Long waiting times, lack of staff and overcrowding at Mamelodi Hospital
Staff shortages and a lack of beds are among the chief challenges faced by doctors and nurses at the Mamelodi Hospital.
Others problems include inadequate ventilation and no seclusion rooms for mentally ill patients.
These issues - and other constraints - came to the fore during a tour of the hospital by a SA Human Rights Commission (SAHRC) group on Tuesday.
The visit formed part of an investigation into an incident in which 76-year-old Martha Marais was tied to a bench at the hospital two weeks ago. A nurse, security guard and two doctors implicated in the matter have been put on special leave.
The commission's Gauteng manager, Buang Jones, said the purpose of the site visit was to examine a number of factors, including infrastructure and human resources issues - to ascertain whether patients were receiving proper health care.
"This is on the back of what happened [to Marais]. We will also look at the state of the hospital equipment," he said.
It emerged that the challenges started right in the reception area, where there was a "challenge of waiting time".
"The ideal waiting time is 160 minutes but we are far above that. We are on 240 minutes," the hospital's quality assurance manager Maesela Phogole told Jones during the visit.
Phogole attributed the long waiting time to a shortage of administrative staff at reception.
He told Jones that the hospital has a shortage of doctors and nurses.
The hospital's casualty area is the busiest, according to officials. Scores of people were waiting on benches while waiting to be attended. Others could be seen lying on the floor.
Referring to the Marais incident, Dr Adeleye Awolola said the woman had been waiting for a doctor.
"She was sitting on the bench. We just don't know how she ended up underneath it. The thing is, when a confused person is sitting, they can find their way anywhere," Awolola said.
He said Marais should not have been restrained on the bench, but because there was a problem with the shortage of beds, she could not be taken into a ward.
"If we have an acutely psychotic patient, you can ask security to help you in restraining the patient. If we don't have sufficient beds, security personnel are not able to manage the patient at all."
One of the officials demonstrated to Jones how Marais had been tied to the chair.
Phuphuma Mthombeni, a nurse at casualty, said overcrowding was a huge problem.
"We have a shortage of nurses, a shortage of resources such as stock. So we try to improvise most of the time," Mthombeni said.
She said when they were out of stock, they asked other hospitals to replenish it.
She said they were not able to adequately perform their duties because of the challenges they faced.
Mthombeni said the casualty area also did not have ventilation.
"When you leave the building and go outside you can tell the difference in how you breathe. The patients become irritable with us and they blame us for things we have no control over," Mthombeni said.
She said they got about 25 patients on an average day and the number increases to more than 40 on weekends.
Asked what kept her and her colleagues going despite the challenges, Mthombeni said: "It's knowing what we are here for. We motivate each other as a team."
Jones said the SAHRC would write a follow-up letter to the hospital following the site visit.