Warring Zithulele Hospital leaders transferred

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The feuding clinical manager and chief executive of Zithulele Hospital, near Mthatha, were transferred on Thursday. 

The transfer of clinical manager Dr Ben Gaunt has triggered disquiet among the Rural Doctors Association of South Africa’s (Rudasa) members, veteran rural public sector physicians and the local Zithulele community, who support four long-service senior doctors at the hospital who have resigned, with eight remaining doctors considering doing the same.

Last week, the police fired teargas and rubber bullets at about 250 local residents who were protesting over the crisis at the hospital. Seven protestors were injured. They have questioned the integrity of an official investigation blaming Gaunt.

The Eastern Cape MEC for health, Nomakhosazana Meth, said in a statement that Gaunt had a ‘‘clash of interest” between hospital activities and the long-standing nonprofit organisation (NPO), Jabulani Health Trust, that he had helped set up and fund. The trust is one of several NGOs the four senior doctors, comprising two married couples who moved there 15 and 17 years ago respectively, helped set up to improve desperately needed nutrition, education and healthcare.

Meth added: “The CEO, Ms Nolubabalo Fatyela, tried to do everything according to the book and decided that the clinical manager’s role in both the hospital and the NPO was against legislation. He was suspended, which had the community up in arms. We’ve decided to temporarily transfer both the CEO and the clinical manager, both of whom erred, but to different extents, to other institutions to allow us to consult the community. We want the dust to settle and to get to the bottom of the issue.”

Fatyela is a nurse who claims doctors are resisting change, are racist and are not following policy at Zithulele. The hospital, which has won multiple awards for its multi-disciplinary maternal health, TB and HIV/Aids care and research, stands to lose more than 100 years of medical experience.

On Thursday Meth said the investigation would centre on “what happens when an employee who was also a director of an NPO brings in the resources of that institution”.

“Will we treat that employee the same as one who has a conflict of interests in terms of business? It’s quite a lot of issues which need more time to deal with so that we learn and come up with lasting situations to prevent this from happening again.”

Gaunt, who declined to comment, is taking up a position as a medico legal consultant to the province.

A source close to a crisis meeting convened by the MEC on Tuesday at Zithulele said the findings were “pointedly damaging to Gaunt because the NPO is not a business and can therefore not be a conflict of interest. It’s strange, because Jabulani Health Trust finances are publicly audited and published. I think the MEC knows it won’t pass legal muster, hence the continued probe. I mean, Gaunt put R500 000 of his own money into that trust to support the community and the hospital, and accrued no individual benefit.”

Another added: “It seems as if they’ve closed ranks around the CEO. The bottom line is the MEC is fighting for the CEO against the loss of up to eight other clinicians. You have to ask whether that’s worth fighting for.”

He said the local residents were deeply suspicious of the motives of Fatyela, who was appointed last September, given her relationship with a local councillor and a chief and a R890-million hospital upgrade, which is about to begin. 

Residents have told the Mail & Guardian that R280-million of the project is reserved for black economic empowerment and small and medium enterprises tenders and that allies of the chief executive had canvassed for a petition in support of her, saying anyone who refused to sign it would be vetoed when it came to the 200 jobs on offer.

Two other senior clinicians have been given until September, when one’s sessional contract ends, to vacate an on-site home they’ve lived in for 10 years. They’ve requested an extension to December, during which time they would continue to teach junior doctors and attend to patients. One is looking for someone to replace her as the principal of a local junior school she established and runs.

A spokesperson for the Zithulele Community Protest Committee said the health department had focused on Gaunt, falsely accusing him of fomenting last Thursday’s protest and failing to address two petitions they’d handed in.

“We’re protesting an observable decline in health care provided under the management of the CEO, Ms Fatyela. The report findings seriously call into question its integrity. Victimisation of a senior clinician will make it more difficult to attract and retain quality personnel — or for staff to raise concerns about the functioning of the hospital, with negative consequences for patient care,” he added.

Dr Victor Fredlund, a decorated veteran rural physician suspended as chief executive of Mseleni District Hospital in rural northern KwaZulu-Natal in 2018 in remarkably similar circumstances, said that “it’s difficult where people have policies and think you can just implement them without appropriate preparation and arrangement to suit each situation. Some regard direction from their departments as Mount Sinai tablets — they come down on a thundercloud and you must do thus. They misunderstand clinicians — instead of seeing their role as supportive, they want to control and see us as naughty boys when we don’t do exactly what they tell us.”

Fredlund said such actions were widespread and “demotivate an awful lot of people. It’s bad management.”

Rudasa chair, Dr Lungile Hobe, expressed sympathy with the injured protestors and said Zithulele was “a beacon of hope for excellent rural health service in a province frequently criticised for poor service delivery”.

“Our concern is that all rural health services are fragile. No matter how good they are, they can quickly fall apart, and it takes many years to rebuild trust relationships within the hospital team,” he said. “We appeal to the department to focus on what is policy and what is practical application of policy in a local rural area, rather than individual personalities, to listen to community members and patients and follow up on the concerns raised by Zithulelele’s doctors.”