769 20.08.2014 Nurse Hlophe, an 18 year old who gave birth two months ago to her baby girl¸ sits at her bedroom with her baby girl. Hlophe gave birth at her home as she went to labor at her home just after mid-night assisted by her mother, the ambulance then later came after four hours, her community just outside Amsterdam township, the community depend on the clinic for medical issues. The community battles to reach ambulances in time and they have wait hours before it arrives. Mpumalanga. Picture: Itumeleng English

Women in Mpumalanga are teaching themselves to deliver babies because there is such a dire shortage of ambulances, which take up to six hours to respond to calls.

The province’s Gert Sibande District, a pilot site for the National Health Insurance scheme, has only 38 ambulances to serve almost a million residents, according to documents in Health-e’s possession.

The district’s 149 000-person Msukaligwa Municipality centred on Ermelo has just three ambulances, while Albert Luthuli Local Municipality around Carolina has one hospital-based ambulance.

“People are either giving birth on the street (or) sometimes in bakkies,” said Patrick Mdletshe, a field researcher for the public interest law organisation Section27.

“Many people have died in these townships while waiting for the ambulance.”

When Nurse Hlope’s water broke two months ago, her mother called an ambulance to take her to Piet Retief Hospital 20km from her rural village of Wolvenkop. The family posted the father of Hlope’s baby at the roadside to guide the ambulance to the family home.

But the ambulance arrived six hours later, by which time Nurse’s mother, Elizabeth Maseko, had delivered the baby.

“I have taught myself to deliver babies because it’s not often that ambulances make it on time in this area and many babies have died,” said Maseko.

Hlope lost her first child due to illness two years ago.

When Mduduzi Khoza* suffered chest pains, he paid R200 to hire a car to take him to the local clinic in Amsterdam. There, he was told he would need to be rushed to Piet Retief Hospital.

When he realised that he was part of a queue of patients awaiting emergency transport to the hospital, he paid a friend R300 to take him via car.

He and other community members have written to the Department of Health to request that an ambulance be stationed at Amsterdam’s 24-hour clinic.

Christabel Mahlangu, from Mbalenhle outside Secunda, says that she often has not been able to reach anyone when she dials the local 10177 ambulance hotline.

“When you call the call centre, it just rings and (there’s) no response,” she alleges. “One minute you could be talking to the call centre agent and then they hang up on you.”

According the Department of Health’s latest annual report, 42 percent of posts at emergency communication centres are vacant.

Among ambulance and emergency response personnel, about 14 percent of posts are unfilled and some staff have neither the appropriate qualifications or professional driving licences.

Budget constraints have prevented staff appointments and the purchase of additional ambulances in the province. The Health Department has overspent massively and is currently under the administration of the provincial Department of Finance.

Thoko Madonko, of the civil society Budgetary Expenditure Monitoring Forum, says the Mpumalanga Department of Health is set to overspend its budget by R500 million and it has a R80 million overdraft.

Since 2011, the Treatment Action Campaign has written several letters to health officials at provincial and district levels to complain about the poor ambulance service.

“To this day, there is no plan coming out from the Mpumalanga Department of Health as to how they will solve the problem,” Mdletshe said. “It’s as if they don’t care about people’s lives.”

* Name changed upon request

Health-e News Service