Places of death, not life
The state of the public hospitals in the Eastern Cape is horrific. And I understand that the conditions I encountered there also apply to similar hospitals in other parts of the country. I relayed my experience and my findings, in writing, to both the national and provincial ministers of health and only resolved to go public when I did not even receive the courtesy of a reply.
My assessments are based both on personal experience as a patient at the Nelson Mandela Academic Hospital in Mthatha in June of this year and on two visits to the Mjanyana TB Hospital in the Ngcobo district, as well as on information gleaned in discussions with health workers in the province.
Although I am a retired professor of English and history, I also have experience in the health field, having been a certified caregiver in the states of New York and Michigan for 14 years until 2003.
I was born and raised in the Eastern Cape. On a visit home I collapsed on the night of June 7 and was admitted as an emergency case to the intensive care unit at the Nelson Mandela Hospital. There I was stripped and lay naked in bed under an obviously used sheet for two days until a member of my family managed to bring me some night clothes. In all my 80-plus years I have never felt as insulted as I did for those two days and nights lying naked in that bed.
Yet this is a modern, state-of-the-art facility, well designed and with the latest equipment. Unfortunately, however, some of the equipment malfunctions. Toilet tanks, for example, do not fill up automatically and remain dry, with the result that waste is not flushed away. Nobody seemed to know why this should be so, or why lights in the wards are dim or do not function at all, or why there are no lights or bells for patients to summon help.
There are also no side rails on the beds, something regarded as a must in most hospitals, even in non-intensive or critical care units. Why this should be so I was unable to ascertain. It may have been through poor usage over time.
There is also the fact that many of the doors, especially to the toilet facilities, lock automatically and often remain so. At one stage, I was locked inside a bathroom for 45 minutes, banging on the door in panic while staff outside tried to open it.
Finally freed, I asked: “Why didn’t you break down the door?” Some of the staff seemed shocked. A door, it seems, is more important than patient care.
Yet in these conditions, the doctors and many of the nurses did their best while they were clearly overworked and understaffed. There was also an acute shortage of supplies such as linen, gowns and towels. I asked to be discharged, feeling I was safer at home than in the hospital. I only hoped when I left that my already thrice-used sheets were sent to the laundry.
But the conditions at Nelson Mandela were a marked improvement on what I discovered at the Mjanyana TB hospital. I went to check on that hospital because of reports I had received from a friend, Nokhaya Gladile, whose son Khangelkani had been referred there in 2003 with suspected tuberculosis.
There was no doctor on duty when he was admitted and he stayed there for three weeks without being examined or having a chest X-ray taken because the X-ray machine was out of commission. His family finally removed him and he was referred to a doctor in East London where he was diagnosed with TB and treated.
Armed with this information, and fresh from my experience in Mthatha, I visited Mjanyana. I had been told that it was dilapidated, dirty, wild and unkempt, with only two or three nurses on duty, no night duty nurses and one resident doctor. What I saw beggars description.
An old “meals on wheels” van and two vegetable vendors surrounded by empty plastic bags and other garbage greeted me at the gate. Inside the grounds there was grass a metre high, littered with plastic and bags caught in the bushes—an ideal environment for snakes and vermin.
On the way to the wards is the kitchen, where just about everything is old, dirty or broken. The linen cupboard is half filled with what is called imiRhayi in Xhosa and which probably translates most accurately in English as tattered rags.
The patients’ mattresses are slabs of foam covered by dirty sheets and thin blankets, with the bottom sheet having no waterproof slip. When patients wet their beds, which, I was told, they often do, the nurses have no alternative but to put the mattresses out in the sun to dry. The same applies to other bedding. Because of a shortage of supplies, only severely soiled linen is washed.
To say the washrooms are not clean would be the ultimate understatement. I would describe them as filthy death traps where germs must be multiplying by the millions. Toilets do not flush, tiles are cracked and broken and there is moisture everywhere. In such an environment, it is difficult to imagine how anyone could come out alive.
In these conditions, the nursing staff were extremely polite and helpful. The fault does not lie with them, but with an inefficient bureaucracy in Bisho.
I discovered, for example, that the provincial health department last year returned more than R15-million of its unspent capital budget to the national department of health.
The provincial health minister also visited the hospital in 2003. But no improvements were made. And the X-ray machine still does not function three years later.
We need ...
Equipment shortages listed at the Mjanyana TB Hospital: mattresses, mattress covers, sheets, blankets, suction machines, blood pressure machines, bed cradles to elevate blankets in the burn unit, HB meters, glucostics to check blood sugar, wall heaters, gowns, oxygen, X-ray machines, geysers, wash basins, bed pans, urinals, disposable napkins.—africanewsfeatures.com
Dutywa-born Phyllis Ntantala is a former professor of English and history at Wayne State University in the United States and maintains regular contact with her large extended family in the Eastern Cape