EDITORIAL | Neglected and dysfunctional Gauteng hospitals face collapse

Another day, another scandal at a state hospital in Gauteng.

A report released on Tuesday by health ombud Prof Malegapuru Makgoba on the Rahima Moosa Mother and Child Hospital in Coronationville, Johannesburg, painted a shocking picture of a facility crippled by dysfunction and failure.

As Makgoba, alongside health minister Joe Phaahla, detailed a litany of damning findings, a clear picture of the extent of the horror began to emerge.

Broken toilets, pregnant patients left to give birth while lying in filth on the floor. No heating, no blood bank, no laboratory service, no intensive care unit, and a broken CAT scan machine. Staff were being mugged at work, cars were being stolen, and the CEO was often absent. The description conjured up scenes from a horror movie.

To add insult to injury, paediatric gastroenterologist Dr Tim de Maayer, who blew the whistle on the appalling conditions and claimed in an open letter that “hospital-acquired infections spread like wildfire”, was suspended for speaking out.

We are unlikely to ever know the true cost of his abhorrent situation. How many patients were casualties? How many mothers and babies died due to these inhumane conditions? Because of their financial situation, these women had no choice but to put their lives in the hands of a facility that was unable to give them even the most basic care. And possibly in some cases, unable to keep them alive.

The birth of a child should be a magical and rewarding experience. Instead, for these women, it was the stuff of nightmares.

Makgoba also revealed that over the years, the issue of a serious nursing shortage at the hospital was repeatedly raised with the Gauteng health department. This is a similar lament from frustrated staff at many healthcare facilities across Gauteng, who say centralisation of health means hospital management is often unauthorised to make even the simplest decisions.

The report is yet another reminder that Gauteng’s state health system is facing collapse, with a long list of health and criminal crises that have made headlines.

In many cases, hospitals continue to operate due only to the dedication and hard work of the doctors and nurses who work in untenable situations, yet have not forgotten their Hippocratic oath to uphold professional ethical standards.

Who can forget the Life Esidimeni tragedy in 2016, when 144 people at state psychiatric facilities died from starvation and neglect after 1,500 patients were relocated to cheaper care centres, many of which were not registered and unequipped? No official has faced criminal charges for this.

At Tembisa Hospital, the Special Investigating Unit (SIU) confirmed in December that a probe had found maladministration and possible fraud and corruption related to the supply chain management process. It identified R1bn in payments to criminal syndicates.

The mayhem continues at Charlotte Maxeke Johannesburg Academic Hospital in Parktown. Two years after arsonists gutted a large portion of it, police are none the wiser as to who started the blaze.

While parts of the hospital have reopened, in January Daily Maverick reported that more than R3m worth of copper piping had been stolen from above an operating theatre, disrupting surgeries in several theatres.

Soon afterwards staff in the ICU and the emergency department refused to work overtime because they had not been paid for it since last year.

Over at Helen Joseph Hospital in Auckland Park, two nurses have been stabbed while on duty this year, and doctors have spoken out about having to cancel surgeries due to leaking ceilings, broken aircons and other infrastructure and resources problems.

At Diepkloof’s Chris Hani Baragwanath, the third largest hospital in the world, crippling lawsuits are the order of the day, with provincial health confirming in December that the hospital’s maternity unit was facing claims worth almost R1bn.

And just last month, a leaked video showed rain pouring through the roof at Steve Biko Academic Hospital in Pretoria.

These examples are just a drop in the ocean of the challenges that our health professionals face.

In many cases, hospitals continue to operate due only to the dedication and hard work of the doctors and nurses who work in untenable situations yet have not forgotten their Hippocratic oath to uphold professional ethical standards. This must be overwhelmingly difficult, given the conditions they have to work under, and we salute them for their dedication.

Government has failed to provide decent health care to the people of Gauteng and by doing so has prised wider the massive chasm between the rich who can afford private healthcare and the poor, who must put their lives in the hands of officials who are under-resourced, underpaid and overworked.

To subject citizens to this level of health care (or rather lack of it) is not only barbaric but also clearly unconstitutional and criminal.

Are our lives worth so little to our leaders? We think we all know the answer.

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