Load shedding in South Africa has significant effects on both private and public healthcare. These are far-reaching and can have severe consequences for patients, medical facilities and healthcare professionals. So just what is the impact of load shedding on healthcare in South Africa?

In the realm of healthcare, load shedding exacerbates the existing challenges faced by hospitals and clinics. Load shedding further strains infrastructure and compounds existing shortages, compromising patient care. 

New regulations allow larger public hospitals exemption from load shedding however, Eskom has warned that it would be technically impossible to isolate and exclude most healthcare facilities from load shedding. 

Dr Morgan Mkhatshwa, Clinical Executive of Bonitas Medical Fund says, ‘prolonged or frequent loss of basic services, including the lack of electricity, has been shown to have financial, psychological and physical implications.’

The importance of private healthcare was highlighted during the Covid-19 pandemic.  ‘Medical aid changed from being a grudge purchase to an absolute necessity and, once again, this is being reinforced by the electricity crisis and load shedding,’ says Dr Mkhatshwa.  ‘Apart from having access to private hospitals, which are predominately well equipped with generator banks and/or inverters, medical aids take every precaution to ensure other services are available at optimum levels and the highest quality.’

He says, ‘To ensure the delivery of cost-effective healthcare, we have a network of hospitals and clinicians with whom we have negotiated favourable rates to minimise co-payments for our members. All of these hospitals and clinician practices have put effective contingency plans in place to ensure they are able to generate sufficient back-up power for uninterrupted patient care.’

Provision of pharmaceuticals

These include vaccines, insulin and certain antibiotics, which are sensitive to temperature fluctuations and require refrigeration/strict maintenance of the cold chain. During power outages, the lack of electricity can compromise the integrity and efficacy of these medications, rendering them ineffective or potentially harmful. This does not only pose a risk to patient health but also leads to financial losses as medications and vaccines may need to be discarded, due to compromised storage conditions. He says the provision of chronic medications is essential to ensure members are able to adhere to their medicine regime.

The Fund ensures their Designated Service Providers are proactive in developing contingency plans to ensure an uninterrupted medicine supply to its members.  This includes having generators and backups, double dispensing of medication to ensure chronic medication deliveries are doubled up and developing communication tools to inform and educate members about medication supply.

‘More than 80% of South Africans are reliant on public healthcare services at the approximately 420 state-run hospitals and more than 3 000 state-run clinics. While private facilities, secondary- and tertiary-level public hospitals appear to be well equipped with generator banks, smaller healthcare facilities including primary healthcare clinics, are often left in the dark,’ says Dr Mkhatshwa.  ‘The cost of alternative sources of power can be substantial, with a private hospital group recently reporting an average monthly expenditure of R800k to run its generators.

‘The situation is not only unsustainable but is also putting the healthcare of our citizens at risk and, once again, it is the most vulnerable who are compromised the most.’

The original study by the University of the Witwatersrand’s Department of Emergency Medicine, Faculty of Health Sciences in 2019.

http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742019001200003