‘I’m the voice of 91%’

Doctors and nurses pushed to the limit, a health system and budget unable to cope with an influx of illegal foreigners and the Limpopo health MEC who insists she was right to dress down a patient in a hospital ward this week

Limpopo health MEC Phophi Ramathuba has flatly rejected calls for her to apologise or resign following a video in which she berated a Zimbabwean patient who had sought surgery at a public hospital.

Ramathuba told the Sunday Times that she would not say sorry for taking out her frustration about the influx of foreigners on the patient. And she defended her encounter as appropriate, saying she only berated her after she had received treatment.

She said calls for her axing came “from the middle class, who do not use public hospitals”, and that her views had the support of the majority of Limpopo citizens.

“As a leader you are leading a constituency and you must listen to that. The constituency I represent is suffering. I am the voice of the 91% of Limpopo citizens using public health care and if they say I must go, I will go. But I cannot be told by the less than 9% who know they are comfortable where to go.”

However health experts canvassed this week said there was a tendency to “scapegoat’’ foreigners and blame them for the failings of the SA health system.

Ramathuba, a qualified medical doctor and rising star in the ANC, said she would be steadfast in her mission to deal with “illegal migrants” from Zimbabwe who crossed the border to seek medical care in Limpopo.

“Zimbabwean nationals are abusing the system and collapsing medical health care in Limpopo.

“They cross the border illegally. They go from one clinic to another collecting medication and go sell it in their country. In the morning the person is called Maria, in the afternoon the same person in another clinic is Josephina, and later the same day the same person is Sophie,” said Ramathuba.

Asked if she believed that taking her frustration out on a patient was the right thing to do, she said: “From where I am sitting, that was the correct place to raise these issues because it is my workplace.

“How I spoke to that patient is how I speak. I am probably too old to change and we differ on how we express ourselves. We differ on how we show the pain we are going through. Other people may think I was harsh, [but] I do not think I was harsh. People who work with me can tell you, when I express myself with

compassion and love, that is how I talk.

“Maybe the people in the background [of the video] who were laughing were very wrong because I was not joking there, I meant business.

“I have never spoken to a patient before they are seen by a doctor, before they are operated on. But once an illegal immigrant is discharged and waiting to go home, I have a responsibility to say: ‘But you are illegal in the country and … with the budget we have you are not counted for and your president is not assisting.’”

Ramathuba said Zimbabweans had “gone too far” and had to be “stopped” because even those who used private health care in their country refused to pay when admitted in SA.

The Limpopo health department was owed R500m by patients, most of which was a result of illegal Zimbabweans, she said.

In the past two years, the department had treated 23,000 Zimbabweans who had been billed but could not be traced because they were undocumented, the MEC said.

She said that as recently as this week, a patient had been referred to a Limpopo hospital for a blood transfusion by a private health-care institution in Zimbabwe, which meant they could afford to pay. After the transfusion, the patient had claimed they could not afford to pay, she said.

“They are collapsing our system. In their own country they can pay but they come here and they do not want to pay.”

The MEC said the department had received one qualified audit opinion after another, because it could not explain how it spent money on foreigners who could not be accounted for.

“When I go and say I have treated Phophi Ramathuba [who] is unemployed and is on Sassa, I must show proof, but in this instance I cannot because this one is illegal.”

Ramathuba said she had done nothing wrong, and had merely implemented ANC policy, which she said her counterparts were scared to do, fearing a backlash.

In any event, she said, the Zimbabwe government had said illegal immigrants in SA were criminals and “must be treated as such”.

“When the system collapses, people will have nowhere to go, so we are also doing it for the Zimbabweans.”

Ramathuba said Messina Hospital in Musina near Beitbridge was “under siege” from Zimbabweans.

“You will find that some months, 60% [of patients] are Zimbabweans and 40% are South Africans. This is a small hospital which unfortunately is called ‘Messina International Hospital’ because of all the people from Zimbabwe.”

South African women were delivering babies on the floor while undocumented Zimbabweans occupied beds, Ramathuba said.

Just this month, 22 illegal immigrants without proper identity documents had died in Limpopo hospitals, and mortuaries were inundated with “unknown” bodies, she claimed.

“This department of health has become an undertaker for illegal immigrants.”

Ramathuba said she had raised the issue within ANC structures and that the ANC had adopted her stance as policy.

“Those who say this issue has never been discussed are lying. Go and read ANC policies and the NHI [National Health Insurance], these issues are there. We just do not want to grab the bull by the horn and implement our own resolutions.”

National health spokesperson Foster Mohale said the department was aware of the challenges experienced by some provinces, including Limpopo, in terms of access to health-care services by foreign nationals.

“These have been discussed at government-to-government [level] as part of bilateral meetings, and also multilateral meetings through Sadc [Southern African Development Community] forums.”

Mohale said the department was not investigating Ramathuba for her comments, adding that “the issues she raised were genuine and a long-term solution is needed to address them”.

He said Limpopo’s budget allocation was based on a number of factors, including the population.

“It would be unfair for local citizens to include foreign and undocumented nationals, especially those entering the country illegally, when allocating the budget.

“It is also important to note that health care is not free of charge beyond primary health-care level in SA. ”— Orrin Singh