Most of the exodus has occurred in rural regions, undermining the care of livestock.

The president of the South African Veterinary Association, Paul van der Merwe, said the rate at which veterinarians are leaving has picked up, with more than 100 vets emigrating each year.

He said the international norm is for 200 to 400 veterinarians per million of the population, but South Africa has only 60 veterinarians per million. In addition, the veterinary association receives frequent reports of practices closing in rural areas, either for financial reasons or because of staff shortages.

“With a shortage of veterinarians in rural areas, the health and welfare of production animals cannot be guaranteed anymore, with a direct impact on food safety and security, which in turn has a direct impact on the health and well-being of humans,” Van der Merwe said.

“Furthermore, disease control and biosecurity are not optimal, with failures in the system leading to disease outbreaks such as foot-and-mouth disease, African swine fever and avian influenza, to name a few. This has the potential to spill over to humans, as could be seen with Covid-19.”

According to a 2022 survey by the veterinary association, the majority of qualified vets leaving the country were younger than 25. It said 21% of people aged 25 to 29 had already begun the emigration process, while 38% indicated being fairly certain of emigrating, even if only for a limited period. Only 41% said they were willing to stay in South Africa.

Reasons for the exodus include safety, security and economic concerns, career growth, the working environment and the regulation of veterinary services.

Van der Merwe said all this was despite “huge” interest in the field.

“The faculty of veterinary science receives far more applications than they can accommodate. They have a very strict selection process. Unfortunately, the selection process is no guarantee that more veterinarians would like to work in rural areas,” he said.

Of concern was that only 60% of state veterinary posts were filled. 

Tod Collins, a vet of more than 50 years who works with cattle and other large animals in KwaZulu-Natal, said the departure of veterinarians was a worrying trend.

“The offers they get from overseas financially, we battle to match them here in South Africa at the moment, and they are much stricter with their working hours, and the physicality of their work seems to be a lot less stressful compared to the South African vets; and remuneration packages are very tempting for young vets to go across there to pay off student loans,” he said.

“It’s making the vets that are in the country work even harder because they are fewer doing the amount of work that they should be more vets for.” 

Collins said this was also leading to unskilled people filling some positions.

The compulsory community services programme places 140 veterinarians every January. Some get absorbed into the sector but others choose to go abroad, said Dipepenene Serage, the deputy director general for agricultural production, biosecurity and natural resources management at the department of agriculture, rural development and land reform.

“Our concern is that most of our newly qualified vets are absorbed by the private sector or other countries. Yes, there is a shortage, but it’s not dire,” he said.

“What is important is that at the moment farmers are able to access veterinary services. Farmers in communal farming setups are serviced by state vets. So far we are managing, even though the shortage puts some strain on the current workforce. There are plans to have another additional university to offer this qualification, which at the moment is offered only by the University of Pretoria.”

Veterinarians in rural regions earn less than those in the city, and many of them have started trading in medicine or animal remedies with farmers to help supplement their income, but this is not sustainable and could contribute to more people leaving the sector, Collins said.

The report projects that the sector could contribute as much as R91.4 billion to the economy by 2035 and has increased its share to 1.38% from 0.02% in 2022. This growth includes a cumulative tax contribution of R10.7 billion.

It could create over 341 000 and 157 000 full-time equivalent jobs, based on monthly earnings of R12 000 and R26 000, respectively.

The growth of digital platforms in South Africa enables inclusive participation in the economy, Naspers South Africa chief executive Phuthi Mahanyele-Dabengwa said. 

“These platforms effectively lower traditional market barriers, enabling diverse and previously marginalised groups to participate meaningfully in the economy,” she said.

The report, published in partnership with the Mapungubwe Institute for Strategic Reflection, notes that constraints relating to infrastructure, accessibility, costs and redundant regulations are hindering South Africa’s drive towards digital transformation. 

“Reliable electricity, IT infrastructure, data centres, logistics networks (including roads, transport and mapping) and access to affordable bandwidth are all essential for powering devices, processing data and payments and ensuring efficient supply chains and last-mile delivery,” it said.

“Incumbents and startup platforms alike are increasingly realising that they cannot take advantage of platform opportunities because of their inadequate digital tools, skills and security issues.”

According to the report, the average cost of 1GB of mobile data in South Africa is around R33, making it more expensive than other African countries such as Nigeria, Namibia and Kenya. 

