
Cancer treatment interrupted for hundreds after Eastern Cape health department fails to pay medication bills
Desperate doctors have been forced to make decisions about who receives chemotherapy and who does not, with some oncology units left with only a single vial of the potentially life-saving treatment.
The cancer treatment of hundreds of patients, including children, has been interrupted after the Eastern Cape Department of Health failed to pay suppliers for chemotherapy drugs.
The province's MEC for Health, Ntandokazi Capa, has promised that outstanding bills will be paid immediately, but patients have already been turned away and treatments halted.
Desperate doctors have been forced to make decisions about who receives chemotherapy and who does not, with some oncology units left with only a single vial of the potentially life-saving treatment.
Medical staff said that as their urgent emails went unanswered, they spent the whole of Sunday frantically trying to borrow, exchange or buy chemotherapy medication from private pharmacists to avoid interrupting treatment for hundreds of patients.
The South African Human Rights Commission (SAHRC) has launched an investigation into the repeated interruptions of cancer treatment for public healthcare patients in the Eastern Cape due to unpaid accounts.
Dr Eileen Carter from the SAHRC said the Democratic Alliance (DA) had laid a complaint with them about the matter.
'We have opened an investigation into the allegations received. It will now be undertaken as per our complaints handling processes,' she said.
'This is no longer a cash flow problem. It is a gross violation of human rights,' said the DA's spokesperson for health in the province, Jane Cowley.
'This ongoing crisis is not only jeopardising the physical health of cancer patients but is also taking a severe toll on their emotional and mental wellbeing.
'How does one explain to the mother of a 14-year-old boy that his treatment cannot continue because the department's non-payment has led the supplier to close their account? How does a doctor respond to a heartfelt letter from a 33-year-old woman, diagnosed with a curable form of Hodgkin lymphoma, who is begging for treatment so she can raise her three-year-old child?
Impossible choices
'These are the impossible choices our healthcare workers are forced to face daily. Meanwhile, senior officials sit comfortably in air-conditioned offices, use state-owned vehicles for private errands and continue to protect a bloated payroll of politically connected individuals in non-essential posts,' said Cowley.
The Eastern Cape health department spokesperson, Sizwe Kupelo, acknowledged systemic problems in the public health sector, including the lack of permanent CEOs at Livingstone and Port Elizabeth Provincial hospitals in Gqeberha.
'But we are busy conducting interviews now,' he said.
The hospitals last had permanent CEOs in 2018, when unions ran the management teams out of the facilities.
Kupelo said MEC Capa had stepped in to ensure that R200-million was set aside for specialist medicines, including cancer treatment.
'The department wishes to confirm allocation of R200-million for the procurement of essential specialist medicines, including for cancer treatment. R43-million of this allocation will be utilised in paying pharmaceutical companies for cancer medicines that were owed from the last financial year. This payment is expected to be effected this week.
'Availability of all categories of essential medicines in all our health facilities is a priority, and every year, the department budgets over R2-billion for this purpose. We have strengthened our distribution plan, and our main medicine depots are strategically positioned to supply the entire province. These are the PE medical depot in Gqeberha and Mthatha medical depot in the OR Tambo district,' said Kupelo.
He said cancer patients were receiving their treatment even though alternative medication had to be administered in some cases.
'This week, the department is expecting additional stock from Adcock Health, Fresenius (Kabi), Kiara and Macleods,' he added.
He said two chief directors had been assigned to Gqeberha to accelerate service delivery at Livingstone and Dora Nginza hospitals.
'The MEC gave a clear message to her management. She was there. She received the problems. She has given them until the end of the month to implement the decisions they have taken.
'You don't want to run away from a big elephant,' he said. 'Hospital management knows that the lack of a district hospital makes things difficult in the metro, as specialist hospitals must act as a district hospital.'
