By Melusi Ncala First published in The Star and the Cape Argus

The journey of life is full of decisions. Whether the outcome is good or bad, we can be sure these decisions affect not only us directly, but our loved ones, colleagues and acquaintances too. The decision to pen this piece may seem fruitless to some, for the simple reason that it is one voice among a cacophony of others. But those voices echo sentiments of daily horrors faced by communities and families as a result of certain elites’ politics to give or take as they wish.

As insignificant my resolution to speak out may appear, it is borne out of compromises made, and that continue to be made, by those who have been entrusted with power.

So, too, the decision to engage in corrupt activities has a ripple effect. In the public healthcare sector, corruption is a reality for over 500 persons who have told Corruption Watch of the hardships they endure when they visit government health facilities throughout South Africa.

Their individual stories depict an ailing health system propped up by uncaring, morally bankrupt officials. Corruption is the order of the day – the accused are administrators, nurses and doctors entrusted to alleviate some of the stresses of those who have no choice but to live or die at the hands of a merciless system. As a result, 83% of the population relies on public health facilities that are overburdened because of a shortage in nursing and medical staff as well as beds, equipment and food.

Corruption also lies at the heart of the current nyaope crisis. This evil concoction contains varied ingredients ranging from rat poison, heroin, and cannabis, to crushed antiretroviral tablets – not all at the same time. It has destroyed homes and deepened the hole for destitute youth in this country. Despite the gains made to address the HIV/Aids pandemic after the senseless deaths of thousands of South Africans during the Mbeki denialism era, it is alarming to think that employees of hospitals and clinics are alleged to be involved in this new horror. They are said to supply drug dealers and other criminal elements with ARVs for nyaope, just so they can line their pockets – a quick fix at the expense of the lives of some of the most vulnerable in our society.

We must recall the harrowing cries of a young mother whose baby died after she gave birth on the floor of a hospital corridor. One person recounted the sight of “a patient with a ruptured ectopic pregnancy (who) lost three litres of blood”, explaining that “from admission till time of surgery… the patient waited more than two hours” for a doctor notorious for absenteeism. This incident is part of the 32% of corruption cases reported to us that highlight irregularities in employment in the sector.

These allegations illustrate how moonlighting doctors bill the state for many hours of work not done, while fingers are pointed at officials who issue salaries to non-existing persons, known as ghost workers. These same officials solicit bribes from job seekers, creating an opportunity for the appointment of unqualified persons – these incidences contribute to the more than 17% of health-related bribery cases reported to us.

As if this is not enough, almost 10% of graft accusations show how doctors, nurses, and other officials steal equipment, medication and funds.

It should concern us all when concerns are raised around issues of politically connected companies repeatedly securing lucrative deals without due process being followed.

How can we measure up to the test? We must decide whether corruption aids the country in building health facilities on which you and I, your parents and mine, our children, friends and compatriots can rely, during our hour of need.

Negligence, impunity and corruption cost lives.

• Melusi Ncala is a researcher at Corruption Watch