- Disabled people should be able to access treatment in nearby clinics and also mobile clinics should be made available to them.
- Physiotherapist and other rehabilitation professionals are needed at the hospital.
- More ambulances and patient-transport should be made available even to other villages that are quite far from the hospital.
- The clinics and hospitals should be made friendly to disabled people for example there is a need for a well-structured wheel-ramp at the hospitals and clinics.
- There should be adequate representation of different vulnerable groups.
- Complaint and suggestion boxes need to be well managed.
- The road that leads to Canzibe hospital should be fixed.
- Clinics should extend their operating hours and 3 central clinics should be opened over the weekends to assist the hospital.
HUMAN RESOURCES FOR HEALTH CRISIS
- There are insufficient medical doctors at the hospital.
- Staff shortages are a major hurdle to accessing health.
- Nurses are scarce especially the ones working night shifts.
- EMS staff shortages therefore patients are suffering.
- Not enough pharmacists’ personnel which means that patients don’t get their drugs on time.
- The work environment does not attract doctors to come and work in the area.
- Local university does not offer a range of programmes offering health care training.
- Redefine rural allowance and create incentives for health professionals to come and work in the rural areas.
- Government needs to take initiative in measuring community health needs regularly.
- The hospital board need to regularly report on staffing and other related HR issues.
- The local youth members need to be integrated into the board accounting structures.
- The hospital board should conduct quarterly meetings with the community.
- Education and formal skills training should be offered to the youth in relation to health work.
MONITORING AND EVALUATION AND REPORTING OF THE CRISIS IN THE HEALTH SYSTEM
- Some health care professionals including the nurses are rude and they don’t explain the important information to patients.
- No adequate knowledge on how we can report some issues.
- Suggestion boxes are usually not managed properly and there are never evaluated.
- Less people in the rural community are knowledgeable about the monitoring and evaluation process.
- Report to the manager and move along the ladder if nothing is being done.
- Community meetings (Imbizo) should be held regularly so that the community can be informed about what is happening at that hospital.
- Patients should report on any bad treatment that they receive from the health workers.
EMERGENCY MEDICAL SERVICES
- The ambulance service is very bad.
- There is only one ambulance that covers 16 wards and also takes patients to the Nelson Mandela Academic Hospital.
- The ambulances are not designated for the poor local roads and therefore the ambulances do not go into some villages.
- Few people know the EMS call centre number and most of the time there is no one to pick.
- Sometimes there are no drivers for the ambulance.
- The ambulance if it happens to come takes a long time and inconveniences the patient.
- The road needs to be fixed.
- At least 5 ambulances at Canzibe Hospital that caters for all 16 wards.
- A helicopter ambulance for the remote villages with bad roads.
- There should be more ambulance drivers.
- The EMS call centre number should be made available to everyone.
- There should be a partnership between the local taxi association and the hospital so that local transport owners can also help out in terms of emergencies.
BUDGETING FOR RURAL HEALTH
- The local community members do not have enough knowledge about the budget of the hospital and clinics.
- The board of the hospital does not engage the community on how the budget is allocated.
- No sufficient information on the NHI and how it works.
- Constant meetings between the hospital and the people on how the budget is being used are needed.
- There needs to be transparency from the hospital board.
- The community needs to be educated more about health issues and NHI.
- The summary of the report will be submitted to the Canzibe Hospital Management.
- A task team of local representatives, local leaders, and civil society organisations need to follow up on how the issues raised will be attended.
- A follow up Imbizo with the Department of Health stakeholders and accounting officers will be organized to discuss these issues with the community with the purpose to respond to communities’ concerns and to provide guidance on the implementation plan.