Recent experience with almost month-long power cuts in South Africa due to inadequate generation capacity have highlighted a State-owned entity has been unable to ensure a reliable source of electricity to the country for over a decade. When this first occurred in 2008, I was heading the Western Cape Department of Health and as management we had urgent meetings with officials from the power utility to decide how to manage what was envisaged then to be a short-term problem.
At that time many health facilities had inadequate or no back-up generators and a decision was taken and actioned urgently to acquire and install generators at as many facilities as fast as possible. Those with generators were checked for functionality and adequate supplies of diesel were procured. In addition, the department purchased a vehicle capable of delivering smaller quantities of diesel to facilities to which the oil companies refused to undertake direct delivery. This was achieved over a period of months and ensured that in emergency situations health facilities would have electricity enabling key equipment to remain operational. To my knowledge many of these generators continue to function over a decade later. In this scenario, the immediate problem was identified and urgent remedial actions implemented.
ESCOM officials at that time indicated that similarly the organisation would be taking urgent steps to address the shortfall in generation capacity. Fourteen years later, the situation is far worse and the only positive development has been that the country has become more adept at scheduling power outages on a roster basis across the country. This provides some certainty regarding the timing of what has now euphemistically described as “load shedding” when power from the grid will be unavailable. In the interim, management and board members at the power utility have come and gone with monotonous regularity and billions of rands have been spent or misspent while the provision of power to the country has worsened with most recently the longest period of load shedding in the country’s history. The consequences of this failure have been significant for South Africa in many areas of our society.
A reliable supply of electricity is essential for many sectors of South African society, including the provision of quality health care in both the public and private sectors. The implication of the load shedding has been the cancellation of procedures, surgical or otherwise, with a negative impact on the health of the patients concerned as further procedures must be halted until power from the grid is restored. In some instances generators at health facilities have been unable to sustain prolonged hours of operation necessitated by long periods of load shedding resulting in these facilities being without power. In this case the maintenance of the cold chain vital for the preservation of vaccines and pharmaceuticals is threatened.
Most recently, somewhat belatedly after fourteen years one would add, the National Department of Health has engaged ESCOM in an attempt to isolate as many health facilities from load shedding in the areas in which they are situated. This has posed technical difficulties for ESCOM and the municipalities that supply electricity as the grid was not designed with this in mind. Dedicated power lines from a central point will have to be constructed to hospitals where isolation of the facility from the area grid is not possible. A consequence that now adds to the cost of providing health care in an already financially constrained environment.
A knock on effect of load shedding has been interruptions in the supply of water to certain health facilities, and indeed wider communities due to the pumps supplying water to reservoirs and filtration plants being unable to operate during periods of load shedding. This has left certain health facilities, some larger hospitals, at times without electricity or water. Dark days indeed when an advanced country, such as South Africa, is unable to ensure that patients in a health facility have a constant supply of power and water.
One would expect severe consequences for a situation of this nature, but over the last fourteen years, while the Cabinet Ministers with portfolios responsible for ESCOM as a public entity, ESCOM boards and senior management have come and gone with monotonous regularity, the consequences have been minimal for those involved. In fact to the contrary many appear to have benefited from their involvement with ESCOM in one way or another. As citizens we have become used to a variety of excuses and so-called action plans trotted out by both politicians and management, which have not slowed the apparent downward spiral of what was once regarded as one of the leading power producers in the world. “State capture” has now become a convenient way to deflect criticism of government for the problems currently experience at ESCOM. Six figure salaries and even bonuses have been paid despite an organisation that has failed to deliver on its mandate. Now that failure is no longer merely an inconvenience but it is the cause of potentially increased morbidity and even mortality amongst South Africans.
I am a health professional and health manager and not an engineer but it is patently obvious that for the last fourteen years and before that poor management decisions have not had consequences. Scarce funds have been wasted and targets not achieved but consequence management for whatever reason has not been applied. In ESCOM, as in many other areas in this country, managers point to political interference and politicians point to managerial incompetence but somewhere between the two lies the truth and unless this is grasped and acted upon South Africa faces both literally and figuratively a very dark future. As a health professional I can only hope that someone sees the light sooner rather than later.
