Imtiaz Sooliman – A humanitarian perspective on enabling universal healthcare.
AI: Summary ©
The speakers discuss the challenges of managing the pandemic and the need for universal healthcare. The public sector is pressuring and cannot cover hospitals, while private sector is struggling. The speakers emphasize the need for intervention in the healthcare system to solve the health crisis and upgrade infrastructure. They also discuss the need for psychologists to help manage mental health issues and suggest training and fixing the healthcare system to avoid complications and waste time. The speakers emphasize the importance of helping people in the public sector to improve health and safety, and mention the need for systems of maintenance and management.
AI: Summary ©
All right, for me, one of the highlights of today, and I am an
absolute fan of this man, and I'm sure saw you are and the work he
does. And I was just with him very, very recently, and put him
on the spot when it was a review of the budget that we had gone
through with the finance minister. And if it wasn't for him, I can
promise you, the rhetoric would have just carried on. But he made
it real, and that's what I think is so wonderful about our next
speaker. He makes a situation real. He's on the ground, he is
there, and he sees what's going on, and that's why he is here to
share that with us. So there is an emerging global consensus on the
importance of universal health care, but no consensus on how to
actually achieve it. What we know is that providing universal health
coverage is not the government's job alone. The private sector,
beyond the health care industry players also has a role to support
efforts through corporate social investment initiatives, as does
individuals with the resources and capacity. Joining us now is gift
of the givers founder, Dr Imtiaz Suleiman, now, Dr Suleiman has
been running the gift of the givers foundation since 1992 after
giving up his career as a medical doctor to pursue the field of
humanitarian aid. Today, the gift of the givers, foundation is the
largest disaster response Non Governmental Organization of
African origin. It has been instrumental in relief efforts to
the value of over 4 billion rand. But 29 years in 44 countries such
as Iraq, Syria, Nepal, Mauritania, Tahiti, as well as locally here in
South Africa, I know that they have just returned from or if
they're still there, I'm not too sure, but I do know that they were
embarking on a journey to the Ukraine to try and assist there.
Some of Dr Suleiman's accolades include honorary doctorate from
the University of Stellenbosch and Rhodes University, and the
president's order of the star of South Africa. Dr Suleiman looks at
a humanitarian perspective on enabling universal healthcare.
Ladies and gentlemen, please welcome Dr Imtiaz Suleiman,
thank you, Leanne. Thank you very much. Congratulations to Ahmed
beneker and afrocentrix group and all the speakers who has been
speaking before me and Well, I think I'm the last speaker. But
for for setting up this at the most crucial time in the history
of our country when it comes to health, I
want to speak generally from experience in the last two years
during covid itself, and while saying that we need to understand
that covid is not the only medical problem that we have, the focus
has been on covid for the last two years, but in the process, we have
forgotten about other medical conditions. But while it's
unpacking that I will speak from our own experience, what happened
since march 2020
it was on the 15th of March when the President announced a national
emergency, or national disaster. 12 days later, the announcement
was made for the lockdown of for for for covid 19 itself. And then
the drama started, procuring PPEs, setting up testing providing the
needs of the country, looking at oxygen, and we got involved
immediately. Within the first three days, we managed to procure
PPEs to start driving to hospitals, because there was a
panic. We also set up 10 testing sites in the country, and we had
mobile testing teams. But that already raises a question. When
you come to the problem of PPEs, when you preparing for an event
like covid, which is so critical with so many lives are lost, it
shows how prepared are we in the system of health, as a government,
as a country, we were not prepared. We were not prepared at
all in various ways, our systems, our managements, our ethics, our
values. I mean, how did 14 point 3 billion of PPS disappear at a time
when money needs to be spent in sorting out the crisis in the
hospitals we have it is disappearing. So there's
definitely a system, a problem of management within the health
system and management within the country itself. Yes, there's a
huge crisis with regarding to health, but we can only address
that crisis if we know what the problems are. The problems are
many fall, but it doesn't mean they can't be solved. It requires
several interventions from several levels, and this can be achieved
whilst we have good people in the system, and you have bad people in
the system, you have people like what's happening now with the
summit, where people want to fix the system. So let's take the
journey. We started off with PPEs distributing to different
hospitals. We delivered it to 210 hospitals nationwide. We also
started supplying pulse oximeters and non contact thermometers. And
as you're going along, we found there were problems.
