A whiff of urine, blood and vomit greets you at the entrance of the emergency unit at Helen Joseph Hospital. The cacophony of moans from the injured, pleas from family for assistance and nurses barking orders drowns out the the squeaky wheels on the damaged wheelchairs and dilapidated iron benches.
The sighs of a doctor in navy blue hint at a double shift. Leaving the hospital looking forlorn, his head hung, the man sighs and says: “I want to sleep and never wake up, I just want to die.”
A paramedic standing nearby nods in agreement on this rainy Thursday evening in December. On the same night the dimly lit casualty ward rooms are filled with patients. Droplets of dry blood run from the nurse’s counter where files are opened and patients are categorised according to the severity of their condition, with yellow being the lowest and red the highest priority.
An 82-year-old woman who had a stroke, labelled yellow, is the 32nd patient on the waiting list.
In the corridor are five people in bloodstained hospital beds, also waiting to be examined.
More than 10 people are in one of the small waiting rooms, with more on chairs and benches in the corridors.
The smell of food, medical detergent and urine permeates the unit as the doctors on duty attend to the injured. While reading charts and filling in forms, two doctors take a moment to complain about their working conditions.
One says: “At this point I don’t even know which hospital is better, here or Bara, but I know this isn’t what I signed up for ... I don’t know how much longer I can last here.”
A nurse explains that the wait is due to staff shortages and the high number of patients in need of care. The patients are told that the hospital has no beds available, so they need to “prepare for a long night”.
After arriving at the hospital at about 5.30pm, the elderly woman is only examined by a doctor at midnight before she is sent for various tests. At 12 noon the following day the family, who have been waiting all night, are told a bed is available.
“When a bed finally became available there weren’t any porters to transfer my granny to the ward. It broke my heart to see her lying on the ambulance bed for hours with no assistance. By 4pm when we were still waiting for a porter, I decided to take her up myself, a nurse offered to help but left and never came back. By 6pm my uncles arrived and we carried my granny to the ward,” said the woman’s granddaughter, who asked not to be named.
This week TimesLIVE Premium spoke to Romalia Doubell who was admitted to Helen Joseph around the same time as the elderly woman.
Doubell, 24, has been in and out of hospital for the past seven years and was discharged at the end of December. But her ordeal isn’t over; the mother of two is on a waiting list for surgery to remove her kidney.
In 2016, then a teenager, Doubell was rushed to Helen Joseph and diagnosed with kidney stones. The teaspoon-sized stones were removed and a ureteral stent inserted. A year later she still had the stent in, and in 2018 a second stent was inserted. Stents are usually taken out after six months, but with the postponement of surgeries, Doubell’s stents were left in for years. She came close to surgery in 2021 when she was admitted and prepped.
“I was ready for surgery, then a few hours after I was supposed to go into theatre I was told they needed to reschedule because a cancer patient came in. At this stage I hadn’t eaten for two days because I was waiting for surgery. Over the years the reasons for rescheduling my surgery have been that the theatres were full, I’m young and could still keep the stent in, and one time there was no laser machine. I was told the machine was in Limpopo,” Doubell said.
In December 2022 Doubell was again in excruciating pain and rushed to the hospital, this time with a septic kidney and kidney stones the size of a tennis ball and a golf ball.
Her mother, Roma Williams, cried as she recalled how she begged for clean bedding and even offered to change it herself.
Williams, a teacher, said the bedding had not been changed for three days and smelled of urine leaking from the nephrostomy bag, which is used to drain her kidney.
“I was broken. I would see the nurses on their phones. All I wanted was humane treatment for my daughter. I was told the hospital didn’t have linen and that it only arrives once a week and it only gets changed when the patient is dirty. Eventually I brought linen from home. I would actually also steal the linen from the hospital, take it home to wash it, then bring it back and change her bed myself, just to make sure she had clean linen,” Williams said.
Doubell said she’s still traumatised from her experience at Helen Joseph Hospital. While she had no complaints about the food, she said the taps were broken and there was often no water. With the blackouts and water outages which affected Johannesburg this week, the hospital was affected even more than usual, with patients bringing in their own water.
Staff shortages also affected the level of care patients got. For the 82-year-old stroke patient, it meant waiting almost 24 hours to be placed in a ward. Doubell, who jokes about being a “regular customer” at the hospital, says it wasn’t always this bad, but over time she’s experienced progressively bad service at the facility.
“It hasn’t always been like this, I’d say things at the hospital have got worse over the last five years. In casualty the smell of urine and blood is almost unbearable. Ambulance stretcher beds are covered in blood and just left there, and it reeks. I once spent two days in casualty waiting for a bed. I was left to sit on the floor. It felt like I was playing survivor. When someone got off a chair it was a race between us to get to the chair first,” Doubell said.
In response to questions asked in the Gauteng legislature, health MEC Nomantu Nkomo-Ralehoko said 36,237 patients are on waiting lists for operations in Gauteng public hospitals.
Chris Hani Baragwanath Hospital has the largest waiting list of 10,900 patients, which includes 1,777 patients who wait more than four years for a hip replacement and five months for a knee replacement.
Nkomo-Ralehoko blamed the Covid-19 pandemic for the backlog, saying elective procedures were halted during this time. Other factors for the backlog were delays in the procurement of specialised machinery, delayed renovations of operating theatres, brain drain with skilled staff moving to the private sector or overseas, the number of foreign nationals and delays in filling critical posts. Nkomo-Ralehoko said load-shedding also affected surgery, and linen shortages often led to operations being cancelled.
This is little consolation for Doubell, who is waiting for surgery to remove her kidney. The mother of two knows she will have to go back to ward 21, where the emergency buttons don’t work.
“I can still hear the sound of the machines beeping. One night I was in so much pain, I was calling, crying, and no-one came to help me. I was my own nurse. I told myself I can’t cry. I threw the pillows so that I’d have a softer landing, I rolled off the bed and onto the floor and crawled to the bathroom ... This changed my life and not in a good way. I’ve seen my friends and family accomplish their dreams. I feel so confused, I have been struggling with depression and anxiety,” she said.
There have been questions about whether the National Health Insurance Bill, which is before the National Assembly, could solve these problems.
National Health Insurance head Nicholas Crisp said while the public health sector is ripe for change, it is not uniformly ready for the reforms that will roll out over the next five to 10 years as NHI is implemented.
Crisp admitted hospitals are not ready and that the process of preparation will take time.
“The budget projections for health, and you will no doubt see it in the budget speech after the state of the nation address (Sona, on February 9), is down, so there will be less money allocated for a growing portion of the population, and that is extremely worrying. At the same time the private sector is close to implosion. They are losing beneficiaries who can afford the approximate 9% increase in contributions, increasing out-of-pocket payments, downscaling of benefit options, increasing over-servicing and waste.
“Both sectors are in trouble, and each one’s salvation lies in working with the other and not in parallel silos. This is not a short-term project, it is a journey of patience and commitment,” Crisp said.
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.