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Senegal:Youth Tackle Sex Taboos in Bid to Boost Contraceptive Use

Photo: Kieran Guilbert/Thomson Reuters Foundation

Women wait to be seen at a health centre in Dahra, Senegal on September 29, 2017.

By Kieran Guilbert

Louga — Watching as dozens of children don robes and belts for a karate class at a youth centre in western Senegal, Aissatou and her peers are gearing up for a different kind of fight.

Armed only with leaflets, posters and advice, these young volunteers are taking on a deeply entrenched taboo in the mainly Muslim nation: the use of contraception among girls and women.

“Girls are scared of seeing relatives at a health centre, or being judged by staff,” said Aissatou, one of 50 volunteers in the Louga region who advise young people about family planning and encourage them to seek health services at the youth centre.

“We offer a safe space to discuss sex, contraception and pregnancy,” the 22-year-old told the Thomson Reuters Foundation.

West and Central Africa has one of the world’s lowest rates of contraceptive use among women and teenage girls, who often lack knowledge about their options, struggle to access health centres, and face objections from their husbands and families.

However in Senegal, a drive to raise awareness, increase stocks of contraceptives, and provide youth-friendly sexual and reproductive health services has led to a rapid rise in the number of women and girls on birth control, health experts say.

“In recent years, the family planning community has pointed to Senegal as a beacon of hope for a region that has lagged behind on virtually all health indicators,” said Perri Sutton, senior programme officer at the Bill & Melinda Gates Foundation.

TARGETING TEENS

In Senegal, about one in four married women and girls aged 15 to 49 use modern contraception – up from 12 percent in 2011 – according to the country’s latest national health survey.

The Senegalese government aims to lift that figure to 45 percent by 2020, and increase the number of youth who use sexual and reproductive health services to 70 percent from 10 percent.

But only 7 percent of married teen girls use birth control in a country where one in three are wed before 18 – leaving many likely to fall pregnant, and at risk of dying during childbirth.

Complications during pregnancy and childbirth – such as fistula – are the leading cause of death among teenage girls worldwide, according to the World Health Organization (WHO).

Reducing teenage pregnancies not only saves lives, but can also improve gender equality in education and in the workforce, thus boosting economies in developing countries, according to an annual flagship report by the U.N. Population Fund (UNFPA).

Investing in family planning and narrowing inequality is therefore crucial if the world is to meet the U.N. Sustainable Development Goals (SDGs) – a global plan to end poverty, hunger, advance equality, and protect the planet by 2030 – UNFPA said.

“In Senegal, we are honing in on teenage girls … this is the first generation to have access to information and these services,” said Andrea Wojnar-Diagne, head of UNFPA in Senegal.

“The real impact will be seen in 20 or even 40 years … but more still needs to be done to change attitudes in rural areas.”

CONTROL

About one in three married girls and women in Senegal’s cities use birth control, compared with less than a fifth in rural areas – where men are often in charge of such decisions and many people consider family planning to be ‘un-Islamic’.

In Louga, 180 km (110 miles) from the capital Dakar, Aissatou and her fellow volunteers visit homes, talk on radio shows, and work with imams to challenge stigma surrounding contraceptives.

“We make it clear that we don’t encourage sex, or just give out condoms … and that family planning is not about stopping births, but spacing them, and preserving health,” she said.

In the nearby town of Dahra, midwife Fatim Fall said more girls and women were coming to discuss family planning with the blessing of their husbands. Yet many others, particularly teens, tended to visit at odd hours, without anyone knowing, she added.

One night, a woman came with her 14-year-old daughter. The girl had been forced into a marriage her mother had opposed.

“The mother was powerless to stop the wedding,” Fall said. “But she realised she could preserve her daughter’s childhood and protect her by secretly bringing her to get contraceptives.”

Among those waiting to see the midwife, 30-year-old Aminata said she started taking the pill after her first marriage ended in divorce, and discreetly continued to do so after remarrying.

“I feared the marriage wouldn’t last, and it didn’t,” she said, smiling wryly. “I feel at ease about using birth control, my family and friends know I do so and they don’t say anything … people are much more open to it than before.”

FUNDING FEARS

From pills to implants and injections, modern contraceptives are increasingly available for Senegalese women in the health system, even in rural regions, and tend to cost less than 500 CFA francs ($1), mainly due to funds from international donors.

Yet the United States, one of UNFPA’s top donors, said in April it would stop funding the agency as it supports “coercive abortion or involuntary sterilization” – a charge UNFPA denies.

