Department of Health readiness for the 2010 FIFA World Cup: Briefing

Meeting report

The Department of Health briefed the Committee on its state of readiness for the 2010 FIFA World Cup. The delegation comprised Ms Carol Marshall Acting Deputy Director General: Health Planning and Monitoring, Mr Peter Fuhri Director:  2010 World Cup, Mr N Mphaphuli Director: Revitalisation of Infrastructure and Mr Joe Kgatla Parliamentary Liaison Officer for the Department of Health. Mr Fuhri conducted the briefing.

A Ministerial Guarantee had been given to FIFA on the availability of health and medical services. It included the accreditation of foreign medical staff, approval of medicines and also the marketing, distribution, serving and consumption of alcohol at stadia. The scope of responsibilities was command and control of management and control, planning, communications, national health operation centre and provincial health operation centres amongst others. It included health services which comprised of environmental health, port health, travel medicine, hospitals and communicable diseases to mention a few. Medical services that had to be made available included EMS, medical centres, mass casualty, aero-medical and chemical, biological, radiological and nuclear hazards.

The Department and the Local Organising Committee (LOC) had entered into a Memorandum of Agreement in June 2008. It would provide clarity on either’s responsibilities in order to prevent overlaps. The Department was appointed as service provider for the LOC. Some of the service areas of the Department included monitoring communicable diseases at ports of entry, having medical staff at headquarter hotels and being prepared for mass casualties or deaths.

Host City service areas included clinics, FIFA Fan Parks and Public Viewing Areas. Members were provided with a breakdown of work done by the Department during the 2009 FIFA Confederations Cup. A Health Technical Task Team had also been set up by the Department. Amongst the role players were provincial health departments, SAPS, host cities, SALGA and South African Military Health Services (SAMHS). A Preparations Work Group was also set up.

Members of the work group included the National Department of Health 2010 World Cup Unit which was the convener, provincial health 2010 co-ordinators, host cities and the LOC Medical Office. The Health Technical Task Team met quarterly and the Preparations Work Group met monthly. Preparation activities included the 2010 FIFA World Cup Plan, environmental health strategies, provincial and host city visits, FIFA inspections, a web based project management system and training.

Stadia, FIFA Fan Parks and Public Viewing Areas had certain criteria for medical facility design and specifications for lighting, ablutions, backup power etc. A casualty clearing station was also needed. FIFA issued specific requirements for the players and VIP medical centres, and doping control. The Department had recommended plans for spectator facilities based on statistics from previous events, and with a view to forthcoming legislation. Mass gathering regulations would be utilised to determine medical resource requirements at mass gatherings.

The Department was considered for the most part to be in a state of readiness. Some of the challenges included not having timeous information, budgetary constraints and EMS.

For further details please refer to the attached document, “National Department of Health, 2010 FIFA World Cup, State of Readiness”.

Discussion
The Chairperson said that the Committee wished to check on the preparedness of the Department for the 2010 FIFA World Cup. There were problems with service delivery in provinces. The briefing had been silent on the issue of traditional medicines and the role that it played. Tenders, shortage of personnel and HIV were some of the issues members had hoped the Department would elaborate on.

Mr M Waters (DA) noted that the briefing had alluded to the fact that funds had been allocated to the 2010 World Cup but had not been used for it. He asked how much had been allocated, used and where did the rest of the funds go to. Was the health service to South Africans being impacted upon by the preparations for the 2010 World Cup?
He said that strikes by EMS staff over OSD issues were possible. What was the Department doing about preventing strike action?
A significant upgrade of health infrastructure for the 2010 World Cup was in the pipeline. Was it over and above normal infrastructure upgrade? Where were these hospitals located?
Were there regulations regarding tobacco use for the 2010 World Cup?
Referring to environmental health, not much had been said about water, food safety had been spoken about. Were there discussions with the Department of Water Affairs?
If 524 new persons were being trained in forensic pathology were these individuals to be permanent employees? Forensic pathology needed staff as it had huge backlogs.
Port health covered legal points of entry. What about illegal points of entry?
What was the Department doing about informing visitors about HIV and AIDS?

