Horror of hospital with just one doctor

A psychiatric patient sits motionless, strapped to a wheelchair in a 400- bed hospital with just one full-time doctor and a handful of professional nurses.

"Unbearable" is the word staff use to describe working conditions at Tower Psychiatric Hospital in Fort Beaufort in South Africa's Eastern Cape province.

A chronic shortage of medical staff at the hospital was uncovered during an inspection by the provincial health portfolio committee, which wants the vacant posts filled urgently.

The committee reported that only 23 of 231 professional nursing posts were filled, while there was only one full-time doctor and one psychologist.

Tower and Fort England in Grahamstown are the only psychiatric hospitals in a province with a population of over 6.5 million.

The impact of the staff shortage at the ageing hospital was evident during a visit by the Sunday Times.

A 35-bed ward with patients who cannot feed, bath and walk without help was being manned by one staff nurse and one assistant.

Staff said the situation at Clinic A and Clinic B - which house critically ill patients - was dire. They were overwhelmed with work and said absenteeism was rife.

"Can you imagine what happens here if there is only one of us on duty? How can you carry such heavy patients all by yourself when you still have the responsibility to bath them, feed them and move them around?" asked a nurse.

A patient was found strapped to a wheelchair. "If we don't restrain her she will fall off the chair. We don't have any other means to enable her to remain seated," said a nurse.

The committee's inspection on September 30 revealed that:

• The hospital's mandate was to rehabilitate mentally ill patients yet it did not have a psychiatrist. There is just one psychologist;
• The hospital had a vacancy rate of 64%. There is only one full-time doctor, helped by two sessional doctors;
• Chronically ill patients were sent there despite not being ready for rehabilitation;
• The hospital had no funds to run rehabilitation programmes;
• There was a shortage of medical equipment, and funds meant for security had been spent on food and municipal services; and,
• Board members did not attend meetings or were incapable of carrying out their mandate.

Health portfolio committee head Viola Mtongana said the provincial health department had been given 30 days - from October 5 - to submit a plan of action to resolve the crisis.

Health department spokesman Siyanda Manana said, in response, that action was being taken to fill the vacant posts. There are now 31 professional nurses at the hospital while community service nurses would be deployed there from next year.

Mtongana said management and staff had painted a bleak picture. "They gave all the figures (and) you could easily understand that everyone is overworked. How can a 400-bed hospital for mentally challenged patients have only one psychologist?"