Credit of the solidarity front. Within 15 minutes, They conversed
within themselves, and they send a message back. It's a yes, we made
the announcement, and the different medical health groups
started taking the machines, and as we started giving out the
machines, hospital I won't mention hospital groups, but hospital
groups started calling, and they said, thank you very much. We'll
take six verse towards the country in a box with six six verse within
minutes, they said, We will open up all our wards when we got
oxygen points, we will take 60 machines. What did that simple
intervention do? It got private sector to buy in, to open up their
hospital beds. So the pressure the public sector is reduced because
people were driving to hospitals in the second wave, in the beta
wave, and they were dying in the car parks. They were dying in the
car they were coming late from home because oxygen saturation
dropped from 100 to 30 within seconds, and nobody knew the
smiling hypoxic just died in front of your eyes. And at that point,
early intervention was important. So when the private hospital said,
yes, we'll open it so people who had had no chance to get to a
public hospital found the money and went to the private sector,
and we said, be lenient. Don't charge exorbitant prices. It's
time to save lives. It's not time to make money. And to the credit
of the loss of the private groups, they got involved, took the
machines, spread it out, and one guy would phone, I got five
hospital groups. Can you send 21 machines here? 17 year 20 there,
and we send the machines to everywhere. This was very good
news, where the public sector government paid for a machine that
could be used in the public sector, but private, what's
difference? Private people's lives gotta be safe too. The private
sector did have the machines. Money couldn't buy the machines.
You couldn't get the machines anywhere in the world. You had
them in South Africa. They were in a public sector hands, and they
could be used to the private sector. 20,000 of them lying
around. So yes, we gave it to them, and they saved lives. It was
used achievement. It was something that showed that we could work
together in something beyond covid 19. Because covid 19 is not the
only thing in life. There's much more disease patterns to deal
with. And then whilst we were doing that, they would say, you
know, we got no water. There's no water. We're talking about hygiene
and safe practice and look after ends. But we got no water in the
hospital. What do we do? So we said, again, just an intervention
that government should do. We started putting balls in the
different hospitals, and right now we've put balls in seven different
hospitals in Eastern Cape, besides what we've done before covid And
during covid itself. And then you get the uncanny request from the
richest city in the continent, not some god forsaken place in the
heart of Africa. This is a city called Johannesburg, where I'm
standing right now. And you have two hospitals called Rahima Musa
and Helen Joseph Hospital. And for weeks, the government can't work
out how to solve the water problem in Helen Joseph and Rahima Musa,
we come out of a wave, and we're supposed to do catch up surgery,
but you can't put a cat up surgery because there's no water. The
south side of Joburg is not functioning, so there's no water
in hospitals. And nobody can think, can you put a borehole?
Because everybody's got affiliated a lot of forms and a lot of
papers, because government doesn't understand three words, urgency,
emergency and disaster is not in the vocabulary of government.
Everything needs to be written down papers. They have to do
things. And this is a crisis. You can't say I'll do it in four weeks
time. People are going to die. In four weeks time, you need to fix
the system. I said the systems have to be fixed up. So we
intervene. In 48 hours, we drill. Adam Joseph, my geologist, is
sitting in Namibia. He punch point a spot exactly in the car park in
the corner near the road in Helen in Rema Musa, and we hit 12,000
liters per hour. Now, why couldn't all the geologists and the
scientists from government do that? What is a big crisis? Why
could we do that? We have to fix the system of intervention in the
country. The next example, we do the balls. We go to different beds
in hospitals. We don't have enough beds. So they got patients, they
got oxygen point, but they don't have beds. So we started putting
beds into the hospital. And then as you go along, a new phase has
come up. Hospitals need infrastructure upgrade. Now this
is where you talk the last part, where you introduced,
introduction, what role everybody is going to play. We need the
private sector participation. We need medical aid societies. We
need medical companies. We need we need corporates who are not
medical everybody to get involved together, to be fair to
government. 5.2 million people's taxes. Can look after 60 million
people. It's impossible. And with all the difficulty with the drop
in economy, job shed, decreased collection from SARS, decreased
tax collection, the budget got depleted by covid itself. There's
just not enough money to deal with health crisis or any other crisis
in the country that's.
