Izindaba ze-BMET ngesiZulu A U G U S T 2 0 1 3

Ngonyaka ka 2009 i Centre for Economic Governance and Aids in Africa (CEGAA) kanye Treatment Action Campaign (TAC) bakha umfelandawonye ukubheka ukulethwa kwezidingo zezempilo kubantu eMgungundlovu KwaZulu-Natali, kanye nase O.R. Tambo eMpuma-koloni, kusukela kwisabelo-zimali kuya endleleni izimali ezisetshenziswa ngayo ekhuphuleni izinga lezempelo zabantu abaphila nesandulela-ngculazi (HIV) kanye nesifa sobu (i-TB). Loluhlelo lwaqondiswa ngqo ekusikeleleni uhlelo lwahulumeni lokuletha izidingo zezempilo kubantu, nokuthi izimpilo zabantu zinakekelwe ngendlela eyiyo kusetshenziswa lezi zimali uhulumeni asuke esezifakile ezinhlelweni zezempilo.

Ukunikezelwa kwamandla ebantwini Izinkathazo zihlangene nethemba kwezezimali zezempilo, ne HIV/AIDS

kanye ne-TB eMgungundlovu nase O.R. Tambo (eLusikisiki)

Imininingwane yokuxhumana: CEGAA Email: nhlanhla@cegaa.org or admin@cegaa.org Telephone: +27 73 198 7219 Websites: www.cegaa.org www.tac.org.za Izithombe ezakwa CEGAA

Ibhalwe ngu MLUNGISI MAJOZI (Durban University of Technology – Indumiso), beno MLUNGISI VILAKAZI (ilunga lakwa TAC), yahlelwa ngu NHLANHLA NDLOVU wakwa CEGAA

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Zahlangana kanjani lezizinhlangano ezimbili, u-TAC no-CEGAA? Ngaphambi kwale-project, ebizwa nge Budget Monitoring and Expenditure Tracking (BMET), u-TAC wayelwela amalungelo abantu kwezempilo ukuze abantu abaphila nesandulela-ngculazi nengculazi babhekeleleke kwezempilo ezitholakala emitholampilo nasezibhedlela. Isikhathi esiningi uhulumeni wayesebenzisa izimpendulo ezimayelana nezimali ukucacisha izizathu zokuhluleka ukufeza izidingo zeziguli, ethi izimali azenele. Kodwa kwelinye icala u-CEGAA wayebheka ezezimali ukuthi ngabe ingakanani imali efakwe ezinhlelweni zokulwisana nesandulela-ngculazi nengculazi nanokuthi lemali isetshenziswa kanjani. Ngesikhathi u-TAC nomphakathi bekhala ngokuthi izidingo zabantu azitholakali emitholampilo u-CEGAA wayehalalisa ngobukhulu bezimazi ezifakwa kulezizinhlelo zezempilo nanezinga uhulumeni ayesekwazi ngalo ukusebenzisa lezizindodla zemali efakwa kumnyango wezempilo ukuze ulwisane ne HIV/AIDS. Kwabe sekucaca ukuthi kukhona okushodayo emsebenzi owenziwa yilezinhlangano zombili uma zizimele ngazodwana. Kwadingeka ukuth zihlangane ukuze kuphenduleke imibuzo yezezimali u-TAC ayenenkinga nayo, kanjalo nemibuzo yokuthi kungani abantu bekhala kodwa kube kunezimali ezingaka u-CEGAA ayezibona zifakwa kulezinhlelo zezempilo. Kwadingeka ukuthi u-CEGAA aqeqeshe u-TAC ekulandeleleni ezezimali nokuthi zisetshenziswa kanjani, esebenzisa uhlelo olubizwa nge BMET – Budget Monitoring and Expenditure Tracking. Kanjalo no-TAC kwakumele aqeqeshe u-CEGAA ekusebenzisaneni nomphakathi nabantu abasebenzisa umnyango wezempilo ukuze luthi lonke ucwaningo olwenziwa u-CEGAA lube nobufakazi ukuthi kungabe abantu emiphakathini bayayibona yini imiphumela yalezizimali ezingaka ezifakwa uhlulumeni ezinhlelweni zezempilo, eze HIV ne AIDS, kanye nezesifo sofuba. Ucwaningo lokuthola ubufakazi ngezingqinamba ekunikeni abantu izinhlelo zezempilo ezisezingeni elifanele Ukuze kutholakale ubufakazi mayelana nokutholakala kwezidingo zezempilo kusetshenziswa izimali ezivela kuhulumeni omkhulu kwadingeka ukuthi kube nezinhlelo zokuthola imininingwane kubantu abasebenzisa imitholampilo nezibhedlela, kanjalo nakubasebezi bakulezi zikhungo ukuthi bona bazibona kanjani lezinhlelo abazidlulisela kwiziguli emitholampilo nasezibhedlela. Kuningi okwatholakala kulolucwaningo, njengoba izibonela zinikiwe ngezansi. Izinselelo ezisasele Kusenezinselelo ezikhungweni zezempilo okuveza ukuthi imitholampilo nezibhedlela azikakulungeli ukunikela izidingo zezempilo kubantu ezisezingeni eliphuzulu. Ucwaningo lwaveza ukuthi imitholampilo nezibhedlela zinendawo encane ukwamukela izinye iziguli eziningi okuholela ekubeni iningi labantu libuyele emakhaya lingalutholanga usizo.