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The Citizen
2 days ago
- The Citizen
Staff shortage leaves 122 ambulances unused
Only 72 out of 194 Mpumalanga ambulances are operational as the province faces a dire emergency personnel shortage crisis. The Mpumalanga department of health has come under fire for not using 122 ambulances due to a shortage of staff. The unions and political parties have slammed the department after the portfolio committee on health recently revealed the department has 194 ambulances, but only 72 are in service. Flip van der Walt, provincial leader of the Public Servants Association of South Africa, slated health MEC Sasekani Manzini. Only 72 ambulances in service 'The officials seem unable to manage the department in line with the Public Finance Management Act,' said Van der Walt. 'Why do you procure 194 ambulances while you know that you only have 72 possible drivers? We all know when vehicles are not operational and standing, it is then that vehicles get damaged.' According to the emergency medical norms and standards, there must be one ambulance per 10 000 people, which means that ideally, Mpumalanga should have at least 480 fully operational ambulances. ALSO READ: Thief who stole ambulance with patient inside granted bail 'At 72 ambulances for a population of five million, it means Mpumalanga has one ambulance for 69 000 people,' said Bosman Grobler, DA spokesperson on health in the Mpumalanga. 'This cannot be acceptable and it is against the emergency medical norms and standards. It is concerning that the shortage and late arrival of ambulances when summoned has become a normality,' said Grobler. 'This is especially true when taking into consideration that the South African national norms and standards recommend EMS [Emergency Medical Services] response time of 15 minutes in urban areas and 40 minutes for rural areas.' Prioritise employing more EMS He urged Manzini to rather prioritise employing more EMS personnel to operate the 122 ambulances standing idle, instead of relaunching the 2021-22 Impilo citizen engagement platform application. He said the app, which has 'failed dismally', was procured in 2021-22 with Vodacom on a twoyear contract worth R33.4 million. 'It was initially aimed at helping the department address the effective management of their EMS resources in terms of call taking and call dispatching,' said Grobler. ALSO READ: Department of Health confirms 24 ambulances allegedly sabotaged by staff 'The app was also meant to help communities register their concerns and complaints experienced during emergencies. 'But the department abandoned the app in 2023 when the contract with Vodacom lapsed – partly because they realised the majority of residents who rely on public health did not have access to the app as it required a smartphone and data to even access it.' He said they were concerned that the department was on the verge of relaunching the app in September at a cost of R750 000, a monthly operational cost of between R50 000 and R100 000. Concern about app relaunch He added the DA would engage Manzini to propose she consider employing more EMS personnel to operate ambulances, instead of spending millions more on an app that did not serve its purpose in the past. Democratic Nursing Organisation of South Africa (Denosa) provincial secretary Cyril Mdluli has also expressed concern. 'We are concerned about the severe and chronic shortage that the department has on EMS personnel, especially since this shortage on EMS relates directly to nursing,' said Mdluli. ALSO READ: EC hijacking horror: Ambulance transporting eight-year-old patient hijacked 'This shortage has resulted in many incidents where patients will wait for long at primary health care after being referred to hospital for further management, which might result in some complications.' He also called on the department to employ more EMS personnel not only with basic qualifications, but also with advanced qualifications that can be able to manage patients' conditions inside ambulances. 'As Denosa we have advised our members to stop escorting patients as their work is in the clinic or hospital and not in an ambulance,' he said. Dept must speed up EMS college Mdluli said the department must speed up an EMS college in the province that will accommodate the current staff members to upskill them on advanced courses as per the Skills Development Act. He said the province currently has few of them and the majority of personnel have basic life support. Mpumalanga department of health spokesperson Dumisani Malamule had not responded to questions by the time of publication. In a recent article by IOL, South African Emergency Personnel's Union president Mpho Mpogeng said Mpumalanga is one of the provinces facing a huge shortage of ambulances. ALSO READ: Ambulance stoning incident condemned Meanwhile, it is also alleged that in Limpopo there is a shortage of qualified ambulance crew, but health department spokesperson Neil Shikwana dismissed the claim. Health Minister Dr Aaron Motsoaledi conceded in parliament that there was a shortage of ambulance personnel. He said the government was addressing the matter.


