Four of the largest public hospitals in Durban are crumbling and lacking basic services such as access to water. News24 reports that the grim state of these government-run hospitals in KwaZulu-Natal was detailed in a report commissioned by National Health Minister, Dr Aaron Motsoaledi.
In December 2016, Motsoaledi tasked the Ministerial Task Team (MTT) to undertake visits to Prince Mshiyeni Memorial Hospital in Umlazi, Mahatma Gandhi Hospital in Phoenix, Addington Hospital, along Durban's south beach and King Edward VIII Hospital in Umbilo.
They found that: the buildings are in a poor physical state; that hospital management was incompetent; the hospitals have a lack of service delivery; and that management positions are occupied by people with no relevant qualifications.
The report says one of the members of the MTT who did the assessments was seasoned health official, Professor Ronald Green-Thompson. The report found that at the four hospitals assessed, there had been a drastic reduction of more than 40% over the last three years in the number of registrars (specialists in training) appointed in the various medical specialties.
The first assessment was done at the 36-year-old Prince Mshiyeni Memorial Hospital, in the south of the eThekwini Metro, which seemed neglected. The hospital was challenged by its location on a steep slope, with a single entrance next to a taxi rank which itself had no access to water or sewerage. The report found that even the local community accessed water from the hospital. It also found that the supply chain manager post had not been filled since March 2016 due to a provincial moratorium on the filling of posts. During the walkabout at the hospital, it was found that the maternity unit was a dark and somewhat depressing area, with little natural light and in need of maintenance.
The report says the second assessment was done at the relatively new regional and district hospital Mahatma Gandhi Memorial. The team found that the male medical wards, converted for eight mental health patients, instead accommodated up to 16 patients. There are no specialist psychiatrists at the hospital. Staff at the obstetrics and gynaecology wards were burnt out due to a high number of patients, with a high turnover rate of midwives. Deliveries were between 550 and 620 a month. During the walkabout at the hospital, the team found that the on-call doctors' beds had unchanged linen, there was dirty crockery and rubbish bins were overflowing.
At the 83-year-old, crumbling King Edward VIII, the report says it was found that the hospital presented the greatest challenge in terms of patient care of the four hospitals. There were limited skills of the management team and staff shortages. CEO at the hospital, Dr Mandlenkosi Mazizi felt that the management was more administrators than managers. Mazizi said in the report that the finance manager had a "weak personality" and was unable to control staff members. The old hospital infrastructure imposed a major maintenance burden on the hospital. The "worst" visit was to the surgical ward on the fifth floor, where the lifts regularly were out of service, requiring patients to be carried up the stairs.
The report says the last assessment was done at the "toxic physical environment" Addington Hospital on the Durban beachfront. The management team was not strong, lacking a permanently appointed nursing manager and medical manager. Shortages of surgical sundries, antibiotics, and vacuum assisted dressings and assistive devices had limited the ability to undergo orthopaedic surgery.
Motsoaledi said he had tabled the recommendations to Parliament's portfolio committee and to Premier Willies Mchunu.
The report says the KwaZulu-Natal Health Department was not immediately reached for comment.
“We welcome the outcome of this report as it confirms our views regarding the state of health care service in KZN,” said Health and Other Service Personnel Trade Union of SA (Hospersa) general secretary Noel Desfontaines. “Poor management and corruption runs deep in this province’s health department. We reiterate our call for the KZN MEC for Health to resign, as this would be a step in the right direction in addressing issues faced by the ailing public health facilities,” added Desfontaines.
“We have a clear mandate from our members to address the various issues related to poor management and corruption, staff shortages and Occupational Health and Safety (OHS) particularly in the public service,” said Desfontaines. “The issues that came under focus with this report touched on these core problems. Hospersa will continue to campaign for these burning problems to be addressed,” added Desfontaines.
The task team recommended that the budget allocations for the four hospitals need to be reviewed. It also recommended that appointment of critical staff without the limitation of professional nurses and medical doctors should be permitted as well as for infrastructure and maintenance issues to be prioritised.
“We will wait with bated breath to see if these recommendations will be implemented by the KZN Health MEC. To date, he has allowed the delivery public health care in the province to collapse and this is another report confirming these sentiments,” argued Desfontaines.
“We call on the Minister of Health to extend this investigation to other provinces in order to fully understand the deplorable working conditions that our members work in and the poor levels of health care service being delivered to communities as a result,” concluded Desfontaines.
Academics from the University of KwaZulu-Natal’s Nelson R Mandela School of Medicine are, meanwhile, dissatisfied with being strong-armed into doing extra duty at public hospitals that faced crisis situations, says a Sunday Independent report. The academics also claimed that the process to enlist their services was not well planned, and they will not receive compensation for work done in hospitals, over and above their university duties.
Some academics said they were required to work at the King Edward Hospital VIII as well as the King Dinuzulu Hospital from December, where they were required to work in the outpatients and other departments. They labelled their new work directive as “exploitation” because of the work load they would have to deal with.
And, if they were not satisfied, the academics said they were asked to find new jobs.
“We do not mind helping out in times of a crisis, we are here to heal not kill patients. But why exploit us?" said one academic from the university who requested anonymity. He continued: “They gave us a take it or leave it ultimatum, which makes us feel like our value means nothing to the department of health.”
The academic is quoted in the report as saying that the instruction was given by the head of the medical school but no plan of action had accompanied it. “We were just told we would have to report to these hospitals and perform various duties there, and we are also expected to fulfil our other academic duties.
“No proper plan was presented to us regarding how this system is going to work, who would have to go where, and how we should balance performing multiple duties at once. We need answers,” said another academic who also declined to be identified.”
The academics said they previously offered their services for free at King Edward VIII Hospital, but were now feeling exploited by being forced to work for no pay.
The report says KZN MEC for Health Dr Sibongiseni Dlomo declined to comment as he was still to discuss the matter with the parties involved.
[link url="https://www.news24.com/SouthAfrica/News/the-dire-depressing-state-of-four-durban-public-hospitals-20171129"]News24 report[/link]
[link url="http://www.hospersa.co.za/news/hospersa-welcomes-ministerial-task-team-report-kzn-health-facilities/"]Full press release[/link]
[link url="https://www.iol.co.za/news/south-africa/kwazulu-natal/ukzn-academics-unhappy-over-exploitation-12234199"]Sunday Independent report[/link]