DENOSA supports the Call to Action for Greater Investment in Nursing globally to achieve goal 90-90-90 ...

    Media statement 
    Thursday, 21 July 2016 
    The Democratic Nursing Organisation of South Africa (DENOSA) joins hands with the global nursing groups in the Call to Action at the 21st International AIDS Conference in Durban, for Greater Investment in Nursing to achieve 90-90-90 objectives, and calls on all community to demand hiring of nurses in facilities in preparation for this vision.  
    The aim of goal 90-90-90 is to reach at least 90% of people with HIV to know their status, and ensure that at least 90% of them are enrolled into the Anti-retroviral Treatment (ART) programme, and that 90% of all people on the ART programme have their viral load suppressed by year 2020.
    This call is for every country, state/province, and every district to promote health access, equity and rights for all patients. Organisations behind the Call to Action include DENOSA, ICN, ANAC, ICAP, IAS, ANA, and UNAIDS.  
    The Call to Action demands adequate staffing, payment of nurses and equipping of all health facilities where communities are served, and it also demands adequate supply of medication, as well as inclusion of nurses in decision-making about health issues in their countries, provinces, and districts.  
    DENOSA says for the 90-90-90 to be achieved, more nurses must be hired and their well-being in the workplace must be looked at and prioritized. In South Africa, the new World Health Organisation (WHO) guidelines on Test-and-Treat will be implemented in September this year. As DENOSA we are happy with this pro-activeness from our government. However, our concern is that this ambitious plan may come to expose the extent of severe shortage of nurses in the country as this plan will be wholly driven by nurses, who are few and far between in facilities and most of whom carry out the work of two or three other nurses who are not hired. Queues will become longer if more nurses are not hired, and this may result in tensions between community members and nurses who are the face of the system.   
    DENOSA is calling on community members to assist nurses and all health workers in demanding the hiring of nurses and procurement of medication and equipment in their facilities ahead of the implementation of this plan. Currently the country has 3.4 million people on the Anti-retroviral Treatment (ART) programme, which is the largest programme in the world due to NIMART. Expanding the programme will result in longer life for many patients who are infected by the HIV pandemic in the country.      
    We call for equitable representation of nurses on policy guidelines and other decision making bodies; and Government to remove economic barriers to nurse-led care in order to guarantee access to healthcare as a human right by addressing social determinants of health.    
    The shortage of nurses, as well as the low production of student nurses in the few public colleges, has proven be too little for the country and yet HR Planning has been so poor that some of the produced nurses are not absorbed and placed at institutions where their service is greatly needed. 
    DENOSA calls for reopening of previously closed nursing colleges, equipment of nursing colleges and nurse educators. We also call for establishment of staffing norms countrywide, so that we could start measure the shortage against the norms.         
    As nurses of South Africa, we demand that the nurses who work overtime because of the shortage must be paid adequately and not have to wait for months to get their money. Safety of nurses in the workplace should be assured at all times. 
    Issued by the Democratic Nursing Organisation of South Africa (DENOSA) 
    For more information, contact: 
    Simon Hlungwani, DENOSA President. 
    Mobile: 079 501 4922 
    Sibongiseni Delihlazo, DENOSA Communications Manager 
    Mobile: 079 875 2663 

    Read more
    DENOSA President to co-chair a session at the 21st International AIDS conference in Durban at 11:00...

    Media Advisory  
    DENOSA President to co-chair a session at the 21st International AIDS conference in Durban at 11:00 on: Nurses at the Forefront: The Key to Achieving 90-90-90 
    The session will be held at Session Room 12 at 11h00.  
    Members of the media are invited to attend the session and report.

    Read more
    Speakers and experts for comment at the July 16th and 17th International AIDS Conference Pre-Meeting at Durba...