Ms Marshall said the Department’s budget planning had taken place years ago. The original approach was just to request funds and to see if it was approved. National Treasury gave the Department a budget. Treasury said that much of what was needed for 2010 was not in the system.
He said that he would try to obtain figures on how monies allocated to the provinces for use on the World Cup had been used elsewhere.
The Department was now mobilising its resources in a more integrated way. There was a need for single alignment. Provinces were at present also placing their resources on the table. Earmarked funding was only part of it.

Mr Fuhri said EMS staff believed proper evaluations had not taken place. Salaries were the main concern. The situation had to be managed better.
He noted that there were no extra funds for the upgrading of facilities. More funds had been spent on EMS.
Smoking or tobacco use was banned in the stadia. No guarantees were given by the Department on it.
Water integrity was captured but discussions with the Department of Water Affairs were yet to take place. Environmental health was all encompassing.
Training had taken place on forensic clinical medicine. Nurses were trained on how to deal with persons that had been attacked or assaulted. There was a psychological component.
He could not comment about port health on illegal points of entry.

Mr D Kganare (COPE) asked if provinces had used funds allocated for the 2010 World Cup for other purposes. Would there be a shortage of funds?
EMS reaction times were a problem. Was it to be addressed? If reaction times were better during the World Cup would it be maintained after the event?
How was the World Cup going to affect the provision of health services to normal South Africans?
Had arrangements been made with health workers so no one was allowed to take annual leave during the World Cup period?
Had the Department entered into agreements with the private sector regarding assistance during the World Cup?
Labour disputes should also be prevented at World Cup time as it could tarnish SA’s image.
Had the Department identified the possible communicable diseases that could perhaps find its way to SA?
Tenders were important and had to be monitored by the Department. It should not be left in the hands of the provinces alone.

Mr Fuhri said that EMS reaction times were an ongoing issue. A strategic plan was in place to improve EMS by 2015.Provision of normal health services had to continue. More funds were, however, needed to pay for overtime. Negotiations were taking place over the issue of annual leave at the time of the World Cup. National Treasury had put out tenders to attract staff from the private sector to assist during the 2010 World Cup. Bed usage at private hospitals was also being considered. Hence the private sector was coming on board. Communicable diseases were an ongoing issue. As communicable disease cases came up it would be treated.

Ms T Kenye (ANC) asked if stocks at blood banks had been considered, if there was a disaster during the World Cup.
She asked if emergency helicopters could not fly at night, what alternatives would there be.
How were delays in EMS response times to be addressed?

Mr Fuhri said that the National Blood Bank Services was working on a campaign to build up stocks and to have stocks where it was needed.
The use of helicopters at night was a worldwide issue as the costs were astronomical. EMS response times were an issue that required daily improvement. The Department did not see a worsening of response times.

Ms M Dube (ANC) asked whether during the World Cup there would be dedicated lanes for emergency vehicles.
Were bed and breakfast establishments visited to check on health issues?
Had condoms been distributed to places where tourists were to reside?
Was there an emergency hotline for ambulances?
She questioned why alcohol was even allowed at the stadia. If consumed irresponsibly it could cause violent behaviour. Was it to be served in glass or plastic containers?

Mr Fuhri said that there were traffic free zones around stadia. Work was ongoing with SAPS, traffic and metro police.
Negotiations were taking place with the LOC, on placing condoms in toilets. Condoms would also be available at fan parks and public viewing areas. Discussions with hotels were taking place over the condom issue.
The hotline emergency number for ambulances was 10177. It was a national number and it was toll free. It had been in existence since 1987.
Alcohol would be sold in plastic cups at stadia. Only Budweiser beer would be sold. Budweiser was one of the tournament sponsors.

Ms M Segale-Diswai (ANC) was disappointed that the delegation only comprised of persons dealing with 2010 issues. Every time the Department appeared before the Committee new faces were seen.
If each province had a health operations centre where in each province were they located? Details were required.
If hospitals were upgraded, what about clinics and health centres?
She asked what was being done about the issue of staff shortages. How were vacancies to be filled if the budgets were lacking? Was funds allocated for the taking on of extra staff?
How was health staff at stadia to work with staff from other departments?
The issue of sex workers was a concern. What was the Department doing about this?