It follows the reinstation by U.S. President Donald Trump in January of a policy known by critics as the “global gag rule” which withholds U.S. funding for international organizations that perform abortions or provide information about abortion.

While other nations have vowed to help fill the funding gap, the decision puts pressure on developing countries such as Senegal to invest more in family planning, health activists say.

Senegal says it will almost double spending on provision of contraception to 500 million francs ($900,000) by 2020 as part of the Family Planning 2020 (FP2020) initiative – which aims to give 120 million more women worldwide access to birth control.

In the meantime, volunteers like Aissatou and midwives such as Fall are determined to get more women and girls in Senegal talking about sex, contraception, and family planning – and taking control of all decisions concerning their bodies.

“Sometimes I hear about teenage girls – some as young as 13 – and their newborns both dying,” Aissatou said. “It is so sad … such a waste of life,” she added. “It makes no sense.”

– Reporting By Kieran Guilbert, Editing by Ros Russell

South Africa:Taxi March Suspended

The leadership of the National Taxi Alliance (NTA) has agreed to suspend the proposed protest action that was planned for Thursday.

“The Transport Minister would like to express gratitude to the leadership of the NTA for resolving to suspend the protest march and allow an engagement process to unfold in order to attend to the challenges facing the industry,” the Department of Transport and the NTA said in a joint statement.

On Tuesday, the department as well as the leadership of the NTA held a media briefing about the outcomes of a meeting that was held last with the Minister of Transport Joe Maswanganyi.

“The Minister would like to assure the taxi industry and the public that the department is fully committed to the provision of a safe, secure, reliable and quality public transport system.

“Taxis are by far the biggest mode of choice among the majority of South African commuter,” the statement said.

The taxi industry accounts for over 68% of passengers transported daily. The industry contributes R40 billion to the national economy each year and produces more than 300 000 direct and indirect jobs.

“As a result, the department will make all efforts to attend to current challenges facing the entire public transport sector and in particular the taxi industry,” the statement said.

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South Africa:Public Works On Cost of Repairing Public Buildings Damaged in KwaZulu-Natal and Gauteng During Recent Storms

press release

The preliminary cost of repairing public buildings under the custodianship of the National Department of Public Works damaged in KwaZulu-Natal and Gauteng during recent storms and flooding is estimated at over R16 million, Public Works Minister Nkosinathi Nhleko declared on Monday.

“While the final cost is being quantified to inform the final assessment, repairs at some of the 30 properties in KwaZulu-Natal, i.e. 17 state owned facilities occupied by South African Police Service, Departments of Labour, Justice and Defence as well as 13 leased facilities has commenced.,” highlighted Minister Nhleko.

Nhleko confirmed that repairs to South Gauteng High Court and Krugersdorp Home Affairs in Gauteng which were minimum have already been attended to.

He said that contractors are expected to be on site by the end of this week at all remaining sites after emergency procurement procedures and appointment of contractors have been finalised.

Minister Nhleko committed to mobilise resources to assist the affected provinces wherever possible.

He said that the MINMEC meeting held on Friday had noted progress and the leadership provided by Premiers of Kwa Zulu-Natal as well as Gauteng and expressed confidence that interventions aimed at mitigating the effect of the damage will minimise disruption to services.

“MINMEC expressed condolences to families that lost their loved ones during the disaster and appreciation of the commitment of officials who were part of rescue operations, disaster relief efforts and technical assessment teams. The heroic action of ordinary citizens and humanitarian organisations has demonstrated Ubuntu,” added Nhleko.

Issued by: Department of Public Works

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Ugandan Bank Fails to Sell All Shares in Mixed Trade

By Bernard Busuulwa

DFCU Bank Ltd’s rights issue was undersubscribed by 4.79 per cent, raising Ush190.67 billion ($52 million) against a target of Ush200 billion ($54.6 million) in a transaction characterised by strong institutional investor appetite and low uptake from retail investors.

The bank’s share price fell shortly after listing of the new shares.

Latest data compiled by Crested Capital, a Ugandan stock brokerage and investment advisory firm, shows that the DFCU rights issue recorded a subscription rate of 95.21 per cent as 250.88 million shares, priced at Ush760 ($0.21) per share, were absorbed.

Some 263,157,895 new shares were on offer, with an allocation ratio of 0.53 to one rights share issued. Abandoned new shares were 12.63 million, valued at Ush9.6 billion ($2.6 million), the data shows.