South Africa has a “stable macro-environment characterised by a relatively low inflation rate and steady currency and interest rates”, which set it apart from other African nations, making it an attractive investment market but weak economic growth and high unemployment are setbacks. 

“A protracted low-growth environment and a small population limit the scalability of local platforms. Broad reform efforts aimed at growing the economy and increasing household incomes will improve the fortunes of digital platforms,” the report says.

The digital economy is projected to contribute 5.2% and 7.8% to GDP in Africa and South Africa, respectively, by 2025, with potential growth to 8.2% and 13% by 2050.

“Platforms in innovation (like software and app stores), classifieds (such as AutoTrader), and accommodation (for example, Trivago) are seeing broad adoption,” the report says.

The e-commerce market, which includes platforms such as Takealot.com and Checkers Sixty60, is valued at between $5 billion and $6 billion, representing 6.3% of total retail value, and boasts between 11 million and 18 million users. 

Fintech companies such as Yoco are also growing rapidly. According to the report, revenue in this market is projected to reach $434 million in 2024, driven by developments in digital payments, digital assets and neo-banking, a form of online banking. The portfolio of assets in fintech is valued at $7.5 billion and slated to have significant impact and potential for future growth.

E-hailing services like Uber, and food delivery platforms such as Mr. D, are expanding fast but are approaching critical scales. 

According to the report, the ride-hailing sector, valued at $350 million, is set to expand at an annual rate of 2.9%, reflecting increasing demand for convenient transport solutions.

Digital platforms are increasing competition by allowing price comparisons and have a social impact in areas like agro, health and educational technology, although these sectors are still emerging.

But South Africa also needs to consider new challenges. 

“Key concerns include the potential impact on job security and losses, limited market competition for both consumers and businesses, and issues surrounding privacy and access to services,” the report says.

“President Cyril Ramaphosa has noted with concern media reports containing allegations of corruption against the minister of justice and constitutional development,” the presidency said in a statement.

“The president has requested a detailed report and briefing from the minister on the matter.”

This comes after reports that the municipality made unlawful investments in VBS Mutual Bank in 2016, during Simelane’s tenure as mayor of Polokwane. 

A forensic report by advocate Terry Motau found that VBS, historically a small lender and a depositor for retailers and stokvels, had embarked on a campaign to attract substantial deposits from municipalities through a system of paying “commissions”. 

“This, in many instances, included the payment of bribes to various public officials who were in a position to influence the making of such deposits,” he wrote in 2018, the year the bank collapsed, in the report commissioned by the South African Reserve Bank.

Simelane has confirmed that she received a loan of R575 000 from the company that brokered the municipality’s investment into the bank, Gundo Wealth Solutions, which was owned by Ralliom Razwinane. He has been accused of receiving kickbacks from the bank for brokering investments from municipalities.

The minister said it was a commercial loan that she had used to buy a coffee shop and had since repaid it in full.

But the information has caused unease within government circles and prompted calls for Simelane to provide more information. 

Democracy advocacy group Freedom Under Law noted that the minister has not provided proof of the loan agreement or settlement.

“Further questions arise too — even if there was a loan which was settled in full, the facts in the public domain raise serious questions about whether it was appropriate for the minister to have entered into such a loan in the first place, considering the apparent connection to unlawful deposits into VBS bank by the same municipality in which she was mayor,” it said.

It stressed that Simelane carried political responsibility for key law enforcement agencies, including the National Prosecuting Authority, at the forefront of the state’s fight against corruption.

These are also involved in investigating and prosecuting the collapse of VBS bank itself.

“South Africa has, on far too many occasions in recent years, suffered the effects of compromised individuals having a negative impact on the justice sector, and from the ravages of corruption,” Freedom Under Law said.

“We therefore call for the minister to account fully for her involvement in the incident. It would be untenable for such serious allegations against a minister in such an important portfolio to remain unanswered.”   

ActionSA’s Athol Trollip said, given Simelane’s influence over the National Prosecuting Authority, the public protector must determine whether her involvement in the transaction is a conflict of interest or if it violates ethical codes. 

“I am of the view that the integrity of our justice system is at stake if the person tasked with upholding the law is potentially compromised by involvement in unlawful transactions linked to one of the most egregious corruption scandals that stole from the most vulnerable.” 