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Amabanga ahanjwayo kuyofunwa usizo lwezempilo nawo made kakhulu kwezinyo ezindawo ezisemaphandleni ikakhulukazi ezindawe zaseLusikisiki eMpuma-koloni. Ngokomthetho-sisekelo bonke abantu bayalingana kanti kufanele baphathwe ngendlela elinganayo futhi ekutholakaleni kwezidingo zabo. Iziguli azenelisekile ngesikhathi sokuvula nokuvala imitholampilo ngoba isikhathi esiningi sichitheka iziguli zishishiliza ezihlalweni, kwesinye isikhathi ize ivalwe imitholampilo, ikakhulukazi lapho kukhishwa khona imithi namaphilisi, i-Pharmacy, iziguli zibuyele emuva zingakutholanga ebezikuzele. Kwaba sekushiwo ukuthi ukushoda kwabasebenzi bezempilo okwenza ukuthi kube nalezinkinga isikhathi esiningi. Kanjalo nokuminyana kwezindawo ezinikezela ezempilo kubantu kube into engamukeleki ezigulini. Lokhu kuze kube ingozi lapho iziguli ezinesifo sofuba zihlala ndawonye neziguli zonke, okungaholela ekutheni i-TB yade kutheleleke neziguli ezifike emtholampilo zingenayo. Kusenjalo kwaphinda kwavela ukuthi abasebenzi bezempilo abaziphathi kahle iziguli, bezithethisa bengaziniki inhlonipho eziyidingayo. Kwaphinda kwacaca ukuthi uhulumeni akakwazanga ukunyusa ubuningi bezisebenzi ukuze isibalo seziguli esandayo sikwazi ukubhekeleleka kahle. Bebuzwa ngalokhu abasebenzi bezempilo bakhale ngobuningi beziguli okumele bazibone, baphinde babeka nabo ukuthi ukunganeli kwezidingo zomtholampilo ukuze usize abantu nabo bakuthola kuyisinengiso, okwenza ukuthi nabo bacasuke uma iziguli zibacasukela ngoba nabo abanawo amandla okushintsha izinto. Kwaphakanyiswa ukuthi ukubonelelwa ngokudla kusemqoka ukuze ukwelashwa kuhambe kahle. Uhulumeni kufanele enze isiqiniseko sokuthi iziguli ezelashelwa isifo sengculazi nesofuba zithole isibonelelo sezijumbana zokudla ikakhulukazi laba abangenayo imali ukuze baqhubeke nokudla imithi yabo. Kufanelekile futhi ukuthi kube khona izimoto eziyimitholampilo ukuthi zihambele izindawo ezingenayo imitholampilo. Kanjalo nama ambulensi ayafuneka ukusiza abantu abakude nezibhedlela. Okubi ke ukuthi lezizinsiza azitholakalanga kahle ukuze kusizakale abantu abakude kakhulu nemitholampilo nezibhedlela. Enye yezinkinga ezinkulu ezatholakala ukuthi amapheshana anolwazi ngezempilo aphelile ezindaweni zezempilo, okwenza ukuthi iziguli zingatholi lutho ezingakuthatha ziyokufunda emakhaya ukuze zithuthukise izimpilo zazo. Amahovisi akwa TAC agcina esesiza ngamapheshana – ama-leaflets, booklets, posters – ukuxhasa imitholampilo ngokubhaliwe. Kodwa namahovisi akwa TAC nawo asephelelwe ilamabhukwana osekwenza kube nzima ukufafaza ulwazi kwezempilo. Kufuneka lamapheshana akhiqizwe ngokukhulu ukushesha ngoba asadingeka namanje emitholampilo. Ukucwaswa kweziguli emitholampilo nasemphakathini kubambezela ukubhekana nokukhuluma ngesandulela ngculaza nengculaza uqobo, ngakho kumele kuthathwe izinyathelo ukuze kuqedwe lokucwaswa kweziguli. Amakomidi emitholampilo (clinic committees) namaqembu okusekana (support groups) kumele kuvuselelwe ukuze kulwe nezinkinga ezifana nalezi. Nokufundiswa komphakathi kubalulekile ukuze imindeni ifunde ukunakekela nokwamukela amalunga ayo agulayo.

