Imtiaz Sooliman – A humanitarian perspective on enabling universal healthcare.

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