Daily Maverick
4 days ago
- Daily Maverick
When we think about hunger we don't think about peace — here's why we should
Hunger isn't just about food. It's about power. It's about who gets to eat, who decides and who is heard. If we're serious about justice, then no one should be hungry. In South Africa, hunger is not just about empty stomachs, but also about unequal systems. It exists in crèches that exclude children whose parents can't pay fees, in homes where grant applications fail quietly, and in the lives of people with disabilities navigating systems that overlook their most basic needs. The student who is excluded from funding because they are considered too poor to afford university, yet not poor enough to qualify for state assistance, caught in the gap of eligibility. The woman who sits at the traffic lights with her child asking for small change or food. The problem is not that the country does not produce enough food, the problem is about who eats and who does not. Hunger is not just about food, it is about power, it is about peace, and it is deeply gendered. Women, especially Black women, carry the heaviest load in South Africa's food crisis. They cook, stretch budgets, sell in the informal economy and absorb the emotional violence of food insecurity. They go hungry so children can eat. And when food runs out, so does safety. As we've seen time and again, from the Covid lockdowns to the July KwaZulu-Natal unrest, scarcity breeds violence and is expressed against Black bodies. Despite producing enough food to feed everyone, South Africa has more than 63.5% of households facing food insecurity. We live in a country with one of the world's most progressive constitutions, in which section 27 guarantees the right to food and water. Yet every day millions go hungry. And too often we forget who exactly is being left behind. Hunger is a multidimensional crisis that undermines health through malnutrition, poor disease resistance and skipped medication. It fractures social cohesion, creating stigma, shame and desperation, worsening economic outcomes, especially for women and young people already at the margins. Women in informal settlements skip antiretrovirals because they can't take them on an empty stomach. The missing population that is not reported on include those not in employment, education or training, outside of the Not in Education, Employment or Training (Neets) active or inactive. There are people who are not in employment who are not receiving social grants and are not in the youth category, including children who are not in early childhood development, and are left without resources to access food. Despite policy interventions such as school feeding schemes, social grants and the 2023 SAHRC-led right-to-food study commissioned by the Department of Agriculture, significant structural gaps remain. Many interventions are not reaching those outside formal systems – such as children excluded from early childhood development programmes or people with disabilities navigating inaccessible services. These omissions reveal a deeper issue: our food security mechanisms are not designed with the most marginalised in mind, reinforcing cycles of invisibility and exclusion. This is not just a failure of delivery. It is a failure of vision. If we think of hunger only as a developmental or nutritional issue, we miss its full impact. Hunger is relational. It creates shame, fuels desperation and destabilises communities. We need to stop treating hunger like an economic inconvenience and start addressing it as a political and peace issue, one that is deeply gendered. The Centre for Social Justice, under the leadership of Professor Thuli Madonsela, has reframed hunger as a constitutional crisis. In the recent expert symposium I attended on 10 April in Pniel discussions rightly rooted the right to food in section 27 of the Constitution, making the case for structural change that is systems-based and a rights-driven approach to food insecurity. The research on Gendered Dimensions of Hunger and Peacebuilding by the Centre for the Study of Violence and Reconciliation and University College Dublin drives the conversation further, urging for a widened lens where food security is a catalyst for peace. Because hunger, when it intersects with gender, exclusion and poverty, becomes something even more dangerous – a disruptor of peace. A participant in the ongoing research said that in one of the dialogues they conducted a man asked: 'How do you expect me and my people to engage on peace when we are hungry?' Let's be clear: we have the policy tools, we have the research and we have the constitutional mandate. What's needed now is a shift in mindset from hunger as a welfare issue to hunger as a peace and justice imperative. When hunger intersects with gender inequality, disability and exclusion, it fuels gender-based violence, erodes trust in the state and drives protests, looting and resentment. As the UN Security Council warned in 2025, hunger isn't just a consequence of conflict. It's a cause. We must act like it. That means embedding gender, peace and inclusion into every food policy. It means tracking how hunger affects social cohesion, how it exacerbates violence, how it chips away at democratic trust. It means giving voice and space to those most affected not after the fact, but as architects of the solutions. If we are serious about building a future rooted in justice and peace, then we must start treating hunger as both a political emergency and a moral failure. This means going beyond food parcels and short-term aid. We need women-led food and peace councils that place care, equity and lived experience at the heart of decision-making. We need disability-sensitive food access tools that acknowledge the everyday barriers disabled people face in reaching nourishment. And above all, we must ensure that no child goes invisible simply because their stomach is empty outside of school hours. Hunger is not just a symptom it is a warning signal. And ignoring it now means paying the price in conflict, unrest and fractured futures. Hunger isn't just about food. It's about power. It's about who gets to eat, who decides and who is heard. If we're serious about justice, then no one should be hungry – not a mother, not a child, not a person navigating hunger with a disability. Because food justice is peace work. Because peace doesn't start in Parliament – a place where conflict should be dealt with – it starts in homes where children eat, with women who aren't forced to trade their bodies for bread, and with the ability of persons with disabilities to access food without stigma. Where food security is not a charity but a human right. So, what would it look like to build a hunger strategy rooted in gender justice and peace? We are at a turning point. With the National Food and Nutrition Security Plan (2024-29) in development, and a government of national unity on the table, the political moment is ripe. But the question remains: will we continue with business-as-usual? Or will we reimagine hunger as the crisis of dignity, justice and peace that it is? As one working at the intersection of gender, hunger, and peace, I say this: until hunger is addressed as a breach of peace and women are recognised as leaders in healing it, our democratic promises remain half-written. We don't often think of food when we talk about peace. But we must – because in every empty stomach lies a silent protest against injustice. If we want peace to flourish, it must begin with food security, dignified women and inclusive food systems. DM Naledi Joyi is a gender programme officer at the Centre for the Study of Violence and Reconciliation. Her work focuses on the intersections of gender-based violence, food systems and structural inequality. She has conducted research across rural and urban South Africa and post-conflict Liberia, exploring how violence is embedded in institutions, economies and everyday survival.