The rights issue was concluded on September 25 and the new shares floated on the Uganda Securities Exchange on October 10, 2017. The total number of listed shares on DFCU’s counter rose from 497,201,822 shares to 748,082,989 while its market capitalisation grew to Ush561.06 billion ($153 million).

Whereas most institutional investors took up their rights shares, we could not point out specific reasons for the high uptake within this segment.

Arise B.V., DFCU’s largest shareholder increased its stake from 55.08 per cent to 58.71 per cent while the National Social Security Fund increased their interest from 6.28 per cent to 7.69 per cent.

The Kimberlite Frontier Africa Naster Fund L.P-RCKM increased its stake from 5.93 per cent to 6.15 per cent while SSB-Conrad N Hilton Foundation-00FG raised its stake from 0.97 per cent to 0.98 per cent.

Vanderbilt University increased its stake from 0.8 per cent to 0.87 per cent while the Bank of Uganda Staff Retirement Benefits Scheme managed by Stanlib Uganda slightly expanded its stake from 0.58 per cent to 0.59 per cent.

In contrast, SCB Mauritius a/c CDC Group saw its shareholding drop from 15 per cent to 9.97 per cent, a change partly attributed to the company’s desire to exit the business after a 50-year relationship with DFCU while Banque Pictet and Cie sa a/c Blankeney L.P saw its shareholding fall from 0.95 per cent to 0.63 per cent, the data revealed.

DFCU Bank Ltd boasts of 10 institutional investors on its shareholder list that currently hold 88.81 per cent shares, a factor that leaves its fate in the hands of large, deep-pocketed investors.

However, the overall shareholding pegged to retail investors dropped from 12.96 per cent to 11.19 per cent, suggesting low appetite towards the transaction among individual investors.

While some institutional investors were apparently motivated by hopes of a smooth integration of DFCU Bank’s operations with those of the former Crane Bank that it acquired in January, stronger demand for credit, backed by steady declines in the benchmark policy rate and projected economic recovery, retail investors appeared discouraged by insufficient information on the acquisition, The EastAfrican has learnt.

A higher rights issue offer price of Ush760($0.21) compared to a previous trading price of Ush758 ($0.207) also put off many retail investors, with most of them preferring to buy new shares at the USE instead of taking up allocated rights shares.

The Bank of Uganda cut its Central Bank Rate by 0.5 per cent to a record low of 9.5 per cent this month, signalling a further decline in interest rates that’s badly needed to accelerate credit demand and economic growth that grossed just 3.9 per cent at the end of 2016/17.

Uganda:Ugandan Bank Fails to Sell All Shares in Mixed Trade

By Bernard Busuulwa

DFCU Bank Ltd’s rights issue was undersubscribed by 4.79 per cent, raising Ush190.67 billion ($52 million) against a target of Ush200 billion ($54.6 million) in a transaction characterised by strong institutional investor appetite and low uptake from retail investors.

The bank’s share price fell shortly after listing of the new shares.

Latest data compiled by Crested Capital, a Ugandan stock brokerage and investment advisory firm, shows that the DFCU rights issue recorded a subscription rate of 95.21 per cent as 250.88 million shares, priced at Ush760 ($0.21) per share, were absorbed.

Some 263,157,895 new shares were on offer, with an allocation ratio of 0.53 to one rights share issued. Abandoned new shares were 12.63 million, valued at Ush9.6 billion ($2.6 million), the data shows.

The rights issue was concluded on September 25 and the new shares floated on the Uganda Securities Exchange on October 10, 2017. The total number of listed shares on DFCU’s counter rose from 497,201,822 shares to 748,082,989 while its market capitalisation grew to Ush561.06 billion ($153 million).

Whereas most institutional investors took up their rights shares, we could not point out specific reasons for the high uptake within this segment.

Arise B.V., DFCU’s largest shareholder increased its stake from 55.08 per cent to 58.71 per cent while the National Social Security Fund increased their interest from 6.28 per cent to 7.69 per cent.

The Kimberlite Frontier Africa Naster Fund L.P-RCKM increased its stake from 5.93 per cent to 6.15 per cent while SSB-Conrad N Hilton Foundation-00FG raised its stake from 0.97 per cent to 0.98 per cent.

Vanderbilt University increased its stake from 0.8 per cent to 0.87 per cent while the Bank of Uganda Staff Retirement Benefits Scheme managed by Stanlib Uganda slightly expanded its stake from 0.58 per cent to 0.59 per cent.