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Ngubani olalele izikhalazo zabasebenzi bezempilo? Ucwaningo  lwasemphakathini  nasemitholampilo  lwaveza  ukuthi  abasebenzi  abajabule  ngezinga  lezinhlelo  zezempilo  abazidlulisela  ebantwini,  ngenxa  yenani  elincane  labasebenzi  basemitholampilo,  abagqilazekile,  bengakwazi  nokuthatha  ikhefu  (leave)  okuyilungelo  labo  ngenxa  yobuningi  bomsebenzi  nokushoda  kwabasebenzi.  Imithi  ithatha  isikhathi  ukufika,  ikakhulukazi  eLusikisiki  lapho  kusakhalwa  ngikungatholakali  kwemithi  yengculazi  ne-­‐TB  ngendlela  esheshayo.  Lendlaki  seyaxazululeka  eMgungundlovu  seyifana  nephupho  nje  ukuthi  kwake  kwaba  khona  ama  ‘waiting  lists’  ne  ‘stock-­‐out’  –  ukungabibikho  kwemithi.    Yize  kade  kunezinkinga  emitholampilo  uhlelo  lwe-­‐BMET  lusize  kakhulu  ngoba  amalunga  omphakathi,  ikakhulukazi  amalunga  akwa-­‐TAC,  kunye  nabasebenzi  basemitholampilo  bathole  ithuba  lokuxoxisana  ukuze  kutholakale  izixazululo  ezinkengeni  ababhekene  nazo.  Loluhlelo  lwe-­‐BMET  lusize  ngendlela  eyisimanga  ngoba  lunike  amasebenzi  basemtholampilo  nasezibhedlela  ithuba  lokuvula  isifuba,  bakhiphe  konke  obekubahlupha  bengazi  ukuthi  bazokutshela  bani.  Lokhu  kwenze  ukuthi  kube  nokuzwana  okukhulu  phakathi  kwabasebenzi  bomphakathi  bakwa  TAC  kanye  nabasebenzi  basemitholampilo  okwenze  ukuthi  kube  lula  kakhulu  ukuthola  ulwazi  ngezinto  eziphazamisa  ukusebenza  kwemitholampilo  nezibhedlela.              

 

From left: Teresa Guthrie – CEGAA Executive Director; Silindile Shezi – Programme Coordinator; Judith King, Communications and Advocacy Manager. At a public hearing in Pietermaritzburg August 2012.

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Okube yimpumelelo eMgungundlovu kanye nezimali zemitholampilo

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-­‐ Imitholampilo  eminingi  isivakashelwa  

ngabodokotela  kabili  ngesonto,  okuyinto  enhle  kakhulu.    

-­‐ Uhlelo  lwephilisi  elilodwa  elihlanganise  amaphilisi  amathathu  engculaza  eMgungundlovu  namaphethelo  lithuliwe  kusukela  zingu  30  ku  April  2013,  futhi  liyatholaka  kuyoyonke  imitholampilo  nezibhedlela.  Okwamanje  lisatholwa  ngabesifazane  abazithwele  nalabo  abaqalayo  ukungena  ohlelweni  lokwelashelwa  isifo  sengculaza.  

