Race to ready field facilities as Covid-19 peak edges closer

Bed, oxygen and medical supply shortages have the Gauteng and Eastern Cape health departments scrambling to ready field hospitals for the Covid-19 surge.

In the Eastern Cape, phase 2 of the Rev Dr Elizabeth Mamisa Chabula-Nxiweni field hospital in Port Elizabeth has been delayed as the health department searches for oxygen equipment supplies.

In Gauteng, of the five planned field hospitals, only the Nasrec field hospital is receiving patients. The remaining four have yet to be built.

Clinicians volunteering at the Nasrec centre last week called for medical volunteers and supplies, including oxygen monitoring equipment and bedpans. The facility is designed to take mildly ill Covid-19 patients still requiring oxygen treatment from Charlotte Maxeke, Helen Joseph and Chris Hani Baragwanath so that beds in those hospitals can be freed up.

The Gauteng health department did not respond to questions on the hospital's shortages or needs.

However, Lynne Wilkinson, of the Collective of Private and Public Clinicians, whose members volunteer at Nasrec, said: "We were concerned about overall hospital bed shortages, especially beds with oxygen supply points.

"Nasrec had 600 beds for quarantine and isolation purposes, but not all were being used. We approached Gauteng health department to convert it into a field hospital. We are working with the department to ensure the beds are fitted with oxygen points."

Wilkinson said when they arrived last week the facility had 18 staff, with very few professional nurses.

"At the time the centre was only a quarantine facility with many patients self-caring. Now, with patients needing nursing, washing, feeding and stabilisation, the need for staff has increased."

She said they currently have 40 volunteers, including 15 doctors and 15 nurses.

"We need double the number. Fortunately, volunteer numbers are increasing. We receive about five daily. The volunteers include medical researchers, GPs and nurses from the private and public health-care sectors. When people volunteer we make sure they know there is no remuneration."

Wilkinson said the work is strenuous.

"You are in full PPE for six-hour shifts, making eating, drinking or even going to the bathroom very difficult."

She said medical equipment supplies are urgently needed, including bedpans, as many of the patients cannot move.

Wilkinson said through donations they have raised funds to purchase medical oxygen equipment.

"We have received 90 specialised oxygen saturation monitors, allowing us to treat 90 patients. But, because of our volunteer numbers, we cannot assist that many."

She said the biggest challenge was ensuring the provincial government put viable staffing plans in place so more patients could be cared for.

"Health MEC Bandile Masuku committed 300 beds with oxygen points, but those will only arrive in the second week of August. The need is big now and increasing."

Milpark Hospital ICU nurse Silindile Ntuli said her family was initially shocked when she signed up.

"I told them I was helping because many of the patients are poor and their family's sole breadwinner. They desperately need to get better so they can look after their families."

Retired Johannesburg surgeon Dr Tai Seng Schierenberg said he volunteered because he has skills which can be used. "I have been watching the Covid-19 crisis unfold. With the storm becoming real I felt I should make my skills available."

Eastern Cape health department spokesperson Siyanda Manana said the Port Elizabeth field hospital's second phase was deferred while the department sourced oxygen points for the beds.

"The majority of the beds didn't need oxygen points. Now they do."

He said the hospital has nine doctors, including two Cuban doctors, 36 professional nurses, 25 assistant nurses and 45 community health workers.

The hospital has admitted 134 patients to date, with 39 recovering and five dying. The 1,400-bed hospital is the province's only one. It was built by VWSA after a funding appeal to the German government.

Guy Richards, emeritus professor of critical care and pulmonology at Wits University, said the provincial governments should have used the initial lockdown to better prepare. "Instead they wasted time. Virtually nothing has been done in either province."