In contrast, SCB Mauritius a/c CDC Group saw its shareholding drop from 15 per cent to 9.97 per cent, a change partly attributed to the company’s desire to exit the business after a 50-year relationship with DFCU while Banque Pictet and Cie sa a/c Blankeney L.P saw its shareholding fall from 0.95 per cent to 0.63 per cent, the data revealed.

DFCU Bank Ltd boasts of 10 institutional investors on its shareholder list that currently hold 88.81 per cent shares, a factor that leaves its fate in the hands of large, deep-pocketed investors.

However, the overall shareholding pegged to retail investors dropped from 12.96 per cent to 11.19 per cent, suggesting low appetite towards the transaction among individual investors.

While some institutional investors were apparently motivated by hopes of a smooth integration of DFCU Bank’s operations with those of the former Crane Bank that it acquired in January, stronger demand for credit, backed by steady declines in the benchmark policy rate and projected economic recovery, retail investors appeared discouraged by insufficient information on the acquisition, The EastAfrican has learnt.

A higher rights issue offer price of Ush760($0.21) compared to a previous trading price of Ush758 ($0.207) also put off many retail investors, with most of them preferring to buy new shares at the USE instead of taking up allocated rights shares.

The Bank of Uganda cut its Central Bank Rate by 0.5 per cent to a record low of 9.5 per cent this month, signalling a further decline in interest rates that’s badly needed to accelerate credit demand and economic growth that grossed just 3.9 per cent at the end of 2016/17.

Sudan:Malaria in East Darfur, Kassala – ‘More Than 50 Cases in Hospital Each Day’

Ed Daein / Kassala / Delling — East Darfur has seen a surge in malaria cases. The hospital in the state capital receives between 50 to 70 cases each day.

On Monday, a medical source at Ed Daein Hospital told Radio Dabanga that 50 to 70 new malaria victims visit the hospital on a daily basis. “Let alone the number of malaria patients in other clinics in the state.”

A doctor at the Ed Daein emergency department reported that the there are cases of normal type malaria, in addition to cases of cerebral malaria that affects the brain. “Of this type we receive between 10 to 12 cases a day.”

Medicines to treat malaria have seen a significant price increase in pharmacies outside of the capital, with the price of coartem reaching SDG75 ($11.15), while the price of injections against malaria from SDG70 to SDG90 ($13.40).

Doctors in West Darfur have reported a surge in the number of malaria patients starting September, crowding health facilities. The spread of the disease is probably caused by the rainy season and the spread of mosquitoes. Patients have appealed to the authorities and humanitarian organisations to provide medicines in the hospitals.

Kassala

In eastern Sudan, the Ministry of Health of Kassala has recognised the spread of malaria and typhoid fevers in the state, and denied the prevalence of dengue fever.

State Health Minister Abdallah Adam Abbas said in a press statement: “The diagnosis of dengue fever is the responsibility of the Ministry of Health which has the laboratories to analyse it.”

The minister announced campaigns to spray against mosquitoes are underway, to prevent the transmitters of the fever from spreading.

South Kordofan

Medical sources in Tima in the northern part of Delling locality, South Kordofan, announced that more cases of malaria have appeared, especially among children. Speaking to Radio Tamazuj on Thursday, an aid worker in Tima said that there are frequent complaints from locals about the growing spread of malaria among residents, amid an acute shortage of medicines.

Kucho Shaine Abajo, director of a local charity organisation working on peace building in the Nuba Mountains region, confirmed to the station that there are no health services in the area.

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Uganda Sports Official Nuwagaba Dies On Plane to Dubai

By The Independent

Kampala, Uganda | THE INDEPENDENT | Godfrey Nuwagaba, the treasurer of the Uganda Olympic Committee (UOC) is dead. The long time Uganda Athletics Federation (UAF) official died on an Emirates flight that was headed for Dubai on Monday evening.

UAF president Dominic Otuchet confirmed the news, describing it as a big loss to Ugandan sports.

“I talked to him three times before he left Entebbe, only to get news from UOC’s William Blick this morning that tragedy had struck in Addis Ababa,” Otuchet said.

“Because of his abilities he had many responsibilites, including being manager of many of our top athletes like Stephen Kiprotich.”

The cause of death is yet to be established but reports indicate that because of an emergency onboard, the Emirates plane headed to Dubai from Entebbe was diverted to Addis Ababa.

Nuwagaba was confirmed dead on arrival in Addis Ababa.

