Disaster: Firefighters at the Charlotte Maxeke Hospital after a fire broke out on 16 April last year in Johannesburg. Patients were evacuated to other nearby state hospitals. Photo: Elizabeth Sejake/ Rapport/Gallo Images
The Gauteng Health Department says it is urgently trying to source the police forensic report blaming arson as the cause of the first of two fires at Charlotte Maxeke Academic Hospital (CMAH).
The initial blaze threw Gauteng health services into disarray for 15 months by displacing more than 1 000 patients, costing lives and drastically reducing treatment capacity — which has yet to be completely restored.
The blaze broke out in a store room on 16 April 2021, destroying medical goods worth R40-million and forcing the decanting of most of the 1 068 inpatients to other hospitals, disrupting outpatient capacity at and overloading nearby state hospitals.
While nobody died or was injured in the fire, the disruption in care, including trauma capacity and oncology services, may have cost lives, although this tally has never been made public.
Asked about the leaking this week of the now-dated arson finding made by senior police forensic fire investigator, Captain Pravisha Ramsundar, Gauteng health department spokesperson Motalatale Modiba said they were, “anxiously waiting to get hold of her findings to confirm the media reports.”
“This is so the necessary steps can be taken. I don’t want to speculate on media reports that it was arson and that it was related to covering up foul play. It’s very easy to jump to those conclusions in our country and, yes, we can’t rule out anything, which is why the actual report is so critical,” he added.
However, academics and clinicians either working at CMAH or closely linked to it are deeply suspicious because affidavits show the fire coincided with a stocktaking audit uncovering “discrepancies”, prompting an imminent, more comprehensive probe.
The head of internal medicine at CMAH, Professor Omar Mohamed, told Mail & Guardian: “There’s no doubt shenanigans were happening — it’s been going on for years.”
Modiba said CMAH had 974 of the previously empty 1 068 beds reoccupied with all departments running and “just a few constrained,” while outpatient numbers were at around 65 000 per month, compared to 70 000 per month before the blaze.
This graphically illustrates the pressure placed on the already overstretched neighbouring hospitals. Modiba said patients were no longer being decanted externally.
“The route we’ve taken is to balance repair operations with patient care, so any patient or equipment decanting is internally between wards and departments,” he added.
The oncology department, closed after the blaze until May this year, was subject to controversy as patients’ cancers progressed with insufficient alternative spaces available for chemotherapy, life-saving operations and radiotherapy.
Modiba said all areas of the accident and emergency department, including the 21-bed psychiatry acute care unit, paediatric emergencies and the obstetrics and gynaecology emergency units were opened in the first half of May this year.
However, Mohamed said the health department was “playing with bed numbers to create the best possible impression”, while in reality units were sharing wards, disciplines were being mismatched and overall patient care was compromised.
“At the end of day you can’t talk about a single bed. What does it mean and what does it do? Some specialist areas are still closed. From an outpatients’ point of view the numbers are not what we saw pre-covid and pre-fire. They are significantly down. The data is being manipulated and massaged to create the impression that we’re fully functional. Even prior to the fire and Covid we had a problem with insufficient beds.
“Across the Gauteng public health system there are always too many patients waiting in casualty for a bed, sometimes for days on end and many are turned away for procedures, simply because there are insufficient beds.”
It is the fourth Gauteng hospital fire since February last year when R20-million worth of medical equipment including personal protection equipment (PPE) was suspiciously destroyed in a Carletonville hospital storeroom blaze. According to DA Gauteng health spokesperson Jack Bloom, a forensic report cites traces of an accelerant in between store room equipment, leading to an arson docket being opened.
The special investigating unit has already made adverse findings on the R500-million spent on renovating the intimately linked Anglo Ashanti mine hospital, he added.
A fire broke out near Covid tents outside Chris Hani Baragwanath Academic Hospital in Soweto in June, destroying a disposable laundry site. A month earlier, a blaze erupted near the Covid triage entrance area at Steve Biko Academic Hospital in Pretoria.
