On the day we visited Bongani Hospital in Welkom, Free State, the CEO was frantically trying to decide what to do with a R12million winning Lotto ticket after the owner had just died in the hospital. Alida Zwiegelaar was very proud that her staff had been honest enough to hand over the ticket, particularly as the owner had not signed it.
Bongani hospital is regarded as a caring hospital, and the Free State health department has given it the award for the best regional hospital in the province for the past five years for its emphasis on Batho Pele (putting people first) and its general management system.
Zwiegelaar, a former assistant nurse, is a proud beneficiary of the government’s project to empower hospital managers, which saw the Free State government pay for her MBA studies and give her time off to study. “It was such a privilege, I can tell you that,” said Zwiegelaar.
But the awards and the buoyant CEO are at odds with the picture painted by hospital staff.
The hospital is battling with staff and medical equipment shortages. In the renal unit there are 11 machines, but many are outdated and non-functional. “That means we are unable to help all of our patients who come here daily for dialysis. It is a problem, because some patients come from as far away as Hertzogville, which is more than 200km from here,” said Sister H Ferreira.
The lack of equipment is also highlighted in the intensive care unit. “We are terribly short-staffed,” said one nurse. “Ideally in an ICU there should be one nurse to a patient. And they should be professional nurses, not junior nurses. At the moment we have seven patients at a time and only four nurses. We don’t have enough cardiac monitors to observe a patient’s heart rhythm and his oxygen saturation. We also lack infusion pumps, which monitor the fluid movement in a patient. There is only one blood pressure machine. That is unacceptable when you are dealing with critical care. The result is that we don’t give expected care to patients. We have to run from one patient to the other. When the machine is broken down, there is no back-up system.”
A doctor standing nearby nods in agreement: “We have highlighted these issues for years, but management says there is no money. All the same, we have God.” Many of the staffers who spoke to the Mail & Guardian did so off the record, once Zwiegelaar was out of earshot.
One doctor said there are days when the hospital is so full that patients are kept waiting in the corridors, leading to what he termed “delayed medical management”.
This is when a patient’s condition deteriorates while waiting for care, resulting in them being sent to the ICU instead of being attended to timeously when they arrive. A student doctor said the biggest problem for him was the lack of antibiotics. “For the past two months we had no ampicillin. Last week we had no penicillin PG, which is the most basic thing a hospital should have,” he said.