Africa, Development & Aid, Headlines, Health, Poverty & SDGs

Q&A: Major Challenges Will Be Met

Stephanie Nieuwoudt interviews South African health minister BARBARA HOGAN

CAPE TOWN, Nov 12 2008 (IPS) - When Barbara Hogan replaced South African health minister Manto Tshabalala-Msimang in September, her appointment was praised from all quarters. Hogan, who previously chaired Parliament’s finance portfolio committee, is known as an intellectual who stands up for what she believes in and finding hands-on approaches to solving difficult political issues.

IPS: You have acknowledged HIV/Aids as one of the most pressing health problems on the continent. You also expressed concern about its nasty twin, tuberculosis (TB), an opportunistic infection to which HIV-positive persons are particularly vulnerable. How will you tackle this problem? Barbara Hogan: South Africa has always had a good TB management programme, but we are seeing an escalation of cases. Of particular concern is the emergence of multi-drug resistant tuberculosis strains. To address this problem, South Africa is working closely with the World Health Organisation and is forming partnerships with organisations in the private and public sector. The national TB Awareness Campaign is just one way of addressing the problem.

When we work towards combating TB, we invariably also work towards combating HIV.

If it wasn’t for the huge number of community health care workers in this country, including the people who do voluntary counselling, as well as other primary health care workers, we would not be able to make progress in fighting HIV/Aids or TB. They are doing exceptional work.

IPS: You stress the importance of health care workers, yet health professionals are leaving the country in droves, which has led, for example, to a nursing shortage of 46,000. How are you addressing this problem? BH: We have to stem the flow of people leaving the country, but at the same time we cannot expect professionals to work under the intolerable conditions that prevail at some of our health care institutions.

Government became aware that people in civil service are generally not well paid compared to the private sector and implemented the Occupational Specifics Dispensation Programme (OSDP) last year through which the salaries of civil service workers are being adjusted. There will be significant increases in nurses’ salaries. We have had teething problems, which are being addressed, but we are already seeing signs of nurses returning [from overseas].

One has to give professionals their due -– in the form of salaries and the way they are treated in the workplace. The level of professionalism and dedication with which they do their work is astonishing. Of course there are cases where health care professionals are lazy and are not doing their job well, but we will be taking steps against them.

Keep in mind that health care workers have for years been dealing with an [HIV] epidemic that has daily mortality figures comparable only to those seen in times of war. Like in war, young people are dying in greater numbers than old people. Some of the health care workers are simply heroic.

IPS: Critics say South African health education institutions are not up to par. Do you agree? BH: I cannot corroborate these statements. The standard of health care education in South Africa is internationally recognised – that is why people are able to migrate. I think the problem is often more a question of how professionals are managed in our system. They are sometimes distracted by management issues, which make it difficult for them to do their work.

The Hospital Revitalisation Plan [which aims to improve the quality of hospitals and equipment] is a very successful programme for upgrading and making the hospital environment a safe place. The challenge is to scale up all these initiatives [quickly and simultaneously].

Government has huge financial resources and the capabilities to make changes to the health care system. However, no matter how good government policies, optimum health care deliverance cannot happen without the assistance of communities in the form of civil society partnerships and cooperation with health care workers.

IPS: Good nutrition coupled with anti-retrovirals (ARVs) go a long way in fighting TB and HIV/Aids. You recently emphasised the importance of fortified food to address malnutrition in South Africa where poverty is rife. How do you plan to improve food security? BH: Malnutrition is one of the major health problems facing us. If we improve the nutrition of children and pregnant women and young mothers, we will go some way in addressing the Millennium Development Goals of reducing child mortality and increasing maternal health.

Especially at risk are young children and young HIV-positive mothers who are immuno-compromised. This country needs good nutrition to decrease the burden of HIV. Maize and bread are the most frequently consumed foods in the country. Government is already adding nutrients to these products as a way of delivering micronutrients to people who do not have an adequate diet.

IPS: Politicians and South Africans alike expect you to “cure” a health system that has been experiencing many problems. Do you feel overwhelmed? BH: I do feel the pressure of high expectations. But being in parliament gives you the benefit of oversight. As a Member of Parliament, I was fully aware of the issues and problems in the health care sector. However, that does not mean that there are not major challenges to be met.

Although there are great [health] policies in place, all efforts and projects have to be scaled up. We are lucky in this country that we have dedicated professionals who do great work. I can do nothing on my own. But together we can make a difference to the lives of millions of people.