“Consequently, I am raising this issue as it demands immediate and thorough investigations to preserve the credibility and impartiality of our justice system,” he said. 

The Democratic Alliance has also said that the minister must answer the allegations before the justice parliamentary portfolio. 

“At the very least, the minister needs to be brought before parliament to account for what measures she intends to put in place to manage the glaring conflict of interest between herself as minister of justice and constitutional development and her role involving the [National Prosecuting Authority], which must surely be investigating the minister and this transaction,” it said. 

The Economic Freedom Fighters is calling for Simelane’s immediate resignation as justice minister, adding that she cannot be trusted with the responsibility of overseeing justice in South Africa. 

The library was initially closed in 2020 as a result of Covid-19 restrictions but stayed shut after these were lifted because of structural damages. The city’s Emergency Management Services (EMS) also said the building was also not fire compliant 

This week, Stanley Mlambo, the director of projects in the Johannesburg community development department, told a meeting convened on the ground floor of the library that the plan is to partially open the library within six months once a contractor is appointed, and open it fully in 10 months. 

“There has been quite a lot of roof leaks in the building, a lot of water damage, and because of the EMS issue that we could not operate given the concern of the possibility of fire and damage to contain should it take place,” Mlambo said. 

The overall cost to repair the building is R54 million, but there is a shortfall of about R30 million based on the approved budget from the city. 

Siyabonga Gemu, the head of projects at the Johannesburg Development Agency, said the city would need to attend to the leaks in the roof and internal gutter defects.

One escalator that still works leads to the first floor of the library, which used to be filled with the soft chatter of students studying at the desks. The escalators to the second floor were not working this week, so the tour group climbed up to the performing arts room where Mlambo and Gemu pointed out the water leaks. Paint was peeling off parts of the ceiling and there were water stains on the walls. 

A bewildered Flo Bird, founder of the Johannesburg Heritage Foundation that has been lobbying for the reopening of the library, asked the city officials: “You had to close the building to repair that?”

“I’m saying to you, you didn’t realise that the library was so important to people who live in town.”

The escalators to the third and last floor were blocked and the group had to use a side stairway with a marble finish and curved steel rails to get closer to the damage.

All the wooden framed doors of the smaller libraries, including the children’s library, were shut, but a peak through the glass showed a big, dusty room with shelves half-filled with books. There were more water stains and fine cracks on the ceiling, while wooden blocks on the floor were loose. Book cases were covered in dust.

“The facility is old so all this is falling apart because of the age of the structure itself,” Gemu said.

He said the work done to date is repairs to the roof and gutters only with one line of internal gutter that needs to be fixed. The cost to repair these damages was R21 million. 

Across the corridor on the third floor is the Harold Strange Library of African Studies, which houses thousands of books on Africa’s history, people, places and heritage. 

Wynaard Dreyer, a civil engineer who joined the tour, told the Mail & Guardian that the building used to be fire compliant but now a “fire curtain” was needed in front of the glass door to isolate it from the rest of the building in the event of a fire. 

A frustrated Bird said the entire building didn’t need to be closed for the fixes. “They could have done this work. All you had to do was to close Harold Strange, for what, two days? How much longer? You [should] close section by section as you’re working.

“The people who come here are regulars, so the librarians can say, ‘sorry, next two days we’ve got workers coming in to fix that, and then you can come back and work here again’. You just let people know.  The point is you can keep using this library.” 

The group then headed down four flights of stairs and through narrow corridors into the basement.

Dreyer told the M&G that the fire suppression system — four large, red cylinders — contains halon gas that would spread through the pipes on the low ceilings and be sprayed through the nozzles that exclude oxygen so fire can be contained. 

He said the door to the basement was a wooden one, which would allow oxygen to enter the room, and needed to be replaced with a specialised fire door. 

The steel shelves in the basement, which lined up behind each other for about half a kilometre, were packed with books. 

Wynaard said the books were the archive of the city and many of them dated back to the 1800s. The covers were embellished with gold print and delicate patterns. Too precious to touch. 

“From a compliance point of view, currently the entire structure from the basement to the top floor is connected to one system for fire regulation, which is not correct,” Gemu said.

