HEALTH CRISIS: Tensions at Zithulele Hospital boil over as Eastern Cape community protests against loss of doctor

A decision to remove Dr Nick Fine, a family medicine specialist, from one of South Africa’s iconic rural hospitals and send him to a large academic hospital in Mthatha has led to a debilitating strike that caused the shutdown of the hospital and the evacuation of patients to other facilities.

It has been two years since Zithulele Hospital, which became known as a well-functioning rural hospital under the leadership of Dr Karl le Roux, now a DA member of parliament, and Dr Ben Gaunt, was plunged into dysfunction after the appointment of new CEO Nolubabalo Fatyela.

Read more: Zithulele Hospital: A rural success story crippled by the letter of the law

After a stressful weekend when patients had to be evacuated to nearby hospitals as Zithulele faced a total shutdown, the Eastern Cape Department of Health obtained a court order to force staff to return to work.

As protests had shut down the hospital, patients were sent to Madwaleni, St Barnabas and St Lucy’s hospitals. 

The community has been advised to seek medical assistance from nearby hospitals such as Madwaleni and Mthatha Regional hospitals.

The protest was followed on Tuesday by the suspension of seven staff members, some of whom had been on leave at the time of the strike.

Le Roux said they had started engaging with the Eastern Cape Health Department, raising their concerns that the CEO, who was appointed in 2023, was not a good fit for the hospital.

‘Willing to listen’

Mkhululi Ndamase, the spokesperson for Health MEC Ntadokazi Capa, confirmed that “some employees” had been served with suspension letters. It is understood that there are seven of them. 

“This is part of the internal disciplinary process that the department has embarked on following the unprotected strike that compromised health and care services. 

“It is important to note that health is an essential service. When we intend to charge employees, it’s when our regulations are not adhered to. We can also confirm there is no war as workers returned to work today,” Ndamase said.

But community sources say they fear there will be an exodus of clinical staff from the hospital following the high-handed treatment of Fine and staff and community members are fighting for him to stay.

The suspensions came hours after Ndamase said the department was “willing to listen” to the grievances of Zithulele staff members.

“The department has been granted an interim order by the Mthatha High Court regarding the unprotected strike action at Zithulele Hospital. The department approached the court to ensure that there’s service continuity at Zithulele as we cannot afford to have services disrupted. Health is, after all, an essential service.

“The interim order, which was granted on Sunday, has interdicted protesters from continuing with their protest, from intimidating employees and patients at Zithulele Hospital or causing, influencing, coercing anyone to participate in the protest and to vacate hospital premises. The court order states that there cannot be any protests within 100 meters of the Zithulele Hospital gate or fences.

“They have also been prohibited from using the department’s letterhead in any form of their communication pertaining to the protest,” Ndamase said.

He said that senior managers were meeting with organised labour, the hospital board, and district and Zithulele management in a bid to resolve the ongoing protests.

Unresolved issues

This is the second time that the hospital CEO has tried to move Fine back to the Nelson Mandela Academic Hospital in Mthatha.

In May, Fine was instructed to move back by 1 June. But community sources confirmed that at a meeting held on 28 May, staff members at the hospital were fully in support of keeping Fine there. They also confirmed that there was mounting antagonism towards Fatyela.

Read more: More uproar at Zithulele Hospital as senior doctor is moved

At the time, hospital staff members also went on strike, asking that Fatyela be removed from the hospital grounds.

The team from the district office promised that they would come back to the community with answers, but agreed that Fine could remain. But while they set a date for 12 June to provide answers, this never happened. At the end of July, Fine was again instructed to leave Zithulele and report to the Nelson Mandela Academic Hospital in Mthatha.

According to papers before court, some of the allegations that the department had agreed to investigate was that Fatyela had “caused havoc, chaos, unrest, and destabilisation” in the community and with employees. The community and staff members also asked that she be investigated for “vocal racism” against white doctors.

Read more: Acclaimed Zithulele sadly in danger of losing what made it great while patients are the biggest losers

Ndamase said they could confirm that provincial senior managers were in Mthatha on Monday and met organised labour, the hospital board, and district and Zithulele management in a bid to resolve the ongoing protests. 

“Resolutions of the meeting will be shared in due course,” he said.

“The department will continue with internal disciplinary processes against employees who participated in the illegal protest which compromised health and care services at Zithulele,” Ndamase said.

“We encourage our workers to use appropriate platforms to escalate their concerns. We are willing to listen and engage so that we can resolve issues in their infancy.”

Earlier this year, Siyanda Manana, the department’s director of communications, said they were paying for Fatyela, who was appointed in 2023, to be accommodated in a hotel in Mthatha “for security reasons”.

“According to the policy, when you are newly employed, the department pays for your accommodation for three months,” he said at the time.

“However, doctors employed in primary healthcare, especially community services health professionals, are accommodated by the department for up to a year,” he said. DM