 Isimo  sezempilo  sibi  kakhulu  eMpuma-­‐koloni  Kuningi  kakhulu  osekwenziwe  ngaphansi  kohlelo  lwe  BMET  eMgungundlovu  naseLusikisiki.  Futhi  kuningi  kakhulu  osekushintshile  eMgungundlovu.  Kodwa  isimo  sibukeka  sibuyela  emuva  eLusikisiki  ngenxa  yesimo  esibbi  sezezimali  esihlasele  isifundazwe  sonke  iMpuma-­‐koloni.  Ngenxa  yezikweletu  ezindala  ithi  ifika  imali  eMpuma-­‐koloni  evela  kuhulumeni  omkhulu  ibe  ikhokhela  izikweletu  ezindala,  kusale  imali  encane  kakhulu  ukubhekelela  izidingo  zanamuhla  zezempilo.      Lenkinga  yenza  isimo  sihlale  sisibi  ezindawe  ezeswele  njengase  Lusikisiki.  Kuningi  okumele  kwenziwe  ukushintsha  isimo  ukuthi  abantu  bathole  lokho  uhulumeni  abathembisa  khona.  Ngenxa  yalesisimo  kusashoda  kakhulu  ekuqashweni  kabasebenzi  basemtholampilo  eLusikisiki,  kanjalo  nokuthuthukiswa  kwemitholampilo,  nokuthengwa  kwezinsizakusebenza  kanye  nama  ambulensi  okusiza  labo  abagulayo  bebe  bekude  kakhulu  nezibhedlela.        

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Abasebenzi  basemitholampilo  bebengazi  lutho  ngesabelo  zimali  sezikhungo  abasebenza  kuzo  noma  abaziphethe.  Lokhu  kwenze  ukuba  bangabi  nandaba  nezezimali  yize  zibalulekile  ekuphumeleliseni  ukusebenza  kwemitholampilo.  Emva  kokuthola  lolulwazi  abakwa  TAC  behlangane  nabakwa  CEGAA  bayilwelile  imitholampilo  bebuza  ukuthi  kungani  ingambandakanywa  kwezokwaba  izimali  zezempilo.  Sekube  noshintsho  olukhulu  eMgungundlovu  ngoba  abaphathi  bemitholampilo  sebefakiwe  esigungwini  esihlanganisa  izibhedlela  nabaphathi  zimali  lapho  kubekwa  khona  izidingo  kubuye  kubhekwe  isimo  sezimali  sezikhungo  zezempilo.  Lemihlangano  ibizwa  nge  Cash-­‐flow  Meeting  eyenzeka  njalo  emva  kwezinyanga  ezimbili.  Lokhu  kunikeze  abaphathi  bemitholampilo  amandla  amakhulu  okuqondisa  ukufezwa  kwemisebenzi  yemitholampilo  abayiphethe.  Kodwa  kusasilele  ukuthi  laba  baphathi  bakwazi  ukuzisholo  bona  ukuthi  malini  abayidingayo  nezizathu  zalokho.  Okwamanje  basetshelwa  nje  ukuthi  babekelwe  malini  yize  bengazi  ukuthi  kufikwe  kanjani  kulawo  manani  abekiwe.      Yize  abaphathi  bemitholampilo  bengenalo  izwi  ekwabiweni  kwezimali,  kuningi  okuhle  osekwenzekile,  ikakhulu  kazi  eMgungundlovu  uma  uqhathaniswa  nase  Lusikisiki.  Ukubala  okumbalwa  nje  osekwenzeke  eMgungundlovu:  -­‐ cishe  yonke  imitholampilo  enikezela  abantu  

amaphilisi  engculazi  aseyakwazi  ukuziqaqela  wona  iziguli  kuloluhlelo.  Ekuqaleni  iziguli  beziqaliswa  ezibhedlela  lapho  kade  kuthatha  khona  eside  isikhathi  ukuthi  basizakale  kanti  manje  sebeyakwazi  ukuqala  ukulashwa  emitholampilo  yangakubo.    

-­‐ Eminye  imitholampilo  nezibhedlela  sezithuthukisiwe  kokwandiswa  kwendawo  yokusebenza,  osekwenze  kunciphe  ukuminyana  kweziguli.  

-­‐ Ayisekho  imitholampilo  ekhononda  ngokuphelelwa  imithi  yokulapha  ingculazi.    

-­‐ Eminye  yemitholampilo  nezibhedlela  sezithole  abahlengikazi  abaningana  ukuze  kusizakale  iziguli  zithole  usizo  ezisuke  ziluzele  esikhungwini  sezempilo.  

