NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Monday, November 16, 2015

Nomsa Gwegwana is expecting her third child, but the Orange Farm mum says she is a little out of practice.

“My last born child is almost 11 years of age, and some of these processes I’ve forgotten about,” says Gwegwana, who lives in the township about 45km south west of Johannesburg. “I feel so lost in this whole process of pregnancy.”

“With my first and the second pregnancies, we were taught how to take care of ourselves and our unborn babies, but I guess the clinics are not the same,” adds Gwegwana, whose small Orange Farm Ext 7 Clinic is too small to offer antenatal classes.

The same clinic also recently sent her home without the iron (ferrous sulphate) and vitamin B supplements given to pregnant women, to help prevent anaemia and birth defects. The unemployed single mother says she was told to buy the supplements over the counter: “Both my kids are still in school, and I am not working,” she says. “Tell me how can I afford medication and food at the same time?”

The Gauteng and national departments of health deny that Gwegwana’s clinic ever experienced a shortage with National Department of Health Spokesperson, Joe Maila, adding that the district pharmacist had verified that the supplements were in stock. Maila said there was no national shortage of the supplements. But civil society coalition, Stop the Stock Outs, has logged months-long stock-outs of vitamin B complex, ferrous sulphate, and folic acid in the Eastern Cape, and a three-month stock-out of ferrous sulphate in the Free State. These reports follow stock-outs of the iron supplement, and vitamin B complex in KwaZulu-Natal in April and May. So a patient leaves a clinic without pills in hand, yet a district pharmacist says there is stock. Diagnosing the discrepancy between these events means tracing a chain of events that runs from Delhi to Delmas.

Before a medicine reaches the shelves of our clinics, it has made a long journey by land and air from the largely overseas plants in which it was produced, to the shelves of medical depots, before finally coming to rest on the shelves of a local pharmacy. During this chain, it will pass through the hands of inspectors, importers, and even couriers.