Mail & Guardian
4 days ago
- Mail & Guardian
From Jan Smuts to Gareth Prince: The struggle for the liberation of cannabis continues
The South African Human Rights Commission's discussions with the Rastafari and cannabis communities raised its concerns about stories of systematic and personal violations. Photo: Delwyn Verasamy As Africa Month ends, the South African Human Rights Commission (SAHRC) wishes to draw attention to a key struggle for African self-determination, remembering and 're-membering'. That struggle is the struggle for the full liberation of cannabis. Cannabis is a plant which has been used by indigenous South African people in medicinal and spiritual practices for centuries. The struggle for the right to grow, trade and use cannabis can thus be seen as a decolonial one — to reclaim and re-legitimise indigenous knowledge systems, African religion, spirituality and self-determination. The struggle has continued throughout South Africa's democratic dispensation. On 7 March 2025, the minister of health gazetted a new regulation banning cannabis and hemp foodstuffs under the Foodstuffs, Cosmetics and Disinfectants Act 54 of 1972. After widespread contestation and backlash over the constitutionality of the regulations, the minister withdrew them three weeks later. These regulations came unexpectedly, while the Rastafari and cannabis communities were waiting for the draft regulations, which would bring into effect the Cannabis for Private Purposes Act 7 of 2024, from the justice department. The regulation by the minister came exactly a 100 years after cannabis was classified as a controlled drug in 1925 at the Geneva Opium Convention. The classification resulted from a proposal by colonial regimes, including South Africa. Prime minister Jan Smuts was a leading sponsor at the League of Nations, placing cannabis in the same category as cocaine. Cannabis communities thus considered the withdrawn regulations as continued disenfranchisement and suppression of cannabis communities. Less than two weeks prior to the gazetting of the regulation, on 26 February 2025, the SAHRC convened a meeting with other chapter 9 institutions, government departments, civil society and members of the Rastafari community from all nine provinces — the Rights of the Rastafari Roundtable. The Rastafari National Council was also represented. This provided a space for the Rastafari and other cannabis communities to engage in dialogue, to be heard, to affirm their dignity and to find solutions to the structural challenges they experience. The roundtable was precipitated by the SAHRC's discussions with the Rastafari community throughout 2024 where it was troubled by the stories of the systematic and personal violations experienced by this community. Through these sessions emerged accounts of discrimination, criminalisation and persecution — not only because of their cultivation and use of cannabis but because of the general lack of recognition for Rastafari as a community deserving of respect, protection and equal standing in society. The experience of advocate Gareth Prince is one of the better-known examples of the Rastafari struggle. In 1998, the Cape Law Society refused Prince's application to be admitted as an attorney because of his criminal record for possessing cannabis, thereby stripping him of his right to work and earn a livelihood from his profession. Prince is still unemployed and believes members of the Rastafari community are treated as 'third-class citizens' in South Africa. Prince's experience is a reality for almost all Rastafari. At community discussions and the roundtable, Rastafari parents informed the SAHRC of the humiliation at being searched by police officers in front of their children. They believe that their visible Rastafari appearance renders them easy targets for police officials, which amounts to racial and cultural profiling. They endure marital discord when they disagree with their partners on the decision to cut their children's dreadlocks, so that they can be accepted in certain schools, and due to the overt and subtle discrimination against and bullying of Rastafari children. They shared stories of living under precarious employment conditions as they endure regular drug testing by employers because of their visible Rastafari identity and appearance. They suffer unlawful searches of their homes, expulsion from schools, medical neglect at health facilities and social stigmatisation. One Rastafari delegate at the roundtable asked the government stakeholders represented: '… To what extent have your institutions decolonised and transformed? Because, from where I'm sitting, and from your presentations, you are part and parcel of the colonial legacy … because the laws that you are implementing are not the laws that represent us.' They