We have learnt with profound shock of the sudden and tragic passing of our Treasurer Godfrey Nuwagaba. More details will be provided. #RIP pic.twitter.com/n9v0RgMpnh

— NOC UGANDA (@Official_UOC) October 17, 2017

RIP Godfrey Nuwagaba, you have run your race. Ugandan athletics will not be the same again without you @Official_UOC

— Mark Ssali (@MarkSsali) October 17, 2017

Nuwagaba was reportedly traveling with his wife and child to Dubai on a business trip. He was an educationist.

The former long distance runner has been a key figure in Ugandan sports for the past decade where he has rises to treasurer of the athletics body UAF and Uganda Olympic Committee.

His last assignment was in July, when he headed the Uganda team at the Commonwealth Youth Games in Bahamas. Uganda won one medal, a gold by Josephine Lalam Joyce in the javelin.

DETAILS TO FOLLOW

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Govt’s Debt to Rise to 60% of GDP in 2018 – Moody’s Rating

By Kennedy Kangethe

Nairobi — Kenya’s rising debt is set to hit 60 percent of Gross Domestic Product by June 2018 according to Global rating agency Moody’s Investors Service.

In their latest report, the agency says Kenya’s debt to GDP has gone up to 56.4 percent from 40.5 percent in 2012.

Moody’s attributes the projected rise to high primary deficits and borrowing costs.

Kenya’s debt is currently at Sh4 trillion, 13 percentage points above IMF’s recommended benchmark for emerging countries.

According to Treasury, nearly half of the external debt is concessional compared to the costly commercial loans, with the other half held in domestic debts through treasury bonds and bills.

A $750 million (Sh7.6 billion) syndicated loan borrowed in 2015 is due for repayment this year, while the $2 billion Euro bond will mature in 2024, further exerting pressure on the government to set provisions for the payments.

The IMF, in its review of Kenya a year ago, said Kenya’s risk of external debt distress remains low but notes there is need for reduction in the deficit over the medium term.

The World Economic Forum ranks Kenya at number 77 out of 138 countries using the GDP/debt ratio score.

Japan is the most indebted country with a score of 248.1 percent of GDP, followed by Greece (178.4pc), Lebanon (139.1pc). The United States, ranked at 128, has a debt to GDP ratio of 105.8 percent, but with the highest total debt of $17.9 trillion.

Hong Kong, Brunei and Saudi Arabia are the least indebted countries at 0.1, 3.1 and 5.8 percent respectively. Algeria is fourth globally at 8.7 percent, while Nigeria is seventh at 11.5 percent of the GDP.

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Banks to Declare Lower Dividends

By James Anyanzwa

Kenyan banks are expected to declare reduced dividends to shareholders this year due to an increasing number of bad loans as borrowers struggle with repayment in an underperforming economy.

The situation is likely to worsen next year when banks start allocating more resources to cushion themselves from bad debts under a new set of global accounting rules.

The rules require banks to make higher provisions for bad loans by roping in even the risk-free lending to the government through Treasury bills and bonds.

Analysts at Renaissance Capital said high non-performing loans (NPLs) remain a big threat to Kenya’s banking sector, besides the interest rate law that has fixed lending rates at four percentage points above the Central Bank Rate (CBR), wiping out interest income for the lenders.

Analysts at AIB Capital said the prevailing political environment is an impediment to economic productivity since most investors have suspended their plans while some have chosen to trim their workforce to cut costs.

Political environment

“On the back of this we expect loan book quality to deteriorate further,” AIB Capital said in its banking sector report for October.

“With low economic activities, aggregate consumption reduces, corporates scale down on operations and consequently private sector and public sector incomes reduce. This will have the effect of deteriorating the quality of the existing debt stock.”

According to Renaissance Capital, Kenya’s big banks are likely to weather the political and economic storms and provide some fairly good returns to the shareholders compared with the smaller and mid-sized banks that have lost huge deposits to big banks through flight to safety.

These big banks include KCB, Equity, Co-operative Bank, Barclays Bank, Standard Chartered Bank, Diamond Trust Bank and Commercial Bank of Africa, according central bank’s latest ranking in terms of market share.

Equity Bank has suffered the highest deterioration in its NPL book since the rate cap law was implemented in September last year.

This is due to the bank’s unsecured portion of its Small and Medium-sized Enterprises lending, exposure to trade customers and delayed payments for suppliers by the government.

Its loan book has contracted with most of the funds being channelled to government securities.

