In Mzansi, healthcare workers are on the frontlines, not only battling illness but also facing the terrifying risk of violence. The very people who heal and save lives are themselves in constant danger of crime, from armed robberies to assaults and sometimes even death. Following up on our article on the impact of crime on our health workers, Health For Mzansi journalist Vateka Halile spoke to human rights activists who weigh in on the issue and what is needed to protect our health heroes.
‘Victims stay silent’
“It’s sad that people don’t feel safe in their workplaces, especially within government premises,” says Nobathembu Peter, a social activist from Khayelitsha in Cape Town.
“I’ve heard many stories of people being shot or robbed while in hospitals or clinics.”
She questions whether South Africans will continue to watch as crime takes over our spaces and live in fear, or if we will start to speak out against it. She also notes that victims of these crimes often remain silent due to fear for their lives or job security, reflecting how deep the situation is.
Shocking statistics
To shed light on the extent of violence faced by healthcare workers in South Africa, the South African Medical Association (SAMA) commissioned a scoping review in 2022. The study analysed incidents targeting nurses, doctors, and paramedics between 2012 and 2022.
“Evidence reveals a worsening trend of violence targeting healthcare workers over the past decades,” the report states.
Some of the findings include:
- Of the 45 electronic media reports examined by SAMA, 20 were medical doctors, 18 were paramedics, and 7 were nurses.
- Most attacks happened in Gauteng.
- For paramedics, the Western Cape had the most cases of violence. Most attacks occurred while the crew attended to an emergency or accident scene.
- More females were attacked.
- Most violence occurred in state facilities at sites such as wards, staff quarters, and parking lots.
- Of the four attacks in the private sector, three took place in doctors’ surgeries.
- Perpetrators of attacks on paramedics were all strangers, attackers of doctors and nurses were mainly strangers, followed by patients and patients’ relatives.
- Of all the 45 reports, only 17 arrests (38%) were reported, with only 2 resulting in successful prosecution.
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Communities must help
Zonwabele Tshayana, a social and human rights activist from Centurion, Gauteng says, “Lack of ownership in our government institutions remains a major challenge.”
He explains that communities don’t feel a sense of ownership over their clinics, schools, libraries, and other government facilities.
“To them, these are just government buildings. If something happens, the government will replace them, ‘make a plan’ or just deal with it.”
Zonwabele Tshayana
To address this lack of civic engagement, Tshayana suggests establishing clinic committees and other social structures to ensure proper governance of these institutions.
“These committees need to ensure the safety and security of both patients and staff.”
Tshayana adds that a well-structured healthcare facility demonstrates its commitment to security by thoroughly checking everyone entering and exiting, including staff, patients, vehicles, and visitors. This level of security shows that the facility is being properly managed.
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Improving healthcare services
Thenjiwe Ngcobo, the founder of Incema NPO based in Pietermaritzburg, KwaZulu-Natal, says there is a critical need for facilities to offer comprehensive care services that address both the physical and emotional well-being of patients and workers.
“A multidisciplinary care service is what the community needs to prevent them from being referred from pillar to post,” she explains.
Ngcobo explains that when there is a lack of resources or endless needs, frustration rises among both staff and patients, creating uncertainty and unsafety between the community and the staff.
“The hospital wards with 60 beds and five nurses don’t serve the purpose. A clinic that serves the community and sees approximately 200 outpatients a day with five nurses and no medication does not serve the purpose.”
Thenjiwe Ngcobo
Ngcobo emphasises that community leadership must be involved to ensure the safety of their people while working closely with the government.
Work together to safeguard facilities
Foster Mohale, the spokesperson for the national health department, says the health department works with stakeholders such as community-based structures, traditional leaders, community policing forums, South African Police Services, and councillors to ensure the safety of healthcare institutions.
“The safety of the healthcare workers, clients, and customers in our health family remains our priority, hence we have security forces in the health facilities.”
He explains that the department believes it is their collective responsibility to make clinics and hospitals safer for health workers and patients to receive quality healthcare.
“We acknowledge some of the challenges experienced in some facilities. The level of crime in one area determines our security efforts, as you know hospitals are categorised as high crime zones due to the nature of the service they offer. Hence, in some facilities, we have armed security personnel with guns.”
Health department spokesperson Foster Mohale
Mohale adds, “We are working with provinces to strengthen our security systems to install CCTV cameras in health facilities, of course, priority is facilities located in high-crime zones.”
To ensure that all clinics, hospitals, and other health facilities are safe, Mohale notes that it will require all stakeholders in society to work together with the government, as this is crucial to preventing negative impacts on access to essential health services for local communities.
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