    July 16th and 17th
    Durban, South Africa
    2016 International AIDS Conference Pre-Meeting
    NursingHIV 2016
    For info contact:
    About: Public health professionals and leaders in nursing education, nursing policy, and nursing practice will gather for a two-day meeting, NursingHIV 2016 to discuss strategies to strengthen HIV nursing leadership, knowledge, and practice and continue efforts to work towards an AIDS-free Generation.
    The kick-off session (July 16) includes addresses: by Frances Chisolm, US Consult General – South AfricaStephen Lewis, co-director of AIDS Free World; and Aaron Motsoaledi, Honorable Minister of Health South Africa
    Day two (July 17), includes an Open Session for the Press (location: 167 Marine Parade, Durban 4001, South Africa). The session features nurses and their reflections on the frontline experience of working in HIV. Expert responses will be given by Deborah von Zinkernagel, Office of the Global AIDS Coordinator, US Department of State and Dr. Wafaa El-Sadr, director of ICAP at Columbia University. 

    Call to Action:
     The day two event culminates in presentation of the Call to Action, demanding greater investments in the global nursing workforce in order to meet the goals of 90-90-90. It is also available for sign-on’s now at:
    Experts Available to Comment:
    ·        Erica Ehrhardt, International Council of Nurses (ICN)
    ·        Wafaa El-Sadr & Susan Michaels-Strasser, ICAP at Columbia University
    ·        Jason Farley, Association of Nurses in AIDS Care (ANAC)
    ·        Simon Hlungwani, Democratic Nursing Organization of South Africa (DENOSA)
    ·        Lynette Kosgei, Frontline Nurse in HIV Care and Treatment, Kenya
    ·        Nonhlanhla Makhanya, Chief Nursing and Midwifery Officer, South Africa (CNO SA)
    Hosts & Sponsors: This event is hosted by: ICAP at Columbia University, Democratic Nursing Organization of South Africa (DENOSA), the United States Centers for Disease Control and Prevention (CDC), the Association of Nurses in AIDS Care (ANAC), the International Council of Nurses (ICN), and Health Resources and Services Administration (HRSA). It is supported by the: Centers for Disease Control and Prevention (CDC), Gilead, and Janssen. 

    Read more
    View More

    National changes in nursing training: South African perspectives 2015...

    Dr. Respect Mondli Miya,(D.Lit et Phil)

    Senior Lecturer: Psychiatry at Durban University of Technology, Department of Nursing Science


    Nursing is a career of love rooted in rich and fertile soil governed by caring ideologies and philosophies. Individuals within the profession have strong and inexplicable desires to serve and preserve humanity at all cost. The nursing profession drives the health care system and is forever in the forefront of preventing, promoting and management of various diseases.  Nurses have always been there and have survived trials and tribulations. Nursing demands not only the brain for cognitive purposes but a humble heart, selflessness in daily duty execution. An individual without passion for the sick will never survive a minute of nursing’s demanding tasks.

    Nursing novices are professionally socialized and groomed on their first day of training. Noble traditions of nursing are gradually unpacked and monitored up to graduation to enhance relevance and dignity of nursing profession. Nursing demands the utmost respect for humanity even after death itself. Most professions have minimum set of working hours yet nursing philosophy calls and promotes dedication beyond duty. Nursing is a way of living not just mere qualification written on papers but lived and experienced charisma. 

    Historically, nursing was viewed as a religious vocation and was predominantly religious in nature which explains chapels, and meditation designated facilities utilized for prayers before commencing daily duties in old hospitals. Nursing training in South Africa before 1976 was hospital-based hence the notion of viewing nursing as a “hands-on” career has been accepted nationally and acknowledged by most prolific nursing scholars who remain sceptical to have nursing pitched at a degree level and offered in higher training of education in South Africa.   

    Such training exposed and subjected nurses to poor recognition as a career.  Nurses were abused and viewed as medical officers’ hand maids who were good for nothing but to offer a bed pan, bathing the sick, and carry orders as prescribed without being objective. The training at that time was strict and limiting, even the scope of practice was limited and nobody could imagine a degree in nursing or university based nursing teaching and learning. Hospitals mostly trained nurses in general nursing and later midwifery.

    Around 1987, nursing in South Africa was gradually introduced in tertiary education system and scope of practice and curriculum were amended. Nursing graduates were introduced to a 4-year degree obtaining general, psychiatry, midwifery and community health nursing. That made older nurses to feel bitter and never fully accepted university graduates as satisfactorily trained. Even medical officers were threatened and witness role change from nurses as hand maids into fully recognized members of the multidisciplinary health team with independent roles and functionality. These changes failed to bridge the gap of scope of practice and remuneration packages. Even to this date, the university and hospital trained nurses earn the same salary and follow same stream of training regulated by the same nursing Act 50 of 1978 as amended with specification stipulated in Regulation 425 (R.425).

