/ 31 August 2005

A shortage of compassion?

I am writing as a South African nurse working overseas. I recently read of the horrific treatment of a patient in the South African hospital system (”Please help my mom”, July 22), and cannot let it pass without comment. Attie van der Westhuizen is to be commended for the care of his mother, and the heroic response of Ken Ford and the Sunshine Private Hospital in Actonville .

There are three separate but related issues in this sorry saga:

  • The run-down hospital system overseen by an ambivalent Ministry of Health. Primary health is doing sterling work at community level, but cannot remove appendixes and gall bladders. Enough beds and staff have to be available to meet these and other surgical emergencies, based on existing and projected need, and not where the South African population was in 1996.
  • The negligence and malpractice of various doctors on the public health payroll, with no subsequent disciplinary action.
  • Nurses behaving unprofessionally and mistreating their patients. Have they not heard of triaging patients, so the most critical receive priority, instead of being sent to the back of the queue?

What can I say about the Boksburg- Benoni Hospital, the Johannesburg General Hospital and, most of all, the Far East Rand Hospital in Springs? A shortage of resources should not mean a shortage of compassion. Surely health authorities have a legal obligation to ensure health workers can do their jobs?

Why do government and provincial authorities dodge the issue and fail to turn up for scheduled meetings when healthcare problems are raised? The public has health and safety issues that are clearly not being addressed within government hospitals.

As far back as 1993 Professor Caroline Ntoane raised the issue of professional accountability when she said: ”Nurses should not regard themselves as an elite, but answerable to the communities they serve.”

This idea seems to have been quietly shelved. Nurses should be responsible and accountable for their actions and omissions, and the way clinics and hospitals are run needs to change from dictatorial and authoritarian to ”client-friendly”.

Communities have to be educated on their rights instead of putting up with bad service and arrogance.

Where ignorance and prejudice are permitted, patients will continue to be disadvantaged. Respect cannot be demanded, but has to be earned by caring and advocacy on behalf of patients. Ubuntu used to be one of the best features of South African life. What a pity it is being obliterated in the mad scramble for materialism.

Under the African Charter and the United Nations Universal Declaration of Human Rights, patients are entitled to a reasonable standard of healthcare, safe practice, dignity and respect. Where is the evidence that these currently exist in South African government hospitals? The unsafe, unsanitary conditions to which patients are exposed are a sad indictment on a once fine health-care system. What I see and hear in the media reminds me of state- sanctioned terrorism instead of caring and healing.

Of course, it costs money to run a health system properly. South Africa has the wealth, but does the government have the will?

Nursing needs to find its voice again, and to speak out on behalf of those who require their services. I question the role of the South African Nursing Council and the Democratic Nursing Organisation of South Africa .

Surely these official organisations can mobilise themselves and their membership? If not they risk being rendered irrelevant and the question will persist: are they part of the problem, or are they working towards a solution?

I am fortunate to be part of a world-class health system in New Zealand, and feel embarrassed by the negative reaction of my colleagues to media reports such as Van der Westhuizen’s. More people should come forward and make their harrowing experiences known, as they did for the Truth and Reconciliation Commission. Millions of South Africans have no choice about where to turn for health care, and they deserve better than this. All societies are judged on how well they care for their most vulnerable: children, the sick and the elderly. The government has to motivate itself to meet the promises it made to the people.