“So, we managed to separate the basement from the top floor, but what the EMS colleagues have advised us is that we must have one independent system that monitors the top floor and a separate system that monitors the basement.” 

The City of Johannesburg officials said they would try to “squeeze the programme” and try to open the library sooner. 

Bird said she was looking forward to a Christmas opening.

“We have been struggling since the beginning of the year just with basic medical equipment. I am talking about needles. I am talking about syringes. I’m talking about IV bags, drips. Not to mention medication and patients having to be turned away because we don’t have medication or we don’t have medical equipment to perform certain procedures,” said *Zanele Ndoda.

She said staff members have to improvise because of the shortage of resources such as incubators, which meant premature babies had to be kept in boxes. 

“This is just a daily routine — we have to improvise. When you report that you don’t have something or you don’t know how to do this procedure without [the necessary tools], you are told you’re a nurse and you need to improvise.”

The hospital’s maternal facilities was one of six health care facilities the Commission for Gender Equality investigated. The others were Cecilia Makiwane Hospital in Mdantsane, Frere Hospital in East London, Bisho Hospital, Dora Nginza Provincial Hospital in Zwide township in Gqeberha and St Elizabeth Mission Hospital in Lusikisiki. 

The report was released last week, and comes as several provinces, particularly the Eastern Cape, are struggling to provide sufficient, quality healthcare services for women, despite government initiatives to advance gender equality and women’s health. 

“The Eastern Cape is notably grappling with elevated rates of maternal and neonatal mortality,” the report says. 

The Eastern Cape has 775 primary healthcare facilities, of which 733 are clinics and 42 community healthcare centres. It has 90 hospitals.

According to the District Health Information System, maternal mortality ratios in health facilities in the province increased from 106.1 in 2019 to 108.2 in 2020. Increases were also noted in the Northern Cape, while all other provinces reported decreases in the maternal mortality ratios during the reporting period. 

At the Cecilia Makiwane Hospital, which caters for a population of 267 000 alongside the Frere Hospital, 17 maternal deaths per perennial problem identification problem (PPIP)  and 15 maternal deaths per District Health Information System (DHIS) were recorded in the 2020 to 2021 fiscal year. This decreased in 2021 to 2022 to 11 maternal deaths in the PPIP and eight per DHIS, and increased in 2022 to 2023 to 13 maternal deaths in PPIP and 12 per DHIS. 

The commission noted that the majority of deaths in 2020 and 2021 were attributed to the Covid-19 pandemic. 

Neonatal deaths were flagged as concerns. From April 2020 to March 2021, there was a mortality rate of 14.3%, and in the following year it was 11%, but it increased again in April 2022 to March 2023 to 13.9%. 

“These deaths were attributed to various causes, including maternal hypertension, spontaneous preterm births, infections and overcrowding in neonatal units,” according to the report. 

But the commission lauded the Cecilia Makiwane Hospital for cleanliness, maintenance and adequate ventilation.

“It is state of the art in respect of its infrastructure and good government, and we wish the same could have been carried out throughout with other hospitals,” said Tsietsi Shuping, the acting head of legal services at the commission. 

The report noted that overcrowding was prevalent across the six health facilities — Livingstone, Cecilia Makiwane, Frere, Bisho, Dora Nginza and St Elizabeth.

“While instances of overcrowding are not uncommon, deaths resulting from infections attributable to overcrowding should not be frequent,” the report says. 

The report noted that Dora Nginza, a district hospital that has a bed capacity of 220, experienced overcrowding to an extent that patients slept on benches or shared beds. 

“Further scrutiny has validated the challenging conditions within the maternity wards, revealing instances of postpartum patients being displaced due to bed shortages and some patients resorting to makeshift sleeping arrangements on floors or benches.” 

There was also a consistent increase in the rate of early neonatal deaths and neonatal deaths in the facility from 2020 to 2023. This is despite it being “well maintained” in terms of building and floors, ventilation and general hygiene. 

The Bisho Hospital has 205 beds for a population of 100 000 in the district. Regarding the quality of the facility, Shuping said: “There’s visible mould in the bathrooms, overall cleanliness concerns were noted, and there is lack of change in maintenance staff that exacerbate the issues, therefore necessitating and highlighting the need for improvement management of the facilities. 

