IRIN World Health Day Web Special: Taking Africa's Pulse

Providing adequate healthcare is one of the most difficult challenges for Africa. The HIV/AIDS epidemic has strapped the healthcare systems of impoverished and wealthy countries alike. Few of the millions of Africans who suffer from the deadly virus can afford the expensive medicines used to treat the disease.

State-run hospitals are strangled for resources and often provide sub-standard care. The cost of private healthcare is prohibitive for most. Many people turn to traditional healers or charismatic religious leaders for help. But they find little more than fleeting peace of mind.

The poor infrastructure in rural areas prevents millions of Africans from receiving basic, life-saving immunisations from childhood diseases such as measles and polio. Sweeping efforts organised by international aid agencies are necessary to reach at-risk children. Healthcare in countries in conflict is among the worst as governments or corrupt regimes dip into scarce funds from their health budgets to boost their defense capabilities. Meanwhile, the health of Africans continues to deteriorate.

Providing healthcare in South Africa

The buildings look dilapidated. The dirty, cream-coloured walls desperately need a new coat of paint. Most of the linen, and there is a shortage of it, is torn and discoloured. The smell of stale washing water, instead of antiseptic, hangs in the air.

This is the Chris Hani Baragwanath (CHB) hospital. The barracks-style cluster of buildings on the outskirts of Soweto is the biggest health facility on the African continent and one of South Africa's leading teaching hospitals.

Between 700,000 and 900,000 patients pass through its doors each year. Like other public hospitals in South Africa, a lack of resources is taking its toll on the quality and range of services CHB can provide. "Bara", as it is known, is under pressure from the sheer weight of the demands placed on it by the community, which frequently choses to ignore the small local clinics that government policy emphasises are the frontline of primary health care but in fact are short of drugs and qualified staff.

"Although there are many problems in the hospital, the most acute one is the shortage of nurses, so it is something felt very acutely from the theatre to the wards," said Reg Broekman, CHB chief executive officer. "If we had more nurses we could put more operational and diagnostic equipment that we have to better use." He said the hospital is 1,000 nurses short of the necessary 3,000. The total staff is 5,000.

The hospital had about 7,000 employees five years ago. At that stage academic hospitals around Gauteng province were considerably overspent, so belt-tightening measures were introduced. Administrators froze posts and offered severance packages, which were grabbed up by nurses.

"Expenditure over the past four years has been minimal," Broekman said. "We have had to absorb inflation, and take lots of shortcuts to spread the money as best we can."

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