Desperate for an income, unemployed people are paying TB patients for sputum samples so they can dupe doctors into getting them onto the social grant system. TB-ridden residents in Khayelitsha charge R50 to R100 for sputum samples in a ruse which involves ‘sputum sellers’ keeping a stash of sample bottles smuggled out of government clinics which are then handed, with the infected sample, to unsuspecting health workers.
Using the infected TB sample, healthy people get a card from the clinic indicating they have TB and use this to fraudulently obtain a temporary disability grant of R1010.00 per month from the Department of Social Development.
Enquiries in Khayelitsha quickly revealed three TB infected residents willing to sell their sputum in order for fraudulent grants to be obtained.
This reporter approached one of them, a 54-year-old man who legitimately receives a disability grant for his illness, who sold two bottles with sputum samples for at total of R50.
He said on average he made about R500 per month selling his sputum to people wanting to fraudulently obtain grants.
But he said business was “not good” because so many people were infected with TB in the township, which meant he had a lot of competition.
Paid R50, the man, who cannot be named in order to protect his identity, provided two samples of fresh sputum, each in a health department bottle obtained from a stack he kept in his bedroom.
Going to the Nolungile clinic in Site C, Khayelitsha, for a TB test, this reporter was given two bottles by a health worker who said a sputum sample in each bottle was required for the tests.
The health worker did not insist the sputum be coughed up in front of them so it was easy to swop the bottles with those which contained the purchased samples.
Fortunately for the sputum seller, but unluckily for this ‘client’ the samples came back negative, indicating that the man who sold the sputum had likely been taking his TB medication.
Should they have been positive, this reporter could have gone through the process of applying for a temporary disability grant.
Western Cape spokesperson for SA Social Security Agency (SASSA) Shivani Wahab said a temporary disability grant was provided for a minimum of six months and for a continuous period of not more than 12 months.
Wahab said applicants were assessed by a medical doctor who then recommended the applicant based on their medical condition.
Those receiving temporary disability grants would have to be re-assessed after a six or 12-month period.
However, a TB patient who had qualified for the grant said it was rare that doctors did a proper physical check-up and mostly just checked the test results provided by the clinic.
SA National Tuberculosis Association (SANTA) CEO John Heinrich said he’d heard of healthy people purchasing infected sputum in order to obtain a grant.
Heinrich said to prevent this, patients should be forced to cough up their samples in front of a health worker.
This could produce a logistical challenge though, as the best samples for TB detection are produced in the early morning.
Heinrich said another worrying issue he had come across was that some TB patients deliberately neglected to take their medication in order to remain on the grant system, in effect trading their health for money.
He said patients abandoning their six-month course of medication led to multiple drug resistant (MDR) TB or even extreme drug resistant (XDR) TB.
National Health Department spokesperson Fidel Hadebe said the department was aware of TB patients selling their sputum.
Hadebe condemned such trade, which he said was “based on greed” and was illegal.
“This is wrong and cannot be allowed. People have to be tested by professional workers.”
Social Development Department spokesperson Mandla Sidu said he “had no doubt” that such scams were happening.
However, Sidu said the department was not aware of this scam.
He said the correct procedure for accessing grants was to have a TB test at a clinic with the supervision of a professional nurse. If the results revealed an infection, a doctor would write a medical report stating whether the patient qualified for a grant or not.
He said the department would alert the police so this matter could be investigated.
According to SASSA records for September 2009, there are about 30 015 beneficiaries in receipt of temporary disability grants nationally.
The World Health Organization’s Global TB Report 2008 ranks South Africa fourth in the world for TB infection, with an incidence rate of 940 cases per 100 000 people – a major increase from 338 per 100 000 population in 1998.
The Western Cape health department said there were 50,156 TB cases in the province in 2008
Of this figure 3.5% of those diagnosed with the disease, and 6% of those who had suffered from it previously, died. – West Cape News