EC hospitals in extended crisis

Patients the losers as officials mismanage provincial hospitals

By YOLISA NJAMELA

THE Eastern Cape’s newly appointed Health MEC appears to be set on preventing public scrutiny of its troubled provincial hospitals, and staff are too intimidated to speak out. In the meantime institutions are haemorrhaging nurses and doctors.

The conditions at many Eastern Cape hospitals are very poor and health workers fear to speak out as retribution from the province is swift.

Ironically, the province’s health services have deteriorated over the past decade of democracy with patients flocking to neighbouring provinces in the hope of receiving better treatment.

Huge staff shortages, rundown hospitals, shortages of essential medicine, poor management and a lack of infrastructure are just some of the issues that health workers complain about. But none will go on record with their complaints.

Numerous changes in top leadership have also exacerbated the problem.

Health MEC Bevan Goqwana was finally fired in April after a tempestuous term that saw him being charged with fraud at one stage.

His replacement, Nomsa Jajula, and her departmental staff seem determined to block the media from access to the province’s health facilities.

It took six weeks of dogged persistence before Health-e was given permission to visit Mdantsane’s Cecilia Makiwane Hospital, one of the largest institutions in the province.

But when Health-e was at the hospital, the Health Department’s director of communications Mzukisi Ndara suddenly reneged on an agreement to let us speak to management, claiming that the journalist was “pushing an agenda”.

Cecilia Makiwane Hospital is part of what is now called the East London Hospital Complex. Established in 2002, it consists of the Frere and Cecilia Makiwane Hospitals and the East London Mental Health Unit.

The massive complex serves a population of almost three million people, yet specialists rotate through the hospitals as there are not enough skilled staff to keep services going at both Cecilia Makiwane and Frere simultaneously.

Health Minister Manto Tshabalala-Msimang recently revealed in Parliament that 58 percent of doctors’ posts are vacant at the 1724-bed Cecilia Makiwane. Fifty-six doctors resigned last year alone.

Almost two-fifths of the medical specialists’ posts are also vacant, and over one in five nurses posts are vacant, said the minister – although local nurses say this figure is much higher.

The province may well be touchy about Cecilia Makiwane as it could be facing a massive lawsuit for negligence from four mothers who lost their babies during a power failure.

The four babies were in the intensive care unit at the time.

Although the hospital initially admitted to the mothers that the emergency generators had failed to kick-in during the power failure, incredibly no one has been held accountable for this.

Tshabalala-Msimang recently visited the hospital and exonerated the hospital staff from blame, while also announcing that parents of the dead babies would not be compensated.

Nurses at Cecilia Makiwane Hospital refused to speak on the record even though Health-e had provincial permission to interview them.

“If they know I talked to you, I can kiss my job goodbye. Not that I care so much because no one cares about us. But you know, I need this job,” said one.

Morale amongst the nurses was low. They were particularly bitter about their poor salaries, saying they had to work extremely hard because of staff shortages. They were also fed up that very few of them qualified for the “scarce skills” allowance introduced in 2003.

The nurses’ home was filthy and many windows were broken.

At the hospital’s burns unit, the stench was unbearable and there was no air-conditioning.

A sole nurse was in the ward to care for the 30 patients. Burn victims need specialised attention as they are highly susceptible to infection.

At Mthatha General Hospital in the poverty-stricken north east of the province, a third of doctors’ posts are vacant and almost 40 percent of pharmacists’ posts are vacant.

The hospital serves about 2,5 million people, and acts as a referral hospital for over 20 district hospitals.

A massive 348 nurses and 68 doctors have resigned from Mthatha in the past three years.

When Health-e visited Mthatha earlier this year, Aids patients were dying while waiting for antiretroviral drugs as only 10 new patients a week were accepted to the treatment programme.

The then MEC Goqwana ordered staff to work overtime to remedy the situation, but the hospital’s Dr Anele Mani said that since Goqwana’s removal from office, the programme had gone back to operating at snail’s pace.

Patients lie sprawled all over the reception area, some emergency cases on stretchers or sitting on benches with drips on their arms waiting to be admitted.

When Health-e visited, dustbins were overflowing and toilets were filthy.

In Mthatha’s backyard stands the R500 million state-of-the-art Nelson Mandela Hospital, a tertiary institution supposed to alleviate the pressure on Mthatha.

But it is a white elephant as it has been unable to attract skilled staff.

At Sipetu, a district hospital near Mount Frere that refers patients to Mthatha, there is only one doctor and not a single ambulance for a population of about 200000.

Malnutrition is one of the most a serious problems, especially for children.

The operating theatre has not been working for more than a year.

The ARV programme has not been rolled out because there is no one to dispense the drugs. Volunteers dispense medication as no pharmacists want to work at the 147-bed rural hospital.

Meanwhile, advocacy groups in the province say it’s extremely hard to work with the Health Department management in the province.

Public Service Accountability Monitor researcher Thokozile Madonko says alarm bells have been ringing at all levels throughout the Eastern Cape public health sector since 1996.

“At the heart of the department’s problems has been its consistent failure to undertake rigorous strategic planning exercises, which has resulted in it being unable to properly manage its finances,” says Madonko.

“This has led to the department routinely incurring significant over-and under-spending, which severely hampers effective service delivery.”

Meanwhile, the Treatment Action Campaign co-ordinator Phillip Mokoena says that “access to information is a big struggle”.

“We can’t get hold of government reports in terms of the progress especially with the ARV programme,” he says, adding that the new MEC has been instrumental in blocking information. — ©Health-e