    The nursing act 33 of 2005 introduced community service of one year post- training for both hospital- and university-trained individuals. Errors still exist within the nursing education such as same recognition of a hospital and university trained graduate have similar scope of practice, universities are allowed to implement R425 differently. For example, some South African universities train students for six months in midwifery while others dedicate two full years for midwifery and three years for community health nursing which is offered for six months in colleges and some universities. The problem in South Africa is that there is one R.425 and implemented differently from one university to the other.

    The current health ministry is proposing nursing training restructurization. In the proposal dated 23 July 2015, it recommends reintroduction of the old nursing training system with a hope of extending the nursing training duration and to phase out the R.425 of Act 50 (1978). The current proposal overlooks scope of practice and remuneration packages of such graduates irrespective of their qualification which is an error not even Occupational Specific Dispensation (OSD) could resolve in 2007. OSD failed to address issues of salaries in the nursing fraternity; an obvious error is that a nursing lecturer is graded as a nursing specialist.

    The unresolved question here is: Who teaches the other? And why do they earn same salary if the other is a teacher? Up to the very same date, the public health system continues to fail to distinguish university graduates from hospital nursing graduates yet continues to differentiate auxiliary social worker from a University graduate Social Worker, and experienced Medical Officer from a Master of Medicine graduate. Why not with nursing in South Africa? 

    The proposed training changes are as follows: general nursing and midwifery be done in a college over a period of four years without indicating whether that shall be Bachelor of nursing offered in a college which can never materialize as colleges do not offer degrees but universities do. If agreed upon, this will mean degrading the dignity of nursing as a profession over medicine which continues to be offered in the university without interruptions.

    According to the proposed plan, nursing training is extended to 9 years (four year of midwifery and general, 18 months of psychiatry and one year of community health) which is unnecessary waste of time for an undergraduate qualification yet medicines years of training have been reduced to 5 years (MBCHB).


    There is absolutely no need for such drastic changes in the nursing education.  It is alarming to witness MBCHB years of training have been reduced to five years and get paid a satisfactory remuneration package compared to Bachelor of Nursing graduates with stagnant remuneration. The introduction of Masters Degree in Medicines in South Africa is preparing sound clinical researchers and such projects (thesis and dissertations) are evaluated by nursing professors who in turn receive less recognition and degrading salaries compared to MMed graduates.

    The South African health system requires the following:

    1.     Strong and vocal task team of nursing professors who shall preserve the image and dignity of nursing as a profession and strongly oppose plans to change nursing training.

    2.     No college shall be allowed to offer a bachelor of nursing, strictly universities only.

    3.     Salary packages to be reviewed and sort clear distinction of a university graduate over a hospital trained graduate.

    4.     Revised scope of practice, degree holders be given more opportunity to execute complex clinical procedures and be given better remuneration packages.

    5.     Chief Nursing Officer to be more vocal and avoid external influences to disorganise nursing training.

    6.     Hospitals to create portfolios and acceptable remuneration packages for all nursing qualifications from a diploma to PHD level.

    7.     All South African universities to adopt and implement similar training structure  that is two years of midwifery, two years of psychiatry and two years of community health nursing

    8.     Develop a Nursing Ministry by nurses with nurses and for nurses.

    9.     MBCHB degree be afforded same status as B.Cur degree thereafter if need be.

    10.  South African nursing council to be headed by prolific PHD holders and nursing qualifications be regulated and registered up to PHD level.

    11.  Any qualification obtained outside university be regarded as either associate professional nurse and associated medical office until related exam has been endorsed by the regulating body.