“What concerns us most about Equity is the trend in NPLs. While the deterioration in the NPL ratio to 7.3 per cent in the first half of this year from 6.8 per cent in 2016 and 4.6 per cent in the first half of 2016 can partly be explained by the lack of loan growth; NPLs in absolute terms were up by 1.6 per cent in the 12 months to the first half of 2017,” Renaissance Capital Market report dated September 28 notes.

KCB’s NPL stands at nine per cent though the lender continues to struggle with stock of bad loans, compared to its tier 1 peers.

The lender announced a Ksh900 million ($9 million) cost restructuring this year and with only 14 per cent of transactions currently taking place in branches.

Analyst at Renaissance Capital expect the bank to further cut its workforce.

Co-operative Bank which has the lowest NPL among listed banks recorded the highest loan growth of seven per cent in the first half of this year as a result of existing customers taking on additional credit lines, and growth in the personal loan segment of the loan book.

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South Africa:Mental Health Patients’ Lives Could Have Been Saved – Report

Social worker says mental health patients’ lives could have been saved if senior officials visited facilities. Bhekisisa has evidence they did.

A social worker from one of the three Cullinan care facilities responsible for the deaths of at least 25 mental health patients says their lives could have been saved if senior officials had known conditions on the ground. But evidence from an exclusive Bhekisisa interview with former Gauteng health MEC Qedani Mahlangu shows she visited the organisations in August 2016.

On Monday, Cullinan Care and Rehabilitation Centre social worker Daphne Ndhlovu testified as part of an ongoing arbitration process regarding the Life Esidimeni tragedy in which at least 141 mental health patients lost their lives.

Ndhlovu admitted that standard procedures were not followed when the centre admitted 163 public sector patients from private healthcare provider Life Esidimeni after the Gauteng health department terminated its contract with the hospital group in March 2016 to save money.

Replying in response to questions from arbitration leader and retired Deputy Chief Justice Dikgang Moseneke, Ndhlovu says that the centre outside of Pretoria could only accommodate 150 patients but ended up with almost double that number after Life Esidimeni patients were transferred there.

To make room for the influx of new patients, the Cullinan Care and Rehabilitation Centre moved some patients to two nongovernmental organisations (NGOs) operating on its grounds, the Anchor Centre and Siyabadinga.

Siyabadinga, which received 73 patients from Cullinan, was never licensed to provide care to mental health patients, found a February health ombudsman report.

At least 25 mental health patients housed at one of the three organisations later died, revealed the report. Now, Ndhlovu says deaths could have been avoided if senior Gauteng health officials had visited the centre.

We were given instructions from above. The people that weren’t even around at institutional level to see the problems,” she said before lawyers and families as arbitration entered its second week.

But in an exclusive October 2016 interview with Bhekisisa, Mahlangu admitted she visited all three facilities in August 2016.

Mahlangu explained: “During the elections, we visited [Cullinan Care and Rehabilitation Centre], and this Siyabadinga and Anchor. We observed there was no working relationship between the two NGOs. My exact words were, ‘We are all looking after the patients on behalf of the state, you have got to use the common kitty that is provided to you … ‘”

Mahlangu, who is not currently on the list of witnesses set to testify at the arbitration, maintained she inspected facilities such as a shared kitchen on the property in interviews with health ombudsman Malegapuru Makgoba as evidenced in his report.

Ndhlovu also confirmed suspicions of Life Esidimeni families that many patients were transferred to local NGOs or other state hospitals without documentation.

Ndhlovu estimates that about 60% of the patients admitted at the Cullinan centre did not have medical records and almost a third had no identity documents. And as the centre staff were pressured to accept more patients, Ndhlovu says things got “hectic” and normal admissions procedures were not followed.

And she explains that standard screening techniques would have prevented the Cullinan Care and Rehabilitation Centre from admitting patients that needed more care than the centre could provide such as those with schizophrenia. Schizophrenia is a chronic mental health condition that can result in hallucinations and delusions, according to the United States nonprofit research organisation Mayo Clinic.

Ndhlovu warns that Siyabadinga was even less prepared to care for extremely ill patients as it had no professional nurses. She says she voiced her concerns about the lack of professional medical staff but alleges she was threatened with being accused of insubordination if she did not follow orders.

“It was very painful for us to hear every second day that another patient has died. We were not giving justice to our patients but it was instructions from above,” Ndhlovu says.

Arbitration is expected to continue until at least October 30, according to head of the arbitration office Obakeng van Dyk.

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