Why we need buy in for different things, but today we talk about
health. So in health, we need buy in from corporates to help update
hospitals. If you ask me, for the next three years for Mandela day,
don't give out food parcels, don't give teddy bears, don't give
hygiene cracks for the next three years, let's upgrade
infrastructure in this country. Beat classrooms at school, school
toilets, balls at school, balls at communities, balls in hospitals.
Upgrade to the hospital facilities itself. And this is what we drive
in the corporates towards, and to the credit of the corporates,
before the CSI was just there to tick the register. Okay, 95 90% be
black recipients. Take the register. Tax benefits. Take the
register. Did some goodness? Take the register. Nothing serious,
nothing concrete. It was just to take the register. They can carry
on our life today. Credits. What covid 19 itself. The CEOs got
involved and said, What do we have to do? How do we fix the country?
How to hold people up and how do we go forward
infrastructure upgrade right now? I mean, when you already shortage
of medical personnel, the government puts a moratorium.
There are no posts. All Posts are frozen. How the * can you run a
system with all the posts frozen? If somebody dies, retires, gets
sick, those posts are not filled so few people to deal with so many
patients. The patient count is increasing because post covid,
they are coming back with all the conditions, so the number of
patients are multiplying and the number of staff are different
depleting. What are you going to do to the health system? You're
going to collapse it, because the personnel machines don't run the
system. People run the system. The people are going to be depleted.
We need to relook at Ask the finance minister to relook at
budgets. You can't have a moratorium on posts. You can spend
50 million Rand on doctors from outside the country, but you can't
give jobs to doctors inside the country. You can't register your
own doctors, South African doctors that are studied overseas, but you
can bring doctors who's come from outside countries into our
country. Politics cannot play a role. This is about the service of
health in the country. We need to fix the system. And besides paying
additional staff right now, there's no money. We make a call
to corporates. Let's pay for a registrar. You cut the registrar
post by 30 by 50% what does that mean? There's a failure in
academic medicine. There will be no further teaching and all the
interns for the last two years. Sorry to all the medical schools,
your interns have led medicine by correspondence in the last two
years. They don't know what that's going on, and I don't blame them,
because they couldn't do any teaching, and they were scared,
and you were scared of liability. So those interns have to be
returned trained the students for the last two years, and it is upon
all the healthcare workers and the consultants and the registrars to
give confidence to those kids who are now, for the last two years,
not sure of themselves. But how can these consultants and
registrars do the training when they so short of manpower? It
can't happen. So we need companies to get involved, to pay for
registrars and consultants and more staff, more nurses, more
paramedics, more physiotherapists, more dietitians, more OT, more
physiotherapist and OT and we need to train as the government
psychologists. When a healthcare worker says, I need a
psychologist, then you know, we got a serious problem, because
doctors and healthcare workers say, Nah, we don't have a problem.
Mi macho, we the ego takes over. You. Doctors don't have my mental
problems. They don't have psychological problems. The moment
they start saying, not one, but on every medical check in the
country, then you know, we got a serious problem in the country in
terms of mental health. And what universities do? They protect
their health. No, we can only do 21 psychology students, seven,
clinical, seven, counseling, seven, educational. Doesn't make
any sense to me. You're talking about job creation. We don't have
service oriented job creation. We need psychologists in the country
for the healthcare workers, for the teachers, for the saps, for
the parents who lost kids, for the kids who lost parents, for those
who lost jobs for the companies that collapse. And you want to
train 21 psychologists, we need to train and fix the system where the
healthcare system looks at providing more psychologists. So
many kids are left at a disadvantage for OT, there's not
enough OT, I mean, as a catch up surgery the next phase, because my
time is almost up. So supporting healthcare workers in every field,
universities have to look at 30 miles. Psychologists, corporates
have to look at funding people to work, the infrastructure upgrade
and the next thing to catch upward. People are waiting four to
five years for an operation. They die long before the operation
happens. If not, they will suffer for five years. They need
prosthesis, hip knee replacement, cataracts. I'm in a simple
procedure. A guy sees nothing, and within a few minutes, he sees
everything. Why are we denying people that kind of support? The
amazing thing is, we couldn't find money to pay healthcare workers.
We couldn't find money to upgrade hospitals. We couldn't find money
we.
To put in more machines, but we could find money to fund the covid
pandemic. How do you explain that covid pandemic overran everything.