    Read more


    We are professionals, and let us fight to be recognised as such… 
    Vuyolwethu Mashamayite - 20150728_073623
    By Vuyolwethu Mashamaite 
    Ever since I joined nursing in 2005 I have heard nurses say nursing is a ‘calling’ and it's not about money. I couldn't understand why they said so and I still don't.   
    I believe that everyone is called by God to be in the profession or job they are doing, unless nurses consider themselves in the same umbrella as ‘Sangomas’ and ‘Preachers’. Those are the people who will leave their profession or jobs and focus on their calling or do both, regardless of whether they are paid or not. 
    Perhaps this could be the reason why nurses are under-paid and left to work in extreme unfavourablecircumstances ...because it’s a "Calling".
    Don't get me wrong; I have passion and great respect for human life as a nurse. But I cannot keep quiet. Nurses are the most abused professionals by the employer because they consider themselves "called" instead of being employed professionals.
    Nurses you are jack of all trades doing everyone's jobs from a cleaner to a doctor but come pay day you are the ones who cry the most because you are underpaid while doing everyone's jobs. I guess it's the consequences of having been “called" instead of being professional.
    We feel so comfortable working out of our scope of practice to an extent that we run a risk of performing tasks that we are not equipped to do. When told it's not your scope of practice you tell us of how long you've been doing this and you didn't kill anyone. But the South African Nursing Counci (SANC) is out there nailing nurses and not considering your "calling" but rather your profession and scope of practice.
    What hurts the most is the fact that you studied for four years and someone from another discipline who studied the same years is treated and paid better than you. I guess they are professionals and you are in a "calling". 
    Nurses, let's STOP hiding behind "CALLING" and start taking our profession seriously. If you don't do it, no one will do it for you. Like it or not we are professionals and let us fight to be recognised as such. 
    Vuyolwethu is a nurse based in Kimberley, Northern Cape   

    Read more



    From Ntandane Nyebe, a nurse in Cape Town. 

    As the backbone of any healthcare system in the world, it is my honest opinion that nurses deserve proper compensation for the hard work they put in in improving the health of South Africans. After all, nurses are the proverbial Alpha and Omega. The following 10 points are the reasons.    

    1. We are short staffed- one person does a work that should have been done by 4 people.

    2. We have gone through formal education, we have got degrees etc, we are accountable to a nurses' board, we got to be paid decent salaries like Pharmacists and doctors- YES.

    3. The health institutions do not have enough of the unskilled workers e.g. porters and cleaners- Nurses are then forced to work as unkilled workers-on top of their scope of practice, when the need arises.

    4. There are many instances where doctors go & do shopping at the malls when they are on call, or simply some institutions have shortage of doctors- when an emergency situation arises- a nurse does a work that was supposed to be done by the doctor to save the client. Same case when there no social workers- nurses must run around doing what was supposed to be done by a social worker.

    5. We do a risky job - I've heard of many nurses & docs who died from contagious diseases- especially trauma staff.

    6. The governing party admitted in 2011 that there is a dire shortage of nurses in SA, which means nursing is a scarce skill in SA and the last time I checked professionals with scarce skills were getting paid higher salaries in SA.

    7. We work under bad conditions- institutions with no proper security, lack of proper equipment etc. But we always try and do our best to improvise for the benefit of the clients.

    8. Nurses who go & work overseas they don't go there just for fun or to experience different culture- they leave because they feel they are being overlooked by Government in terms of salary- meanwhile SA loses specialised nurses with experience - Government who cares about its people would try and keep nurses by raising salaries.

    9. We deserve better. Our Government can afford to increase our salaries by 100%. There is money in SA- we have seen structural developments in SA & they have been built by companies who have been paid millions and billions.

    10. ANC Government promised to increase salary of Nurses when they were in Mangaung in 2012/13. 

    I Thank You


    Read more
    View More


    Nursing Update

    January 2016

    Nursing Update is jointly published by the Democratic Nursing Organisation of South Afr... More.



    Curationis provides a forum for cutting-edge theories and research models related to th... More

    About us

    The Democratic Nursing Organisation of South Africa (DENOSA) in its current form was established on 5 December 1996.

    The organisation was formed through political consensus after the transition to democracy and was mandated by its membership to represent them and unite the nursing profession. Prior to this, the South African Nursing Council (SANC) and the South African Nurses Association (SANA) were statutory bodies which all nurses had to join. It was also important after the transition to democracy to incorp... Read more