'The situation is dire': Eastern Cape hospitals shock expert team

The scenes at Eastern Cape hospitals that greeted a team of leading doctors and researchers, including an adviser to health minister Zweli Mkhize, left them distraught.

Local and international reports have cast light on horrific hospital conditions in the province, which has SA's third-highest number of Covid-19 infections.

Wits University Clinical Research Unit professor Ian Sanne was among four medical experts, including Mkhize's adviser Dr Sibongile Zungu, deployed to the province to prepare a report on hospital conditions and preparedness for the surge of infections.

The team spent 12 days visiting facilities in East London and Port Elizabeth after the alarm was raised about the failing health-care system, in which patients have to sleep on hospital floors awash with blood and human faeces.

“What we discovered during our inspections of the province's medical facilities was beyond distressing. It aligns with what local and international media have reported on,” said Sanne.

“What the media saw and uncovered is what we were highly concerned we would find. In some cases what we saw is far worse. For years the province has struggled with health-care resources, with the pandemic's evolution placing additional and immense pressure on the system.”

A senior Eastern Cape health official who was among those who alerted Mkhize said “rosy reports” on the province's health management needed to be exposed for the “lies” they are.

“The media were spot on. The problem, however, is far worse than what they often reported,” the official said.

Mkhize used the report to deploy a project management unit to the province, which Zungu is leading. She declined to comment on the position yesterday.

The medical experts' report found weak management was a key problem, and recommended the province address poor co-ordination between hospitals as well as appoint a Covid-19 project manager with the necessary authority.

The team found that the metros have mobilised reasonable infrastructure to meet the surge, but urgent attention needs to be paid to supplies of oxygen, equipment, staff and medicines.

Problem hospitals include Port Elizabeth's Dora Nginza, which was overwhelmed by patient demand and a lack of infrastructure, equipment and staff.

“The situation is dire,” said an Eastern Cape health department source.

This week, premier Oscar Mabuyane appointed a team of six medical advisers to help oversee the turnaround.

Sanne said staffing is the biggest concern.

“The number of health-care workers needed is huge. Thousands and thousands of doctors, nurses, auxiliary nurses and pharmacists are required. We urgently call on the country's medical world to respond and help fill posts. It's vital if plans are to work,” he said.

Sanne said the project management unit will help strengthen systems around hospital patient referrals and testing, tracking, tracing and rapid diagnosis of patients.

“As with the Western Cape and its strong command and control and response systems, which helped turn the tide through their interventions, we will see the same in the Eastern Cape. The same is anticipated for KwaZulu-Natal and Gauteng,” he said.

Sources close to Mabuyane's advisory team said they were horrified by the report.

“The conditions are beyond your worst nightmare,” said one.

“There are no managers there [in the hospitals] and those that are there are completely out of their depth and terrified by the unions. Nothing happens in the hospitals here without the unions' buy-in. For three weeks there have been no permanent hospital managers at Livingstone [Hospital in Port Elizabeth].

“At almost every meeting it's been raised with the health MEC as to when managers will be appointed. The silence is deafening.”

Another blamed poor leadership for patients sleeping on hospital floors.

“When you go to Dora Nginza and Livingstone hospitals and look at their burn and ophthalmology units, you see plenty of open beds. With proper management those beds could be optimally used.”

He said the arrival of Zungu and her team meant the health department is effectively under administration.

“Why else are they here? The provincial health department officials might not want to admit it, but that is what it is.”

Mabuyane said Zungu's unit has been given full administrative powers.

“It's not that the provincial health department has been placed under administration per se, but in this crisis it cannot be business as usual,” he said.

Eastern Cape health department superintendent-general Thobile Mbengashe said: “There are immense challenges, especially from Covid-19. Our resources are definitely stretched and the situation is not ideal.”

He said it was a pity that the media is not showing the good things the department is doing.

“Services in the Eastern Cape have not collapsed. We are in a good space,” he said.

“The arrival of the project management unit definitely does not mean we are under administration. They report to me, there are reporting lines.”

Mbengashe said while the situation in the province is not perfect, “we have not done any worse than any other province”.