THE BMET NEWS 6 AUGUST 2013

 

Isiphelile i-BMET manje, pho sekuzokwenzakalani? Iphele kahle i-BMET ngo August 2013 sekukhona uhlelo olusha lakwa RHAP, i-Rural Health Advocacy Project oluzoqhubeka lapho kugcine khona i-BMET. Loluhlela lona luhlose ukulwela kakhulu imitholampilo esezindaweni ezisemakhaya kakhulu ngoba kubukeka sengathi yizo ezikude nezidingo futhi ezinganakekeleki kahle kwezezimali. Ngenhlanhla enkulu abanye babasebenzi akade besebenza kwi BMET sebeqalile ukusebenza kuloluhlelo noma i-project yakwa RHAP. Laba abazoqhuba umsebenzi futhi baphinde baxhumane nezinye izinhlangano nabasebenzi basemtholampilo obekuvele kusetshenzwa nazo yilaba: Kwazi Mbatha obesebenza kwa-CEGAA, Fikelephi Sithole obesebenza kwa TAC eyi Community Mobiliser eMgungundlovu, kanye no-Bhekisisa Maqepula naye obesebenza kwa TAC eyi Community Mobiliser eLusikisiki. Imininingwane egcwele ngale project ezoqhubeka lapho kugcine khona i-BMET ingatholakala ku-Kwazi Mbatha, kule email: kwazimbatha@ymail.com, noma kulenombolo yocingo lakwa TAC eMgungundlovu ethi 033-394-0845. Izincomo zokubonga abaxhasi bohlelo olube yimpumelelo lwe-BMET Singabakwa CEGAA nakwa TAC sifisa ukubonga kakhulu ezinhlanganweni ebezixhase loluhlelo ngezimali nangolwazi. Lezinhlangano yi International Budget Partnership (IBP), Open Society Institute (OSI) ne Open Society Foundation of South Africa (OSF-SA). Ngaphandle kwalezinhlangano konke okube yimpumelelo kwi BMET ngabe akufezekanga.

Izimbizo ezinkulu zokuphendulana kulungiswe izimo Injongo yemihlangano emikhulu eyenzekile ngesikhathi se BMET project bekuwukubonisana, kuxoxiswane ngezingqinamba ezitholakale kulo lonke ucwaningo obelwenziwa ukuze kulungiswe isimo abantu bathole abakudingayo. Bekubalulekile ukuthi labo akade besebenza kwi BMET babuye

bazokwazisa amalunga omphakathi, abasebenzi basemitholampilo nasezibhedlela, kanye nabaphathi abakhulu bomnyango wezempilo KwaZulu-Natal naseMgungundlovu, ngakho konke okutholakele nokumele kwenzeka ukuze kushintshe isimo nezinkinga zixazululwe ndawonye. Okubalulekile ukuthi

amalunga omphakathi nawo athola ithuba lokuzikhulumela aphendulwe, kanjalo nabasebenzi bakahulumeni baphendula besho lokho abakwaziyo nabazokwenza ukushintsha isimo.

Okwaba yibhadi ukuthi abaphathiswa anamandla kakhulu abakwazanga ukuzibandakanya kulemihlangano okwenza ukuthi ezinye izinto zingashintsheki kalula bengekho. Kodwa amalunga

ezinhlangano zomphakathi azinikela ukuqhubeka alandele labo abasemagunyweni ukuze baphendule balethe nosizo ezinkingeni ezikhona. Lokhu kulandela kubalulekile impela ikakhulukazi njengoba sekunohlelo olusha lokufaka izimali kwezempilo ukuthi bonke abantu base Mzansi Afrika bathole

ezempilo elisezingeli eliphezulu. Loluhlelo olusha lubizwa nge National Health Insurance olusahlolwa ukuthi luzosebenza yini futhi kanjani. Zombili lezindawo zaseMgungundlovu nase Lusikisiki (O.R.

Tambo) zikhona ezindaweni eziyishumi nanye lapho kuhlolwa khona i-National Health Insurance edume nge NHI.

THE BMET NEWS 6 AUGUST 2013

Fikelephi Sithole, TAC CM Umgungundlovu, now with RHAP

Silindile Shezi - CEGAA BMET Programme Coordinator

Kwazi Mbatha - CEGAA BMET Researcher/Trainer. Now with RHAP

Zukile Madikizela TAC CM Coordinator Lusikisiki

Mlungisi Vilakazi - TAC CM Umgungundlovu

Bhekisisa Maqepula, TAC CM. Lusikisiki, now with RHAP

Mlungisi Vilakazi TAC CM Umgungundlovu

Promise Makhanya TAC CM Coordinator Umgungundlovu

Nhlanhla Ndlovu CEGAA Programmes/ BMET Technical Manager

Kholiswa Sondzaba - TAC CM Lusikisiki

Mlungisi Majozi Intern, Durban University of Technology, Midlands