The Democratic Alliance

SOUTH AFRICA'S FIVE WORST HOSPITALS

The 27- million South Africans who depend on the public health service are frequently unable to access an acceptable level of health care.

At the worst hospitals, patients must spend hours waiting just for a file, bring their own linen, stay in wards infested with vermin and reeking of human waste, and often share beds with other patients. Hospital buildings are infested with grime, rubbish and vermin. In these conditions, it is patently obvious that the rights of patients are not being respected and that urgent action is required.

An investigation into conditions in the public health sector shows very clearly that health care is deteriorating on a broad front. By highlighting a few of the worst examples, the DA is attempting to demonstrate that the government's hospital revitalization plans are failing, and that a thorough review of the effectiveness of existing policies is needed.

The DA has identified the five hospitals which our research shows to be most desperately in need of attention. We highlight these examples to bring to light the extent of the crisis facing public health care.

Our selection was based primarily on the following grounds:

Personal unannounced visits to each hospital and discussions with hospital staff.
Information supplied by DA representatives in the provinces.
A series of Parliamentary questions.
A detailed survey of media reports over the past five years.

What is alarming about our research is that the problems they face have been raised repeatedly by hospital staff, politicians, trade unions and journalists over the course of many years. While many promises have been made, there is little evidence of their fulfilment.

The DA will be taking this further by conducting a campaign around these hospitals to ensure that their problems are addressed. Over the course of the next year we will target these hospitals in a dedicated effort to ensure that action is taken to improve conditions. At the end of this period we will revisit all of these hospitals and report back on what difference has been made.

A detailed document relating to each of the five hospitals is contained in the DA's report. However, I will identify a few of the most critical problems at each hospital.

Rob Ferreira Hospital (Mpumalanga)

Vacancy rates at Rob Ferreira are virtually destroying its ability to provide care. For example, 67% of doctors' posts are vacant.
Doctors reported in 2002 that they had been forced to operate by torchlight. Nurses stated that at one stage they had been expected to keep intensive care patients alive by manually pumping air into their lungs during the many power black-outs.
During the DA's visit, I saw patient files jumbled on the floor - and heard reports of patients sent into file rooms to rummage through the piles in search of their own files.
We saw unused beds lining virtually every corridor and abandoned in the garden, and one floor was partially flooded from a leak from the men's toilet. Curtains were hanging half-off the rails; paint was peeling; and tiles were worn through to the cement. The gardens were full of large piles of dried vegetation with signs of vermin. There was no security evident.
There was a syringe lying in the central courtyard. There were hoards of new wheelchairs in a locked, barred room and others abandoned in the garden and being thrown out with the trash - yet they still looked fairly new and were useable.

Umtata General Hospital (Eastern Cape)

On a visit to the hospital in 1998, then President Mandela stated that he "literally ran away" after seeing conditions in a maternity ward.
In 2002, journalists exposed cockroaches crawling over babies in a ward which had not been fumigated since 1998.
In 2003, journalists found that the hospital had run out of disinfectant, anticeptic cream, anti-tetanus injections and gauze. Ninety-one mothers were sharing 48 beds in the maternity ward, and urine and blood were splattered in the corridors.
A Human Rights Commission report in 2003 found, among other things, that the hospital had no ambulances; only one theatre out of three was working; and there was a serious shortage of medicine because people just helped themselves.
On the DA's visit, we found that there was virtually no linen; there were mice clearly visible and overflowing rubbish bins everywhere; what looked like shining toxic waste running under the entrance walkway; there were oxygen cylinders lying in the car park and there was an overpowering stench of human waste. Shower and bath cubicles were filled to the ceiling with broken equipment, and the only area left to wash was in two filthy basins leaning over bedpans and hospital waste buckets.

Cecilia Makiwane (Eastern Cape)

Some 30% of doctor's posts, 28% of nursing posts, and 80% of specialists' posts are vacant. According to a nurse interviewed in 2004, "We are tired and burnt out… People are so overworked that they can't cope with day-to-day responsibilities let alone an anti-retroviral programme".
In 2002, the Health Professions Council of South Africa withdrew doctors from the hospital because of "outdated equipment, unacceptable accommodation and poor training facilities".
The DA found that there was insufficient linen; patients relied on food brought by relatives; the toilets were filthy; there was running sewage on the floors; and a broken window in one ward was stuffed with plastic bags.
There were dozens of cats living on the premises.
There is zero security and many nurses have been attacked.
The burns unit stank of rotting flesh and there was no isolation unit for new patients.
In Ward 20, the DA encountered the remarkable situation of a patient whose brother has moved into the hospital and treats it like a hotel.

Natalspruit (Gauteng)

In 2001, a newspaper investigation revealed that the roof was leaking; wards were infected with cockroaches; there were burst water and sewage pipes; the floors needed new tiles and lighting was hopelessly inadequate.
In August 2004, staff claimed that the hospital was near collapse, and 95% of employees signed a petition demanding the removal of the CEO, Dr Daisy Pekana. It emerged that over the previous two years, 290 doctors, specialists, and nurses had left.
In September 2004 it was reported that 76 children out of the 363 who had been admitted had died at the hospital in one three month period, many of them from easily preventable infections.
During the DA's visit, we discovered that the neo-natal ward held 78 babies although it was designed for 43. The Matron said they only had the five respirators and that if another newborn needed one, it was up to her to decide which baby lived and which baby died. There were two babies sharing one incubator.
Garbage from hawkers outside the hospital gates was uncollected and lying in piles.

Mahatma Ghandi Memorial (KwaZulu-Natal)

Over May and June 2005, 22 babies at the hospital died from Klebsiella infection. Shortly after these deaths were exposed, a report was leaked showing that more than 40 babies had also died from hospital-acquired infections in 2003, but that these deaths had been covered up.
Over the past three years there had been numerous complaints about poor conditions. In May 2005 the Health MEC paid a surprise visit to the hospital because she had been "inundated with negative allegations". Patients had complained about waiting for hours and that nurses were rude and abrupt. It was reported that the maternity section had only ten delivery beds, but saw 11 000 babies delivered a year - an average of 30 a day.
The hospital authorities were tipped off with regards to our visit, and refused to allow anything but a prearranged, sanitised tour. Naturally we immediately sent another DA member in to investigate and she found lengthy queues; bed linen changed only every three to four days; and a stink of urine in the wards and the toilets, which were in a filthy state. In fact the hospital is known for its stench as one enters the front door.

Download supporting documents (Five Worst Hospitals.doc)