Modiba said: “You can classify the Chris Hani and Steve Biko fires in the same, (lesser), category; nowhere near as serious as the other two.”
The police’s forensic expert Ramsundar’s 27 August 2021 CMAH fire report noted “malicious human behaviour”, concluding that the cause of the first fire was “arson classified as incendiary”.
According to media reports, an affidavit by the hospital’s deputy director for assets and inventory says he was in the vicinity of the store room on the morning of the fire (around 9am) to deal with “discrepancies” that emanated from stocktaking as part of the stocktaking requirement before the submission of the final stock report.
When he left the area, he reported “nothing suspicious”.
Included in the SAPS docket are affidavits from CMAH staff who worked in the storeroom and saw the fire in its early stages — allegedly only taken by police in September, six months after the blaze.
The police probe was kept under wraps for over a year until Ramsundar’s report was leaked this week amid continued reports of corruption, sabotage and arson as a cause of a second CMAH fire this July — which was quickly extinguished.
Mohamed said flammable debris from the previous fire was not removed and had reignited.
“There’s apparently forensic evidence pointing to that also being started intentionally. Who knows what they’re hiding. All I can tell you is that the first forensic report was with the police a long time ago, but the departments of health and infrastructure and development were not willing to fetch it. Only now that it’s leaked, are they complaining about not getting it,” he said.
Mohamed said the latest CMAH fire was quickly brought under control and had not affected patient care.
Professor Shabir Madhi, dean of the faculty of health sciences at Wits University told M&G that the “arson” seemed aimed at compromising stock taking, “possibly to cover up something untoward.”
He added: “It’s concerning that there’s been no visible progress in apprehending those responsible.
“Considering the fracas that has surrounded repairs at the hospital, which is now only expected to be completed in 2027, it is difficult not to speculate that the arson is somehow linked with tender opportunities that would have arisen in the restoration of the hospital, which conservatively is estimated to cost R1.2-billion.”
Dr Aslam Dasoo, convenor of the Progressive Health Forum (PHF), which launched the Open Charlotte Maxeke Hospital Now campaign, says the PHF has initiated a comprehensive promotion of access to information request for details about the investigation into the causes of the fire and the damage it caused.
Arson as a means of covering theft and tender irregularities is nothing new in South Africa.
Historically, the Eastern Cape has seen instances of drug depots burnt to the ground when news of an imminent stocktake got out.
Gauteng police spokesperson Colonel Brenda Masondo confirmed that an arson docket had been opened because of the forensic report, but said she was “not at liberty to share any report that forms part of the investigations”.
“Statements were taken from identified individuals as part of the investigation of the case docket. No one has been arrested,” she said. She declined to respond to a claim that the affidavits were only taken six months after the fire.
Mohamed said CMAH remained dysfunctional, with regular flooding from burst pipes due to a “shocking lack” of maintenance, while clinicians had to use faulty CT scanners, resulting in unacceptable patient waiting times.
“They’re even repeating tenders from dysfunctional supply companies, IT being a case in point. Everything of value here was done by Solidarity and Gift of the Givers — nobody else wants to take responsibility.”
He said the earlier Carletonville Hospital fire involved equipment stored there and destined for the former Anglo Ashanti mining hospital, which the state took over and controversially converted into a 170-bed ICU hospital and mortuary, repurposed for the Covid pandemic.
“They sourced ventilators, beds and equipment and PPE, and were storing it all at Carletonville Hospital. They were expecting more equipment to come in that Monday and suddenly the fire happened that weekend,” he said.
Mohamed described the Anglo Ashanti hospital project as “an absolute waste of money; there were no nursing quarters, sleeping areas for staff and no proper kitchen. It was supposed to be up by the first Covid wave using ‘alternative building technology,’ but it was only ready by the third.”
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