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vol.104 número4E Cape health officials nearly turn TB victims into cash cowsIvan James Nurick índice de autoresíndice de materiabúsqueda de artículos
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SAMJ: South African Medical Journal

versión On-line ISSN 2078-5135
versión impresa ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.104 no.4 Cape Town abr. 2014

 

IZINDABA

 

Quack remedy cast - 'We were pawns, not told, didn't know, won't say, don't care'

 

 

The pivotal players in the Immutides Spray roll-out drama say they were either victims of bad government communication, pawns of more senior officials or simply ignorant of what was going on. These were the themes to emerge when Izindaba put the allegations to them.

 

Mr Mike Xego

Spitting expletives aimed at central and provincial government officials whom he defiantly claimed had assured him that all the necessary authorisations and documentation were in order, an enraged-sounding former ANC regional chief, Mike Xego, vowed to sue national government for 'misleading' him after he imported 'nearly R2 million' of Immutides Spray. He said he cancelled plans to destroy the (effectively impounded) consignment after learning that it had expired - because 'further research' by his suppliers in Arizona, USA, revealed that its lifespan could actually be extended for another 12 months.

'Right now I'm f****** stuck with stock that has a 12-month lifespan. I order stock and who pays for it? I'm a layman who applied [for the relevant clearances] like any other layman that does business. I complied, going from office to office - all responded positively. Must I be "Gupta'd" so easily? ... It seems if you follow the protocols ... I don't want to talk about this s*** anymore. I own a big factory in [Port Elizabeth] PE. I was helping two white boys who were going to be stuck on their own (his fellow Saulez Agencies CC company directors, Guy Saulez and Gary Karison). I went to Bhisho to get permission ... they asked me for a V number for national. I did that. National came back to me and said I'd done nothing wrong.'

 

 

Xego said he left the 'boring mediocrity' of the Eastern Cape (EC) provincial legislature in 1999 to focus on his business ventures, adding, 'I'm not a parliamentarian - I'm a money-maker'. His response to the documents claiming to give Saulez Agencies permission to 'import and sell' was the following, 'Who cares? I had permission to procure. Their systems are not my systems. Personally I don't care. They are professionals, they know their own system - they should have advised me otherwise. I have nothing written from them about any pharmaceutical committee. They're not my friends ... I don't care about them. I'm a radical politician who lives his own life and has his own mind. I don't care about how they work except that they keep their heads above their water - they mustn't sink and do things wrong. I've done nothing wrong. If people in the townships want this medicine I'm going to give it to them.'

He claimed three EC Health Directors General (DGs), with the exception of the current DG, Dr Thobile Mbengashe, saw documentation involving the Immutides application. 'Why didn't the DGs take this to the MEC? I'm friends with [Public Service Minister] Lindiwe [Sisulu] and [Deputy President] Kgalema [Motlanthe] - and I never wanted their influence. In my layman's view I thought I was doing the right thing. Why did I get those VC and EC numbers for procurement? Must you be a Gupta in this country? F*** this thing now, let's leave it!'

 

Dr Lulekwa Mayekiso

Nelson Mandela Bay's District Health Manager, Dr Lulekwa Mayekiso, grudgingly accepted responsibility for the controversial directive after it was put to her that its language was replete with imperatives, but insisted she initially viewed it as 'a proposal'. She said her district clinical manager, Dr Francois Fourie, had approached her and asked her to write it. 'For me it was a proposal, an internal instruction. I was very busy and don't have an office manager so he did it for me. I didn't write it myself. He was to report to me after meeting the TB hospital doctors and then we would evaluate if the stakeholders agreed on this issue. I then said let's call it off because it was ill received.'

She said the first company director to contact her was Immutides company owner, Mr Guy Saulez, 'about November' last year (she was appointed in October). 'He presented to me and said he had a contract with the [Nelson Mandela] Metro, supplying the clinics, but that it had been abruptly stopped. I issued the directive after several subsequent meetings with my team and them. My mistake was in not understanding the word that means "directive" and all those issues meaning I'd over-rolled [sic] everybody. I told Dr Fourie it's not supposed to go out without me knowing. His answer was that if it's a directive it's not a secret. We were still supposed to get final buy-in from stakeholders and present to province for approval. It was prematurely sent out.'

She confirmed that Immutides was used on public sector patients at a number of clinics before she took up her current post. When it was put to her that it appeared as a cynical, predatory money-making venture, she responded; 'Yo! ... no ... ayi . I don't want to comment. That one was just doing the job. In my district there's a lot of TB crisis and it's actually . we have a lot of [multidrug-resistant] MDR [TB] patients and its growing. So really I was just concerned about the patients. For me it was not about the money. I didn't even think about the money. For me it was about the immune booster.'

