South Africa: Nelson Mandela Bay Clinics Under Siege As Crime Threatens Healthcare

A series of robberies at healthcare facilities in the Eastern Cape has disrupted services, with patients sometimes left waiting outside while clinics limit the number of people allowed in. This follows the provincial health department spending over R700 million on security contracts in the past financial year, reports Luvuyo Mehlwana.

Fearing for their safety, nurses at Booysen Park Clinic in Nelson Mandela Bay now work behind locked gates as patients are left to wait for hours outside after it suspended indoor queues because of an armed robbery.

Booysen Park Clinic is one of several health facilities forced to operate in this manner as a result of armed gangs targeting healthcare workers and patients in Nelson Mandela Bay, which comprises the City of Port Elizabeth and the smaller towns of Uitenhage, Despatch and Colchester.

In September, the Eastern Cape Department of Health briefly shut KwaZakhele Clinic following reports from community members about potential criminal activities targeting the facility.

"This has saved the workers from potential harm and trauma," said Mkhululi Ndamase, spokesperson for health MEC Ntandokazi Capa. "The department condemns the targeting of healthcare facilities and workers with the contempt it deserves," he added.

KwaZakhele Clinic was reopened after police reported that there was no credible threat of crime, said Ndamase. He encouraged residents to work with law enforcement agencies and report crimes or plans to commit a crime against healthcare facilities and workers.

A patient at KwaZakhele Clinic agreed that making clinics safe will require support from the community. "These healthcare workers are working in our community, meaning it is our responsibility as the community to protect them. As the community of KwaZakhele, we have adopted and are promoting the 'see something, say something' mentality," Sinthia Swartbooi told Spotlight.

"We are scared now to come to the clinic, and we are no longer carrying our cell phones when we visit the clinic due to this robbery crisis....I see no point in robbing a place that saves people's lives," she said.

Multiple incidents

People at Despatch Clinic were robbed for the fifth time in 12 months in August. Earlier this month, Motherwell NU8 Clinic was the target when staff and patients were robbed and the security guard was accosted and robbed. Security guards at Motherwell Community Health Centre was also not spared by criminal gangs when they were robbed of their belongings in July.

The ramifications of these incidents are felt in other clinics too. For example, if a nearby clinic is impacted by a robbery, then patients tend to use Motherwell Community Health Centre's casualty department which operates 24/7 despite it being designed for emergencies, said a nurse working at the centre. She requested not to be named since she is not allowed to talk to the media.

"We realised after these constant robberies in [several health] facilities that casualties are becoming a clinic, as people are flocking in large numbers," she said. "Although the casualty ward is meant for emergencies, like stabbings, gunshots, and those who are struggling to breathe, now we are treating minor illnesses, such as children who are vomiting and those who have high temperatures."

Making it difficult for nurses

"The patients are greatly affected by the closure of clinics due to robbery. They have to travel long distances for healthcare services. In some cases, others will refuse to be redirected to other facilities. That is making it difficult for us to follow their progress," said a nurse working at Joe Slovo Clinic.

Joe Slovo Clinic was robbed for the third time this year in September.

"As workers, we are concerned about our safety and security in this clinic since we have been robbed.... We therefore call upon the department to strengthen security for the sake of our safety and patients," said the nurse who did not want to be named because she does not have permission to speak to the media

"They must deter criminals by installing effective alarm systems and adequate security guards because these robberies create a very unique challenge for healthcare facilities. In the past, facilities operated like shopping centres with all the doors open, but now it is difficult to open the doors because we are easy targets," she added.

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According to Ward 41 committee member responsible for safety and security, Mbulelo Daliwe, a robbery in May at Joe Slovo Clinic led to a pregnant woman going into early labour and being rushed to another clinic. Frustrated residents then decided to close the clinic and raised the issue of safety with the health district office.

"The District Office promised that they would implement some security measures. They assured us that they would add another security officer in addition to the one we already had. We also demanded a fence and gates because there were no gates," Mbulelo said.

"They installed the gates, but we are still waiting for the fence and additional security to come and secure this place. The government must stop gambling with people's lives because these nurses are starting to be demotivated due to poor working conditions."

