Three words to sum up Rahima Moosa Hospital: dirty, filthy and unsafe

Pregnant patients at the Rahima Moosa Mother and Child Hospital were left to sleep on the floor in filthy conditions with broken toilets, while hospital CEO Dr Nozuko Mkabayi was present at work on only 182 days over two years. 

These are among the findings of the latest Office of Health Standards Compliance report announced by health ombudsman Prof Malegapuru Makgoba at the official release of the hefty report handed over to health minister Joe Phaahla.

Makgoba’s office was tasked to investigate the hospital in Coronationville, Johannesburg, after complaints about shocking conditions, some accompanied by hard evidence such as video footage and graphic photographs, making them indisputable. 

This included an open letter penned by whistle-blower and paediatric gastroenterologist Dr Tim De Maayer, who was suspended and reinstated for exposing horrific hospital conditions and claiming “hospital-acquired infections spread like wildfire”. 

Makgoba said the complaints had come from different sources, and his office had been asked to “consider them in a manner which is fair”.

The main focus was allegations that pregnant women were left to sleep on the floor, the health, dignity and wellbeing of patients and staff were severely affected, the severely increased patient load was not being managed and the CEO was not working full time or running the hospital properly. 

“My team spent the better part of a year investigating these complaints and we have drawn conclusions,” Makgoba said.

This had involved in-depth interviews with 34 people from different parts of the hospital, and in which three words had been consistently repeated: “dirty”, “filthy” and “unsafe”. 

Makgoba, whose recent investigations include the Life Esidimeni tragedy and conditions at Thembisa Hospital, said the evidence presented was incontrovertible: women about to give birth were left on the floor. 

“It is also true the CEO was not present. [Mkabayi] gave us information that could not be verified and we found in 2021 there is a shortfall of 27 days that cannot be accounted for and in 2022 72 that cannot be explained,” Makgoba said. 

“It is also obvious the dignity of patients was not respected. The heating system did not work and the toilets were broken. There are lots of pictures and evidence to that effect.” 

Makgoba said while Rahima Moosa Mother and Child functioned as a specialist hospital, it did not have a blood bank, a laboratory service or an intensive care unit, and the CAT scan machine was not functioning. 

“There were many security challenges. Staff were being mugged at work, cars were being stolen and guards were not up to the job,” he said, joking about a security guard being too obese to chase a criminal. 

He said there was a shortage of nursing staff and while patient numbers were very high, an evaluation carried out over three years found 40% of patients seen were foreign nationals who had come to South Africa specifically to access obstetric services. 

Makgoba said recommendations flowing from the investigation were that Mkabayi be removed immediately and transferred to Gauteng health head office while a condition she claimed to have had was “stabilised”, and that she face a disciplinary hearing with regard to her many work absences. 

“It has become clear this job, in her own words, was the most stressful situation she has ever been in,” Makgoba said, explaining the role of his office was “not to be punitive” but to “find solutions in an amicable way”, to recommend where people should be held to account and “be supportive where required”. 

He said Mkabayi claimed to have a condition which she had disclosed to investigators and for which she required treatment and was committed to receiving. He said his powers were limited to recommending that she face a disciplinary hearing, and that she be assessed again in three years when her contract ends. 

The other disciplinary hearing he recommended involved a staff member at the hospital who “made her own concoction” of medical steriliser used for 11 patients who subsequently developed infections. 

Phaahla thanked Makgoba for “a job well done” and said: “This sobering report lays bare the many shortcomings in the system, and we are aware there are other hospitals that suffer the same inadequacies.”

He said he appreciated the plight of mothers giving birth and the need to ensure they don’t have to “endure a harrowing experience before bringing in new life”. 

Phaahla said the recommendations would be followed in terms of the stipulated timelines as far as possible. 

The Gauteng department of health issued a statement after the release of the report, saying many of the recommendations were already being addressed and plans to implement them in the short, medium and long term were being formulated. 

TimesLIVE

Support independent journalism by subscribing to the Sunday Times. Just R20 for the first month.