‘First do no harm’. SA Medical Association reminds Dr Ramathuba of healthcare professionals’ oath

Limpopo MEC for Health Dr Phophi Ramathuba. File Picture: Werner Beukes/SAPA

Limpopo MEC for Health Dr Phophi Ramathuba. File Picture: Werner Beukes/SAPA

Published Aug 25, 2022

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Pretoria - LIMPOPO MEC for Health, Dr Phophi Ramathuba has a duty and responsibility to comply with the ethical conduct befitting a healthcare professional who took an oath, the South African Medical Association (SAMA) has said in reaction to the widely circulated video of the Limpopo senior government official.

In the video, which has divided opinions in South Africa, Ramathuba berates a Zimbabwean patient seeking help in a Limpopo hospital, and laments the burden on resources being caused by an influx of Zimbabweans seeking medical help in South Africa.

“Despite there being a need for a national dialogue to address the matters highlighted, SAMA deplores the manner of addressing this issue by the MEC Ramathuba to a patient at a Bela Bela hospital. The MEC as a leader in the province is aware of the appropriate channels where such matters ought to be raised,” said SAMA chief executive, Dr Vusumuzi Nhlapho.

“Additionally, the MEC has a duty and responsibility to comply with the ethical conduct befitting a healthcare professional who took an oath which clearly states “first do no harm”. The Health Professions Council of South Africa’s ethical guidelines and the SAMA Pledge solemnise all doctors to a duty of care, respecting the dignity of the patient and fostering the noble traditions of the medical profession without prejudice, which in this instance appear to have been contravened.”

SAMA highlighted that healthcare is a fundamental human right.

“Foreign nationals such as refugees and migrants are one of the most vulnerable members of society. When people are marginalised or face stigma or discrimination, their physical and mental health suffers. Discrimination of any kind in the healthcare sector is unacceptable and is a major barrier to global socio-economic development. It is contrary to the central principle of the United Nations 2030 Agenda for Sustainable Development, which is to ensure that no one is left behind,” said Nhlapo.

“In addition, the World Health Organisation (WHO) calls on all countries to respect and protect human rights in health -- in their laws, their health policies and programmes. The WHO maintains that all countries must work together to combat inequalities and discriminatory practices so that everyone can enjoy the benefits of good health, no matter their age, sex, race, religion, health status, disability, sexual orientation, gender identity or migration status.”

Nhlapo also pointed out that Section 27 of the South African Constitution states that no one may be refused emergency medical treatment.

“The Refugees Act of South Africa sets out rights for asylum-seekers and refugees in South Africa. It states that, refugees in South Africa have the same rights to access healthcare as South African citizens. This right is widely interpreted to include asylum-seekers, as well,” said Nhlapo.

“SAMA notes that Canada, mentioned in the video by the MEC, has Interim Federal Health Policy programme for different levels of foreign nationals that is available temporarily and/or as a last resort. In the USA, under the Healthy Environment for All Act, the country would allow undocumented immigrants access to health care through formalised payment contributions and to be eligible for subsidies to offset the cost of this coverage.”

Ultimately, SAMA emphasised that it believes clinicians provide health care services when people are in their time of need.

The Young Nurses Indaba Trade Union (YNITU) has also weighed in on the hot topic, calling for the removal of Ramathuba.

In the widely circulated video, Ramathuba who was accompanied by a team of several officials, addresses a Zimbabwean patient lying on a hospital bed, and the MEC tells the patient that she must not be in the hospital.

“The supreme law of our country and the constitution of the country affords citizens and non-citizens to the right to be treated without any form of discrimination. We think the MEC was grandstanding and the public display that she did to that patient was completely unwarranted,” said YNITU general secretary Lerato Mthunzi.

“This was not the place or the time or the right audience to address these issues. The patient is in a sick bed and if she is admitted she is really sick and in dire of need of assistance from caring health care workers.”

Mthunzi said Ramathuba has a responsibility to exercise empathy as a doctor and an MEC who is leading healthcare in the province.

There has been mixed reactions to the MEC’s outburst during the interaction with an undocumented Zimbabwean national.

After the patient tells the MEC that she speaks Shona, a dominant language in Zimbabwe, the Limpopo government official questions the patient.

“You speak Shona? And how do you end up being in Bela-Bela when you are supposed to be with Mnangagwa? You know he doesn’t give me money to operate (on) you guys? And I am operating (on) you with my limited budget,” the MEC said.

The frail-sounding patient says she appreciates the service, and Ramathuba responded:

“You can’t appreciate that. You are killing my health system. When you guys are sick these days, I hear you just say, let us cross the Limpopo River, there is an MEC there who is running a charity department. It’s not,” the MEC continued addressing the bed-ridden patient, with a crew of health officials laughing loudly.

In the three-minute rant, the MEC also tells the patient that she has been operating (on) patients “for what Mnangagwa is supposed to do”.

Ramathuba’s remarks, which have been widely reported in the news in different African countries, including South Africa and Zimbabwe, have garnered opposing opinions on social media platforms.

Media personality Redi Thlabi commented: “Cowardly. Bullying, or if she is so incensed, she could ask President Ramaphosa to relay her message to Mnangagwa”.

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