The South African Medical Association (SAMA) stated that the ombudsman's investigation into the deaths of six healthcare workers in the KwaZulu-Natal province should serve as an alarm bell for the country's public health system.
Investigation Findings
The ombudsman found no direct link between the specialists' deaths and workplace harassment, persecution, or poor working conditions. Nevertheless, the Association reported on Wednesday that the report revealed a healthcare system under immense pressure.
Affected Specialists
Five doctors and one radiologist died between 2024 and 2025. Social media circulated claims that their deaths were caused by harsh working conditions and harassment in provincial public hospitals. Among the deceased were intern doctor Aluluto Mazvi, 25, from Prince Mshiyeni Memorial Hospital; Dr Tumelo Kgaladi, 31, from Addington Hospital; and radiologist Mvelo Sele from Port Shepstone Hospital. The other victims were Dr Siyabonga Zulu from Ngvelezane Hospital, Dr SI Ngidi from Benedictine Hospital, and Dr Francis Idika from Vereeniging Hospital.
Details of Individual Cases
Public outcry began after Mazvi's death in May 2024, when reports emerged that he collapsed during a shift after his supervisor forced him to work while ill. The ombudsman refuted these claims, establishing that they were fabricated. Mazvi became seriously ill in the doctors' accommodation due to complications from uncontrolled diabetes.
Professor Taole Mokoena, the health ombudsman, presented the report on Wednesday following a joint investigation with the Public Service Commission. The inquiry was initiated after complaints from Health Minister Aaron Motsoaledi and former chair of the parliamentary health committee Sibongiseni Dhlomo.
Systemic Issues in the System
Motsoaledi noted at the report release ceremony that he is perplexed by the series of consecutive deaths occurring in one province. SAMA emphasized that despite the hospitals being cleared, the system remains in a deplorable state. SAMA Chairperson, Dr Mvuyisi Mzukwa, stated that although the doctors did not die due to working conditions, thousands of healthcare workers continue to work in conditions that are simply unsustainable.
He pointed out that the investigation exposed the daily difficulties faced by healthcare workers. These include chronic staff shortages, frozen vacancies, increasing workload, and a shortage of vital medical equipment. Deteriorating infrastructure, inadequate employee wellness programs, safety issues, and severe budgetary constraints exacerbate the tension.
Pressure on Young Professionals
The Association was particularly concerned by the report's finding that many intern doctors felt pressured not to take sick leave. This occurred for fear of extending their training rotations or creating additional burden on already overworked colleagues. Mzukwa stressed: 'No doctor should ever feel that taking care of their own health comes at the expense of patients or colleagues.' He added that 'a healthcare system that makes its doctors feel incapable of being patients themselves is under serious strain.'
Conclusion and Demands
Regarding individual cases, the ombudsman found that Mazvi was never referred to the employee assistance program, even though the hospital was aware of his chronic illness. Kgaladi died in his residence outside of duty; the cause of his death is still under forensic investigation and SAPS inquiry. The ombudsman established that he had a history of depression that was not reported at the start of his rotation, and he did not undergo the required preliminary medical assessment, meaning his mental health needs were never identified. Sele died of cardiac arrest during a shift, and Zulu died in a road accident outside of duty. Idika died of natural causes after an aortic rupture, which refuted claims that workplace harassment led to suicide. Ngidi, a general practitioner, committed suicide outside of duty.
Mokoena concluded that the findings do not mean the healthcare system is free from serious problems. He stated: 'The system cannot effectively care for patients if it cannot adequately support those who provide medical care.'
The report's recommendations include strengthening employee wellness programs, improving staff support systems, and addressing safety issues. These recommendations will be forwarded to the Health Standards Compliance Directorate for monitoring. SAMA confirmed that the findings confirm its ongoing concerns regarding deteriorating working conditions for doctors. The Association called on national and provincial health authorities to move beyond merely acknowledging problems and urgently implement the recommendations. Mzukwa insisted: 'This report cannot become just another dusty document. Every recommendation must be backed by clear implementation plans, measurable deadlines, and accountability.' The Association also demanded the urgent filling of critical vacancies, strengthening workforce planning, adequate funding for wellness programs, and improved workplace safety and sustainable investment in the public health service.