The revelation this week that the body of a newborn baby had disappeared from the mortuary at Durban’s Prince Mshiyeni Memorial Hospital in January has reopened wounds in the medical sector which date back to last year’s doctor’s strike.
The KwaZulu-Natal health department was quick to dismiss any suggestion that the ‘excuse” of staff shortages could have been behind the incident. Instead it questioned the ‘systems and management” at the hospital.
But doctors at Prince Mshiyeni who spoke to the Mail & Guardian say a provincial freeze on medical appointments and a severe shortage of staff at the hospital mean the security and medical monitoring of patients is not being maintained at an acceptable level and compromise their health and safety.
The body of Zinhle Shabane’s newborn baby was taken to the hospital mortuary but there was no one to receive it. It then disappeared without trace.
Health department spokesperson Chris Maxon said ‘negligence” and the sense that ‘management had not put systems in place to provide proper security and service delivery appeared to be behind the incident”.
He said that provincial MEC Sibongiseni Dhlomo, after a visit to the hospital this week, was ‘very angry” about a litany of problems at the hospital, including ‘people being chased away from the ARV [antiretroviral] clinic after noon, long queues at the dispensary and the lack of proper monitoring of patients in the maternity ward”.
‘Government understands the constraints under which medical practitioners are working, but doctors and nurses need to be aware that the province is in financial distress and that health services are being delivered with scarce resources —
We need doctors to be creative and inventive when it comes to health service delivery,” said Maxon. But doctors scoffed at this: ‘The department wants us to stretch ourselves to the maximum to ensure service delivery.
We are already doing this — aware that we, not the government, will be responsible if anything goes wrong — but they are still unrelenting on the structural problems which are compromising the health of patients,” a doctor at the hospital said.
‘The government is giving us a chisel and expecting us to make Mt Rushmore. We can do it, we are doing it, but to ask us to be ‘inventive’ is to ask us not to adhere to our strict guidelines as medical practitioners,” said another.
An example of the dire need for more medical staff at the hospital was given by a doctor who noted that ‘interns at Prince Mshiyeni are allocated 50 patients each, while the Health Professional Council of South Africa emphasises that interns should be allocated no more than 25 patients. You are compromising inexperienced interns and patients with that sort of workload.”
Another said: ‘Our labour ward is the second-busiest in the country, with about 18 000 deliveries a year. I think we’re doing pretty well considering that most nights there are no anaesthetists to sort out things for delivering babies or going into theatre.”
One doctor, who has worked overseas, said the disappearance of the baby’s body could have been prevented if there had been more nurses: ‘In some countries we have a ration of two nurses to every patient and there is strict monitoring of newborns by midwives. In Prince Mshiyeni the ratio is reversed, with one nurse to every two patients. You reap what you sow.”
The problems at Prince Mshiyeni are not particular to just that hospital.
A doctor who worked at King Edward Hospital complained of waiting up to eight months for a Magnetic Resident Image (MRI) scan (a high resolution image of tissue and bone) for spine surgery investigations before proceeding to surgery.
‘You’ve got to monitor a patient for eight months in hospital — when you already have a shortage of beds and a surgery backlog — while waiting for an MRI. This just isn’t logical.”
A doctor working in northern KwaZulu-Natal said rural hospitals experience similar problems. ‘Whatever you’ve heard before, the problems are still there, just worse. I have patients sleeping overnight with their children so that they can get attention.
‘On a Tuesday I am seeing Monday’s patients, on Wednesday I am seeing Tuesday’s patients. There just aren’t enough people to deal with the backlog,” the doctor said.
‘Because of the shortages there is no one to man the ambulances on Tuesday, Thursday and Sunday, so they don’t go out. I’ve had assault cases having to wait for more than 24 hours
before they are seen to because we just don’t have the staff,” said the doctor who asked that the name of his rural hospital not be published.
Maxon was adamant that being in the medical profession ‘requires dedication and commitment to service — which we are not saying that they don’t have —
‘But there are other countries where there is high-quality healthcare despite scarce resources — like Zimbabwe, for example, where the primary healthcare is extremely good,” he said.