Spotlight visited several clinics (Joe Slovo Clinic, Motherwell NU8 Clinic, Thanduxolo Clinic, KwaZakhele Clinic, Booysen Park Clinic, and Schauderville Clinic) across Nelson Mandela Bay. The main entrance gates to each of these clinics were manned by a single security guard. KwaZakhele Community Health Centre and Motherwell Community Health Centre had between four and six security guards searching vehicles entering their premises, but visitors were not checked for dangerous weapons.

'I only have one life'

A security guard, who did not want to be named because he is not allowed to speak to the media, said working at Schauderville Clinic which fell prey to crime in September is risky because of crime in the area. "I am always scared because I only have one life, and I come here not knowing if I will return home safely."

He said the facility has many gates that are open to the public, thus making it difficult to manage the space. "There's the main entrance, and there is another entrance that leads to the councillor's office and community hall, which causes issues for security and the ability to maintain a safe environment."

He suggested health authorities build stronger links with communities and the police to help curb crime, adding: "CCTV cameras can be installed, but these thugs are brave, they can shoot out the CCTV cameras."

The use of CCTV cameras in public healthcare facilities were increased in 2019 after an incident of a patient who was killed at All Saints Hospital in Ngcobo. The suspect barged into the casualty ward and stabbed a patient to death while doctors and nurses were treating him for stab wounds in the chest.

The knife-wielding man forced his way through the casualty area and passed security guards who were deployed at the hospital. The security personnel who were on duty could not prevent the suspect from stabbing the patient to death.

Measures have been taken

Ndamase told Spotlight various security measures have been taken to ensure the safety of staff and patients. "This is why the department has ensured that at each of our almost 1 000 facilities, there are security guards. The department has also installed CCTV cameras, beams, panic buttons that are linked to 24-hour armed response, appropriate fencing, and gates, among other security measures," he said.

The department is also putting more effort into improving access control through perimeter fencing of the facilities. "We have made strides to install automated perimeter gates, and we endeavour to improve the perimeter lighting. We have ensured that all contracted security companies have minimum security equipment," said Ndamase.

Citing findings from the Mexican Council for Public Security and Criminal Justice on its annual ranking of the 50 most violent cities in the world, Ndamase noted that Gqeberha in Nelson Mandela Bay ranked number 10 in the world for the most dangerous cities, adding that the crime in the city has now spilled over to not only health facilities but also other government departments and businesses.

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The high crime rate, he said, is a societal issue that needs collaborative efforts from all relevant stakeholders. "No single department is able to fight crime single-handedly," Ndamase said. "The department has since signed a Memorandum of Understanding with the Department of Community Safety on behalf of the Justice Crime Prevention and Security (JCPS) Cluster, while we have direct relations with the police, the Nelson Mandela Bay Metro Police, and civil society."

Ndamase told Spotlight that 119 break-ins and robberies at health facilities across the province have caused approximately R1.5 million in damages in 2023/24 and the current financial year so far.

He said that during the 2023/24 financial year, the provincial health department spent over R700 million on security contracts to multiple clustered tenders awarded to different companies.

"This was money well spent, as the presence of security guards at our facilities has prevented many other crimes. We can confirm that the services are provided in line with the service level agreements with the security companies," he said.

He stressed: "[T]he security companies are not the ones committing the crimes against healthcare workers and health facilities, but rather the criminal elements often coming from the very communities where our health facilities are providing care, it would be unfair and unfortunate to blame the companies for what is a societal problem."

Names of security companies withheld

Spotlight asked Ndamase for the names of the companies awarded tenders to provide security services at healthcare facilities in the Eastern Cape, but he declined to provide any details. "In line with the [Protection of Personal Information Act] POPI Act and the conditions of the service level agreement, we cannot divulge the names of the service providers," he said.

But the POPIA is not an absolute barrier to disclosing information held by a public body, such as a provincial health department, according to Tina Power, Associate Director at public interest law firm Power & Associates.

"There appears to be an increasing trend in which public bodies are refusing to disclose information by relying broadly on POPIA, without expressly referring to a particular section, or by seeking to rely on confidentiality provisions in service-level agreements. This is contrary to the constitutional values of openness and accountability, and the public interest in information that concerns the exercise of constitutional rights, such as access to health care," said Power.

This article was originally published in Spotlight.