She confirmed that senior officials from the National Department of Health (NDoH)'s Law Enforcement office had visited her office to 'follow up the directive - they wanted to check the evidence. When it started, how it came about ... I didn't feel any stress. It was a normal process ... part of their duties.' Mayekiso said she was not considering resigning, 'If I regret anything, it's even thinking about the concept of bringing in this project. I regret having met with them [Saulez Agencies CC]. If they didn't come I wouldn't have written all these things.'

 

Dr Francois Fourie

Dr Francois Fourie responded, 'I'm not going to really discuss anything or give my opinion above her [Mayekiso] . We communicate through our district manager. Even if I have a different opinion I'm not going to voice it out of professionalism. To be quite honest I'm not going to change the integrity I have because somebody else changes theirs . the bottom line is if somebody wants to crucify me or blame-shift, effectively if will mean that human judgment is above God's. No matter how badly I want to answer that question [speak outside the protocol] ... to save my behind, that's not my choice. I'm going to be ethical even if it kills me. I hope the senior people can answer the major questions and if they can't, they can instruct me to speak to you. I'm not sitting here with fear in my heart. I must say all of this is intriguing for me.' (Izindaba put his response to Mayekiso, who said she'd 'think about it.')

 

Dr Mamisa Chabula-Nxiweni

Chief Operating Officer for the Nelson Mandela Metro, Dr Mamisa Chabula-Nxiweni called and pleaded with Izindaba to await a 'thorough investigation, rather than [participate in] the destruction of my daughter,' denying she'd done anything to influence her child getting the job or any knowledge of an elaborate money-making scheme. 'I don't know if she can take any more. This whole saga is a political thing. As far as I'm concerned, this was approved by Siva Pillay and Mrs Makwedini with Francois Fourie who made them order the medication at the depot. I've been through so many allegations made by people in my own life - I don't want my child to go through this.' Chabula-Nxiweni, a mother of 10 university graduates, four of them doctors, said she knew Xego as a 'comrade and fellow school colleague of my brother. I came to know him in the political field. He's just a friend, like I call you my friend. I'm in no network of Xego's. I've always practiced ethically.' She described her children as 'very independent - if I'd used my influence I could have had my way with my son (now an orthopaedic surgeon in Namibia), getting him a job here. I knew there was not a single orthopod in Port Elizabeth!'

 

 

She said Fourie had once prematurely terminated another of her doctor son's contracts, yet she had not interfered, even dissuading her son from taking the matter to the labour court. 'I've kept myself clean and taught my kids good ethics.' She considered her daughter a 'pawn'. 'I live my life from work to home to church. I never wanted to be a politician. I've always aspired to be a straightforward administrative service-delivery person. A chance to save people of the metro where I was born is a priority of my life. She described her widowed daughter as 'a girl of 43 who's never been in a big place like PE. It's a coveted post and there's a lot of envy around. I've told her not to resign - she must fight on.' She said she had called 'Mike' (Xego) and told him, 'do you realise the thing you've let my child into?' Asked if she was angry with Xego, she replied, 'not really, he's a good friend'.

 

Mrs Nomalanga Makwedini

Acting Deputy Director of EC Clinical Services at the time (now CEO of the Nelson Mandela Academic Hospital), Mrs Nomalanga Makwedini, said Xego was referred to her by Dr Thabo Sibeko, the EC Deputy Director for Strategic Planning in Health. Xeko showed her documentation from the NDoH that seemed to support his contention that the Medicines Control Council had approved the Immutides Spray. 'He never asked me how to go about it. It was as if he'd already done that. It looked to me that what was being proposed would be good for the patient and I had no objection [given the national "approval"]. I knew that Xeko would still have to go via the required national tender process, so there was nothing untoward. The paper he showed said he'd been to national and there was nothing wrong with the drug.' Asked why she had not checked, Makwedini said the document was on an official NDoH letterhead and seemed authentic. She said she was unaware of any previous Immutides 'pilot roll-out,' as this would have happened in the actual district. 'I know the research protocols very well. You don't just impose things and say people will do this. Who underwrote the study? Which university? We (the EC) don't have an ethical committee anymore. There are so many loopholes as we speak... .'

Health MEC Sicelo Qobana was unavailable for comment.

 

Chris Bateman

chrisb@hmpg.co.za

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