Dear Portfolio Committee on Health,

South Africa does not have enough Ambulances or Paramedics. Residents of Witzenberg (which includes the towns of Ceres, Tulbagh, Worcester, Nduli, Op Die Berg and Prins Alfred Hamlet) can confirm this from our experiences of long waiting times both to get to hospital in an ambulance and once arriving at the hospital. Despite being one of the wealthiest agricultural regions in the Western Cape, and with a population of 153 475 people (per the Western Cape Government's 2022 Socioeconomic Profile for Witzenberg), the district doesn't even have 10 ambulances! In 2022, Witzenberg Justice Coalition took up this crisis in our health struggle. We called on the Provincial Department of Health to commit to more doctors, more ambulances and more beds for Ceres Provincial Hospital. Although there have been several engagements with the Provincial Health Department and with the municipality, the solutions are slow compared to the challenges occurring daily at the hospital and at clinics in our district.

Our questions to the Portfolio Committee on Health are:

- What is the plan to address the shortage of ambulances in South Africa?
- How many ambulances are broken, in which health districts, and by when will they be fixed?
- What is the ambulance to population ratio per health district, including for Witzenberg?
- How is an acceptable ratio determined?
- What is the number of unfilled vacancies on the establishment per health district (including Witzenberg) and per medical personnel type (e.g. doctors, nurses, paramedics)?
- What is the patient to doctor / nurse / paramedic / medical administrator / medical assistant / dentist / midwife / pharmacist ratio per health district?
- What are the key shortages in medical personnel and where are these shortages the worst geographically?
- What is being done to address security concerns at medical facilities?
- When is the last time each hospital has had a check on whether the fire alarms and hoses at its facilities are working?
- What measures should the relevant departments and institutions involved in provision of health care be taking ensure that personnel provides care that is in line with the norms and standards?
- When was the last inspection of the Office of Health Standards Compliance per hospital?
- Which hospitals and clinics currently do not meet the required health standards?
- Besides medical facilities self-reporting on health standards indicators to OHSC, how does the monitoring information get verified?

Naomi Betana
Convenor, Witzenberg Justice Coalition