“We noted that the proximity of the isolation rooms to the neonatal ward pose infection risk … infectious units or wards shouldn’t be in close proximity to the wards that are providing services to the vulnerable, to children and mothers who just gave birth.” 

The facility also had a staff shortage and limited resources: an inadequate number of beds resulted in long queues and strained medical services. Shuping said in some instances patients had to bring their own sheets, posing the risk of introducing infections. 

While the facility met some standards, it fell short in providing health and reproductive services for women. 

According to the report, in the 2021 and 2022 fiscal year, Bisho Hospital recorded one maternal death caused by a lower respiratory infection. Two other maternal deaths were reported in the following period. 

“The occurrences of the death due to various causes highlights the importance of comprehensive healthcare and the need for appropriate medical interventions tailored to specific conditions to prevent mortality,” the report states.  

From 2020 to 2023 the number of neonatal deaths increased: a total of 72 early neonatal deaths and 10 late neonatal deaths were reported. 

Delivery among adolescents aged 10 to 19 also contributed to high rates of maternal and neonatal deaths, according to the report. 

This was prevalent at St Elizabeth hospital. 

“The high delivery rate among patients aged 10 to 14 years old is alarming. St Elizabeth hospital is rated fifth nationally and first in the province for sexual offences and rape cases and it is therefore concerning that despite these high numbers, there is no evidence of any steps taken by the hospital to report the cases of statutory rape to authorities,” the report said.

From 2020 to 2023, a total of 3 669 deliveries by 10 to 14 year olds were reported. Over the same period, the overall number of stillbirths was 306 and the deaths of babies aged up to six days was 151.

Frere Hospital was flagged as having “numerous deficiencies”. This included poor maintenance of infrastructure, poor ventilation, sanitation problems and improper waste disposal.

The hospital caters for about three million people, and was deemed to be a “prominent healthcare institution”. But the conditions were sub-standard. 

“What we observed is that in the hospital, infrastructure displayed concerning maintenance issues. There are leaking roofs, mould, peeling paint and poor cleanliness,” Shuping said. 

“The underground tunnels connecting the maternity ward exhibited hazards such as exposing electrical wires, [heightening] the risk of fire and electrocution as well.” 

“While they pass the air conditioning [standard], we noted there are inconsistencies regarding functionality and obstruction of the windows, which compromise ventilation, contributing to the discomfort and potential infections.” 

The Frere Hospital mother and child care unit was also overcrowded and there were extended waiting periods for women seeking to terminate pregnancies, which often led to the women resorting to dangerous backdoor abortions.  

Maternal deaths decreased from 20 in 2021 and 2022, and to 16 in 2022 and 2023. The commission said these deaths were commonly attributed to pre-existing maternal conditions including respiratory, congenital heart and haematological diseases. Other causes of death were Aids and ectopic pregnancies.  

There was a significant fluctuation in the early neonatal in-facility death rate. 

According to the report, in June 2020, it was as high as 29.4% but in September 2022 it dropped to zero. 

On average, the early neonatal death rates were lower than the late neonatal death rates from April 2020 to March 2023. These deaths were mostly attributed to immaturity-related conditions, but the fluctuations are an indication of change in healthcare practices and resources. 

“The fluctuations in rates over time highlight the need for continuous monitoring and evaluation of healthcare services to identify areas for improvement and implement targeted interventions,” the report says. 

The commission noted that overall the healthcare facilities in the Eastern Cape need better administration and governance, and that problems weren’t created by insufficient resources but that they were not being used correctly. 

Ndoda, the Livingstone hospital nurse, said that security for staff and patients, as well as electricity faults, had to be dealt with as a matter of priority. 

“We use a lot of electricity because there’s a lot of machinery, ventilators, monitors, everything keeping the patient alive, and sometimes wall sockets are not working. We [often] have no electricity within the adult critical care unit,” she said. 

The Eastern Cape health department said it had been putting measures in place to improve maternal and reproductive health services in underserved areas. It said it would train healthcare personnel to “treat patients better” and is considering an integrated electronic system to keep patient records.

The commission’s chief executive, Dennis Matotoka, said those who suffered under the strained facilities in the province need justice. 

“It is disheartening that during Women’s Month, we are reporting about women who are pregnant and sleeping on the floor until they get basic healthcare services. Something has to be done, and it is important that the department of health comes to the party and really ensures that justice is done.” 

* Not her given name.