wondered why other religious communities' marriage ceremonies were recognised by the state, but theirs were not. They wondered why their religion, with its African origins, was frowned upon by fellow Africans in an African state. They conveyed their sense of voicelessness in South Africa's democratic culture because they choose not to engage in protest action. They felt 'unseen' and 'unhuman' and carried a heavy sense of non-belonging — pariahs, even under the new dispensation. The unfair discrimination against the Rastafari community and their social position as a marginalised group has largely been left out of the popular discourse about equality and transformation in South Africa's body politic. And yet, the Rastafari community continues to experience some of the worst violations of constitutional rights, including their rights to equality, religion, culture, dignity, health and education. The gazetting of the foodstuffs regulations is an example of the exclusion of the Rastafari from the democratic processes of decision-making in matters that affect them, and is a continuation of paternalistic colonial and apartheid attitudes to this community, and the cannabis plant. Despite a 2018 constitutional court judgment which decriminalised private cannabis use by adults, as well as and the signing into law of the Cannabis for Private Purposes Act 7 of 2024, the Rastafari continue to be arrested for cannabis-related crimes. Police officials conduct these arrests in violation of an August 2023 South African Police Service directive pausing cannabis-related arrests, issued by the national commissioner of police. The Cannabis Act only allows for arrests for dealing in cannabis, where there are reasonable grounds to suspect dealing. Yet, the complaints received by the SAHRC from the Rastafari community suggest that most arrests are still for private possession and use. Because of a lack of regulations from the justice department, which would specify quantities, the definition of 'dealing' has been left to the discretion of individual police officials. Because of the continuing structural and systemic human rights violations which have left the Rastafari community unrecognised, vulnerable, marginalised and criminalised, the office of commissioner Tshepo Madlingozi, at the SAHRC's head office, has designated the Rastafari as one of its two priority communities. The office aims to continue being a partner to the Rastafari and other cannabis communities, to help them regain their human rights. To bring the Rastafari, and other cannabis communities, into the fold of South African society, the state should be more proactive in recognising them as a legitimate community that requires similar protections and measures of redress to other previously disadvantaged and marginalised communities. This includes ceasing all cannabis-related arrests, prohibiting discrimination against children with dreadlocks in private and public schools and expunging all criminal records for persons who have been convicted of cannabis-related crimes. It is imperative that the justice department urgently develops clear and precise regulations on the use and possession of cannabis, including quantities, to guide both cannabis users and the criminal justice cluster. While having been at the forefront of the fight for the decriminalisation of cannabis, members of the Rastafari community feel excluded from the recent rapid commercialisation of the plant. They report that the licensing process is too bureaucratic and expensive, creating artificial barriers to their participation in the formal cannabis economy. In the meantime, 'cannabis shops' are mushrooming in many urban centres, despite their existence in a legal grey area. These and other concerns will be taken forward by the SAHRC in partnership with the Rastafari community and other stakeholders. One such initiative was held on 13 March where SAHRC commissioners Sandra Selokela Makoasha and Philile Ntuli hosted a roundtable specifically for Rastafari women, to provide a safe space for expression and discussion of their specific experiences as a result of their multi-fold identity and intersecting social position as Rastafari, women, wives, mothers, caregivers, workers and cannabis producers and traders. But all interventions such as these, by state and non-state actors, will be rendered ineffective as long as the broader South African society continues to stigmatise and discriminate against the Rastafari. From Jan Smuts to Gareth Prince, the struggle against state overreach and for the valorisation of indigenous cultures and practices continues. Tshepo Madlingozi is a commissioner responsible for anti-racism, education and equality at the South African Human Rights Commission and Naleli Morojele is a research adviser at the commission.