A list of health operation centres in each province would be forwarded to the Committee. The issue of upgrading of clinics would be followed up with the provinces.
Mr Fuhri said that staff shortages were being addressed. National tenders had been published through National Treasury in partnership with the provinces.
He was unable to comment on the progress over the issue of sex workers. Problems with HIV and AIDS continued.

Ms A Luthuli (ANC) was concerned about the cleanliness of SA itself. The surroundings formed part of environmental health.
She asked for detail around the issue of alcohol usage at the stadia.
How was the Department to handle hooliganism during the World Cup?
She suggested that doctors and nurses be used as volunteers. A database should be kept of health persons as a backup in the event that they were needed.

Mr Fuhri said hooliganism did not fall within the ambit of the Department. It was an issue to be handled by SAPS in co-operation with those countries that experienced the phenomenon.
A volunteer database was in place where volunteers could register. A website was available.

Ms E More (DA) asked at what hospitals were significant infrastructure upgrades going to take place.
Where was the Department on the process of accreditation of medical personnel and the approval of medicines?
How was health promotion to take place?
What was the extent of the medical equipment to be purchased?
What steps were the Department taking to ensure the safety of EMS staff during the event.
She asked how far the Department was progressing on the filling of posts.
Not much had been said about diagnostic radiographers. There was a shortage of them. Was the Department addressing the issue? 
She further asked if there were extra funds for the payment of extra staff that would be used during the 2010 World Cup.

Mr Fuhri said a list of designated hospitals for upgrading would be provided to members.
He noted that it was difficult to comment on what each province was doing to ensure the safety of EMS staff. EMS staff were equipped with panic buttons.
No comment was given on the issue of radiographers.
He explained that there was additional funding for staffing. Tenders were in place for the use of volunteers. A stipend would be payable to volunteers.

Ms C Dudley (ACDP) asked if it was correct that the Department felt that FIFA accreditation was holding up the Department’s process of deploying people.
She noted that persons at grassroots level stated that the moratorium on the hiring of doctors should be lifted.
The issue of rats was a problem in the Western Cape. She asked if the problem extended beyond the Western Cape. Rats were huge carriers of disease.

Mr Fuhri said that on FIFA accreditation the Department had a committee with the LOC who represented FIFA. The accreditation of foreign personnel was also taking place. It was an administrative process. Particulars had been forwarded to FIFA and the Department was awaiting the return of the documents. In the end each soccer team would receive an official accreditation letter from the Minister.
He agreed to look into the rats’ issue.

Ms M Mafolo (ANC) asked why little had been said about the H1N1 virus.

Mr Fuhri said that unfortunately he did not have the H1N1 figures at hand.

The Chairperson said that it was evident that members were concerned by challenges faced by the Department. Members wanted assurances on how the Department was coping with the challenges. If provinces were allocated budgets for use on the 2010 World Cup and funds were used elsewhere, the issue needed to be corrected.
The World Cup was during winter, would people have access to medical assistance at stadia.
The Chairperson said that the Committee had hoped to be briefed on the asset infrastructure of the Department but due to time constraints it was not possible. 
Staff shortages, EMS and the monitoring of provinces were some of the issues that remained concerning.
The Chairperson said that the briefing had given him some hope that things were falling in place.

Mr E Sulliman (ANC) took over as Acting Chairperson whilst the Chairperson had to be temporarily excused from the meeting.

Ms Dube had expected the briefing to give the Committee a sense of what the Department had and what was needed. She did not get a sense that the Department was ready for the World Cup.
By now the Committee should have been convinced that the Department was three-quarter prepared for the event.

Ms Luthuli said that environmental health was in a mess as SA was filthy. Dirt was strewn everywhere.

Mr Fuhri said that environmental health would be discussed with local authorities. It did not fall within his realm.

The meeting was adjourned.