Short-staffed hospital may be forced to close
A rural hospital in Eastern Cape intended to serve 262000 people might have to close if it does not get more doctors by the end of the month.
On February 10, the 180-bed Madwaleni Hospital, a 90-minute drive from Mthatha on a half-tarred road, will have only two staff doctors.
The two junior doctors are on short-term placements from Australia and Northern Ireland and will have to treat all the patients in the hospital's seven wards.
Every year, about 1800 babies are born in the labour ward, 15% of them by caesarean section.
Swedish doctor Beatrice Lüthi, who has worked at Madwaleni for almost two years but left last week, said the hospital needed at least 15 doctors.
Last year Eastern Cape health department head Dr Siva Pillay fired Madwaleni's clinic manager for being absent for 94 days in a single year.
Said Pillay yesterday: "If you are absent more than 30 days, you are AWOL so we say 'bye-bye' and I stop your salary."
The post has not been filled.
Pillay "moved" the hospital manager, whom he said was not sufficiently skilled.
The SA Medical Journal reported last year that the hospital manager was suspended for "alleged financial irregularities". That post also remains vacant.
Last year Lüthi and six other doctors - only two of whom were South African - barely managed to keep the hospital running. Most of those doctors have left, "completely burnt out", she said.
"We tried to see everybody, but we were not getting enough time to really get to the real problems. We'd rush through things which might cause complications but we had to be faster and constantly felt the pressure," she said.
Lüthi said she felt like "a pilot who doesn't get enough sleep".
Without senior hospital managers, the health facility was no longer the idyllic rural hospital it once was.
Dr Richard Cooke, a former employee who now works for Wits University's rural health advocacy project, said health programmes at satellite clinics overseen by Madwaleni doctors could not continue operating with only two staff.
"You really need a minimum of six or seven doctors ... On February 10, there will be two doctors left. But if there's not an improvement in the situation they may well leave," he said.
Pillay said yesterday that he had made Madwaleni "a priority hospital" and guaranteed that "before the end of January, Madwaleni should have five doctors, two clinical associates and community service doctors."
Pillay's single-handed attempt to resolve the doctor shortage includes signing an employment offer letter on Thursday last week for a senior clinical doctor from Holland and fast-tracking her registration with the Health Professions Council of SA.
Pillay said he is also "negotiating" for a married couple, both doctors, to work at Madwaleni.
Pillay's other moves include building more houses for doctors and providing medical bursaries to local students on condition that they work at Madwaleni once they have qualified.