By Wilmot James MP, Shadow Minister of Health:
Today, on behalf of the Democratic Alliance (DA), I laid charges, at the Humewood Police Station in Port Elizabeth, against Dr Phumza Dyantyi, the MEC for Health in the Eastern Cape Government.
I was accompanied by Celeste Barker, MPL, the DA Eastern Cape spokesperson for Health and Franay van der Linde, Health representative on the PE Metro Municipality.
The charges relate to violations of the Occupational Health and Safety Act (OHSA) 85 of 1993 as well as of the National Health Act at three of the department’s hospitals – Livingstone, Port Elizabeth Provincial and Uitenhage Provincial hospitals – for not segregating and storing medical waste according to best practice norms and standard operating procedures.
The Occupational Health and Safety Act requires an employer to create and maintain a working environment that is safe and without risk to the health of employees as far as is reasonably practicable.
The National Health Act requires that all health care risk waste should be stored in accordance with the provisions in the SA National Standard.
But, at Livingston, Port Elizabeth Provincial and Uitenhage Provincial hospitals, the improper segregation and below standard storage of medical waste poses a public health risk to employees.
At recent unannounced visits to the three hospitals, I identified first-hand the following deficiencies:
None of the hospitals had:
- a central storage area with an impermeable, hard standing floor with good drainage connected to a sewer;
- a water supply for cleaning and disinfecting purposes, as well as a hand basin, hand soap and a hand towel;
- proper and adequate personal protective equipment (gumboots, work uniform, elbow length gloves, mask and protective eye goggles; and
- a spill kit (a facility where contaminated liquids could be rendered harmless) and a fire extinguisher (PE Provincial had one outside).
- The storage area at Uitenhage Provincial was not locked or otherwise secured, nor was it adequate protected from the rain; and
- The storage area at PE Provincial was unlit with no passive ventilation, and an infectious waste (red) bag was seen in an unsecured area.
The Eastern Cape visit further indicates that medical waste management is a crisis plaguing major state hospitals nationwide. Last month, during an unannounced visit to the National Hospital in Bloemfontein in the Free State and interviews with industry insiders in the medical waste removal business, it emerged that, there too, best-practise norms are being violated. This was my similar experience on a visit to two hospitals in Gauteng at the weekend and three in the Kimberley area.
The hospitals visited have seemingly breached Section 38 of the Occupational Health and Safety Act, read together with Section 8 of the same act, in that they have, among other things, not provided and maintained ‘a working environment that is safe and without risk to the health of its employees’, as well as failed to take steps to eliminate or mitigate hazards in the workplace.
I have already written to Health Minister Aaron Motsoaledi to request a meeting with him to discuss the failure by hospitals to properly manage their medical waste in terms of the National Health Act and to ask him to explain how he will make hospitals nationwide compliant with the law when it comes to the management, “segregation” and disposal of medical waste.
The medical waste management is the sole responsibility of the department of Health.
The root of the problem is budget. None of the hospitals had a specially designed facility for dealing with medical waste (and indeed, Livingston and Uitenhage used temporary mobile containers utterly unsuitable for safe medical waste storage).
Legally compliant facilities funded out of a capital budget must be built at the three hospitals visited and all other hospitals that are not compliant and other deficiencies remedied as a matter of urgency. Improper medical waste storage is a ticking time bomb threatening public health and no government should tolerate it.
Photos and Captions below:
Caption: Improper segregation and below standard storage of medical waste which poses a public health risk at Livingstone hospital.
PE Provincial Hospital
Caption: A red bag indicating infectious waste in a general waste open area, either wrongly bagged i.e. General waste in an infectious waste bag or infectious waste in the right bag in an open area, in breach of regulations at PE Provincial hospital.