There's people with HIV, AIDS, complications. Now, if we going to
go back 20 years, TB is getting complicated. We're going to go
back 20 years all the cancer is going to get complicated. It means
prolonged hospital visits, more operations, more time waste, more
hospital bed space, more hospital time. We're going to lose all that
space and time. How much more money is going to be on the health
system? Again, corporates, you guys, have to come on board to
help for the next two to three years, to help pay for catch up
surgery. We need to do catch up surgery, catch up procedures, and
we have to help in the best way possible. Now, there's two ways of
doing that. One is we can send doctors from the private sector
into the public sector, but there's always a complication. We
can do that some hospitals working, but since you got such a
backlog of patients within the public system, you guys have a lot
of private hospitals that have 35% free capacity or 20% capacity.
You're paying your staff. In any case, for the day, they're doing
nothing for those three hours today available. Why don't you
take these patients from the public sector and put them into
your hospital and do something as a CSI, yes, you may not say you
cannot do it for free, but there is some point you can do it at a
minimum cost, and maybe that minimal cost government can't pay
for it, but the private sector, the other non medical type of
private sector, could come in and say, this is CSI benefit. I will
pay today. I pay for 20 people to do this kind of operation. I will
pay for 20 cataracts. I will pay for this debt and the other at the
end of the day, this country needs hope and it needs dignity. Why
should a rich child or a parent from a rich style go to a private
hospital and swipes the card ah. Half an hour later, the problem
solved, but the same type of child, but the same type of
condition in rural Transkei will wait for an ambulance that may
never come, for a taxi that's not available on the road, gets messed
up in the rain, that can't work, go to a health facility that has
no staff or limited staff. Not their fault. We didn't support
them with extra stuff to go to an infrastructure that's not
functional. They walk into the place and look at it is, oh, I
don't think I'm gonna heal you. I'm gonna die inside here, that
kind of mentality, and we're gonna you kill our people
psychologically. What would the mother say? What hope do you have?
And by the afternoon, the pharmacy is closed. Come back tomorrow, or
there's not enough medication. Why should that be allowed in this
country? They should not never be allowed. Those are the kind of
things we have to fix, and it's not insolvable. You can fix the
system. And medical aid societies, you guys have discussions about
NHI and want to contribute and want things done. Nobody trusts
you. Nobody trusts you. Medical societies, not the public, not the
government, everybody else you want to make a contribution. Start
putting in money into the public sector. Show good work from your
side, and start putting it in the public sector. And let's say how
we can improve as a medical group and say, okay, yes, we want to
contribute to the medical to the Nhi, to the country and the
government itself. Cannot be fixed on its position. The government
itself should come to a table, and let's see how we can find a dialog
to change the system, or to find an equitable system. To me, Nhi,
my own understanding is anybody who have somebody from the public
sector. Outside the public sector, that is energy. So if anybody
funds a person improves his eyesight, helps his operation,
makes things better. It takes somebody. Let's call it a grid
system. The 60 million people on the grid, 10 million people can
look after themselves. Others can have a middle class, a family,
people can support them, take care of the system, and every other
person on the system that private sector intervention takes off the
grid, we've made a difference to the life of somebody in this
country. So yes, in conclusion, government can't do this alone,
but government has got to fix its systems where people cannot be
blocked, people cannot be said, they can't speak openly. They have
to put in more staff. Look at the needs of the people and look at it
objectively, not thinking, Oh, these people speak what? What does
it say about my incapacity or my qualifications or my capability?
There's no place where you go. We are here to save lives, and it has
to be done in a correct manner. And of course, two, there's five
critical elements, health care, workers, personnel,
buildings, infrastructure. Three, equipment. I mean, the moratorium
says we will not fix machines. We will not buy new machines, so
people might have to stay at home. You know, it doesn't make any
sense. Number four, maintenance, we've built a private hospital and
the government hospital. At the same time. After five years, the
government hospital is falling apart and the private hospital is
still working the same way. We need to have systems of
maintenance and we have to have systems of management. These are
the five crucial principles to make the hospital's environment,
health environment work well. And of course, corporates, we need
buying from you guys for the next two to three years to help
government get.
Is taxes into into account, its finances back into position so
that we can help people in the next three years not waiting. We
can't have the two getting to seven years and nine years that
you have to get to two years, one year, six months and no queue. And
the only way we can do that is corporate, private, the public
altogether. Thank you very much. You