‘TLC OXYGEN PLANT MEETS WHO STANDARDS’

Sir,

The agenda for Sustainable Development Goals (SDGs), scheduled for actioning by all member States by 2030, provides a shared template for the 17 SDGs, which include ‘good health and well-being’ (SDG 3). Member States, which include Eswatini, continue to make their final preparations for the United Nations 2023 SDG Summit, scheduled to take place in New York on September 18 and 19, 2023, which will mark the beginning of a new phase of the collective painfully slow progress, to date, in meeting all agreed SDG targets. The priority in Eswatini must be to focus on a quantifiable transformation and agreed accelerated action plans leading up to 2030. During the summit, my own thoughts will inevitably turn to January 6, 2021, the beginning of the second wave of the COVID-19 pandemic and the critical role played by The Luke Commission (TLC). A faith-based NGO located at the Miracle Campus in Sidvokodvo, which, since its inception in 2005, has been providing compassionate and comprehensive healthcare to the most isolated and underserved emaSwati.

TLC was one of just two health facilities in the kingdom during the second wave that accepted COVID-19 patients requiring intensive care (including myself). It is a provable fact that TLC admitted 90 per cent of all COVID-19 intensive care patients, yet still somehow managed to supply medical oxygen to other public and government hospitals around the country, which had run out of their own supply. With no local source for the production of oxygen, Eswatini was entirely dependent on the erratic and often unpredictable supply of imported bottled oxygen supplies from South Africa.

During the second wave of COVID-19, Eswatini’s mortality rate was among the highest in the world, at four per cent. Yet TLC, somehow, managed to secure a supply of medical oxygen, which resulted in the mortality rate actually reducing to two per cent. With thousands of lives saved, thousands of families still had a breadwinner. Yet at the height of the pandemic, at no time did the Minister of Health, Lizzie Nkosi, acknowledge, publicly, the critical role played by TLC in managing the kingdom’s response to the devastating pandemic and unprecedented demand for oxygen. TLC has never looked for compliments, but is motivated by a desire to serve the nation, both now and in the future. Notwithstanding, it was perhaps remiss of the minister not to ensure that TLC received some recognition for their incredible efforts in the face of adversity.

Prepared

For me, one of the key lessons from the pandemic was the need for a decreasing dependency on medical oxygen imports and a guaranteed reliable local supplier. Accessibility to a ready supply of medical oxygen is not just about being prepared for the next public health pandemic. It is also required for the treatment of other respiratory diseases such as pneumonia, accident trauma, snake bite victims and in support of operating procedures, as well as reducing the mortality rate for newborn babies, which is a key personal target for Eswatini under SDG 3. It should, therefore, come as little surprise that yet again, TLC decided to take the lead. On June 9, 2021, the first medical oxygen generating plant began producing oxygen on the Miracle Campus; a first in the medical history of Eswatini. A guaranteed medical oxygen independence which His Majesty officially acknowledged and to which he graciously gave his personal  blessing during the official opening of TLC just a few months ago.

Two years ago, I had the privilege of a personal guided tour of TLC’s E70 million new high tech oxygen producing plant, which now guarantees a reliable independent local supply of medical oxygen not just for TLC, but for other public and government hospitals in the country too. The minister of Health is getting all the benefits, but without having invested any money into the costly capital project; with the major investment in the oxygen plant coming from PEPFAR/USAID, Kirsh Foundation, UNICEF and FNB. The deposit to commence the capital project was provided by the directors using an emergency overdraft, the first in TLC’s history. Having done my own independent research, subsequent to my visit, I came to the conclusion that the medical oxygen produced, using state-of-the-art technology, not only meets, but likely exceeds the World Health Organisation (WHO) standards for medical oxygen. If I were the honorable minister, I would now be shouting ‘hallelujah’ from the rooftops, rather than seeming to offer her silent support to the critics of the much needed medical oxygen plant. But sadly it’s not to be.

Disappointingly, her response, some two years after the first medical oxygen was produced on a large commercial scale, was to belatedly challenge whether the oxygen plant meets the accreditation standards set out by the regulator requirements. Requirements which do not currently exist because, at the same time, the minister of Health is having to acknowledge that her ministry has only recently embarked on creating the regulatory quality control process, for the newly-established local medical oxygen production at TLC. Why, after more than two years, is it only now that a discussion is finally taking place about the need for a regulatory framework for the production of medical oxygen plants in the country? Why was there no guidance for two years, nor any blueprint in place on the regulatory requirements required? Is it a case of putting the cart before the horse without looking at the wider picture? A hidden agenda to actually close the plant at TLC after it has saved thousands of lives, until the regulatory requirements have been met or longer? Could it be that there are ulterior motives as to why the minister of Health is not enthusiastically limping towards the SDGs, but seemingly running away from them?

Accreditation

Respectfully, it could be argued with some conviction that, on the evidence available, the honorable minister would appear to have made a conscious decision to continue to ignore the positive role played by TLC and to join the ranks of the vocal minority, by prematurely labelling the project as an oversized white elephant and by now raising accreditation concerns.
As mentioned in my previous Right to Reply letter to the editor, the key role of any Cabinet minister is relationship building. Not least, with very ethical health institutions, such as TLC, which has always been willing to engage openly and to take up the baton in providing quality healthcare. It would now seem to be a case of damage limitation for the newly-appointed principal secretary. The unhealthy relationship which clearly now exists between the minister of Health and TLC needs to be repaired soonest, for the greater good of  the isolated and underserved emaSwati, whose basic health needs would appear to have been forgotten by the minister.

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