Pat Sidley
THE mortuary at GaRankuwa Hospital has no drainage for its 66 “fridges”, its inadequate power supply is strained by having to cool too many bodies and its floor is “in a noticeably poor condition”.
For those still alive at the hospital complex, things aren’t much better, according to a report after a visit by the Parliamentary Portfolio Committee on Health.
The visit followed several protests, led by staff and students from the hospital and its attached medical school, Medunsa, over uncertainty as to whether it would fall victim to the Gauteng government’s stringent budget cuts.
Both the university (set up in the heyday of apartheid to train black doctors, dentists and vets) and the hospital had too little money to function adequately.
Patients not being fed by intravenous tube are faced with having food prepared in a kitchen described by the group as “appalling”, with floors crumbling and cement for repairs being mixed next to where food is prepared.
The outpatients department is “overcrowded, uncomfortable and offers no privacy”, with toilet facilites which are “extremely run down and wholly inadequate”.
Patients needing drugs must stay overnight on the floor to ensure they get their medicine before the pharmacy closes at 4pm. The casualty department is being expanded — but by the time it is completed it will again be too small.
Some 44 smaller hospitals send their patients to GaRankuwa, but anybody needing resuscitation will find the facilities “inadequate for the work load” and, because of the lack of equipment, patients die.
“There is no trauma unit — in addition to the obvious dangers this creates, there is little opportunity for students to be trained in this area of medicine,” the report notes.
Medunsa trains more than half of the country’s black doctors and dentists.
Many wards are overcrowded, partly because of a lack of equipment and partly because of a lack of staff. The one recently renovated area, the Intensive Care Unit and Cardio-Thoracic ICU, which drew the comment that it was “modern and in good condition” operates on only 75 percent of its staff complement.
The hospital has no facilities to treat cancer. This means students graduating in a speciality from Medunsa are underqualified.
A new spinal unit, according to the report, was built just under a year ago and would have “considerably alleviated the hospital’s workload”, but the new equipment remains in storage — because the hospital doesn’t have the staff to make it work.
“An extremely large area of the hospital grounds was excavated in 1988/89, at a cost of R15-million, in preparation for new hospital premises.” But, the report states blandly, a Cabinet decision halted progress. That is one of several points which made it clear that plans for the hospital had been suspended by executive
The Portfolio Committee’s proposal is to find the funds needed to jack up the hospital and university.
The hospital would like to be housed for budgetary purposes in another province, like the North West, as Gauteng’s budget cannot cope. Gauteng would obviously like to stop funding in order to put its strained resources into other badly needed areas.
At the weekend, Minister of Health Nkosazana Zuma noted bitterly that some academic institutions tend to train doctors for export. However, she noted, that Medunsa graduates stay in the country.
The natural question to be asked is about the quality of the education they receive. It’s a question answered by a source close to the committee with the frank remark: “That’s a valid question”. The report concludes however, that “given the financial and infrastructural restrictions … it is clear Medunsa/GaRankuwa is producing an exceptionally high calibre of work”.
The question of the funding of academic hospital complexes nationally has not yet been addressed, despite the appointment, by the Department of Health last year, of a committee (which has reported) on the issue. Among the questions that need addressing are: How many academic hospitals are needed? What should be taught? Is the quality and expertise meeting needs locally efficiently? Is valid research being done?
Medunsa and a couple of other complexes believe that their institutions are the under-resourced relics of the apartheid era, and urgently need extra resources to redress the damage of the past.