Bay hospitals at breaking point

Nelson Mandela Bay’s public hospitals are bursting at the seams, battling a crisis of too many patients and too few staff — a situation so dire it has threatened to collapse public health care in the city.

The hospitals affected include Dora Nginza, Livingstone and Uitenhage Provincial.

Staff, union representatives and patients who spoke to The Herald this week told how the public hospitals were overwhelmed with all the additional patients being brought in, while nurses who had tested positive for Covid-19 were not replaced, which added pressure to the system.

One of the big concerns coming out of the Bay command council on Wednesday was that the city was running out of high-care and ICU beds.

An insider said if the numbers continued to rise at a rapid rate, there would be no space for patients at public and private hospitals in the city.

The insider, who attended Wednesday’s meeting, said the city had recently included private hospitals in the command council.

“We picked up that the city was running out of high-care and ICU beds, meaning that if the spike continues, we won’t have beds, which is why the VW field hospital needs to open quickly,” the person said.

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The VW field hospital, named after Dr Elizabeth Mamisa Chabula-Nxiweni, is expected to open on July 1, with the first phase to host 1,400 beds.

Once the third phase is completed, about 3,300 beds will be availed.

Explaining the severity of the strain that the pandemic has begun to have on the public health-care system, Democratic Nursing Organisation of SA (Denosa) provincial secretary Khaya Sodidi said there was no time  even to decontaminate rooms where patients had died of the coronavirus because there were too many new patients coming in.

“Before, when a patient died, the hospital decontaminated the room, but now, because of the rising number of infections and people needing hospitalisation, this is not happening — there is no time to do it.

“As soon as a porter transports a body out of the room, another patient is brought right in,” he said.

Sodidi said the rise in the number of nurses, doctors and support staff testing positive for the virus was alarming.

“The infection rate is running away from us, and it’s more than the figures reported because Dora Nginza’s maternity ward has 20 nurses infected with the virus.

“This creates a shortage in staff because you’ll have a large number of nurses in quarantine, some isolating, resulting in fewer staff to perform their duties and service patients.

“This has an adverse effect on the services,” he said.

Sodidi said all public hospitals in the metro had Covid-19-positive patients and were running out of beds in the designated Covid-19 wards.

“This has caused chaos because you’ll have positive patients using beds in areas not identified for Covid-19, so it has resulted in patients mixing together.

“The minister was right to say we’re riding into a storm.

“Our nurses are now living in it,” Sodidi said.

At Dora Nginza Hospital, nurses downed tools, saying they were overworked as the staff who had been sent home to quarantine were not replaced with others.

Adding to the strain, pregnant women from surrounding regions have turned to the hospital for medical assistance as the Humansdorp hospital was closed at the weekend due to Covid-19-positive cases.

The provincial hospital said at the time that it had been closed to undergo a deep cleaning process.

At Dora Nginza, the doctors are working, but they are battling along without the help of nurses, some of whom report for duty but refuse to do anything because they say they are overworked.

By Friday last week, Dora Nginza had 41 staff members who had tested positive.

A kitchen worker tested positive for Covid-19 and patients have, consequently, not been receiving food from the kitchen since the start of the week.

The patients have to rely on their families to bring them food but it must be collected at the hospital gate — more than 100m away — as visitors are barred from entering the premises due to Covid-19 restrictions.

Patients from out of town rely on handouts from those who manage to get food from their families.

National Education, Health and Allied Workers’ Union (Nehawu) provincial secretary Miki Jaceni said the hospital management was to blame for the nurses’ behaviour.

“There is laxness on the part of management to put in place contingency measures where front-line workers [have tested positive].

“The problems arise when you put those who are positive in self-quarantine and there is no plan to substitute [them] so that work can continue.

“As a result, there is an additional workload.

“There was already a staff shortage at the hospitals throughout the metro and we have been calling for a recruitment drive, but that call has been falling on deaf ears.”

Jaceni said the action by the workers —  though they have not gone on an official strike — was the result of being overworked and fear of contracting the virus and dying.

The situation is grim at Livingstone Hospital, with doctors saying systemic inefficiencies of the provincial health department are coming back to bite them.

Three weeks ago, a dispute between unions and management had an impact on patients, some of whom were turned away because the staff had stopped washing  linen and, without bedding, patients could not be admitted.

Some of the disputes have since been ironed out, but the hospital is battling a host of other problems.

The dire situation at the Korsten facility includes insufficient stock of every kind, including personal protective equipment (PPE), and a fraction of the required staff holding the system together but nearing breaking point.

A Livingstone doctor, speaking on behalf of a group of doctors at the hospital, said on Thursday the Covid-19 crisis had exposed long-time neglect by Bhisho of state hospitals, including Livingstone.

“It is systemic, purposeful, not by mistake, and now Covid has magnified the issue.

“We are critically understaffed and working on a shoestring.

“It is not functional, it is abusive.

“Bhisho has systematically over the years destroyed a functional service and decimated and abused the national health-care workforce who are now expected to fight Covid as well.

“We are expecting 1,000 Covid patients next week.

“Where are we going to put them?

“If we need to transfer them to the new VW field hospital with Emergency Medical Services not functioning, how will we do that?

“A lot of people are going to die and the blame will lie at the feet of Bhisho.

“It’s absolutely terrifying.”

The doctor said ensuring they always had sufficient PPE was a huge challenge in itself.

“When we request further stock, it’s needed urgently, but because we have to submit our request through a centralised system it often arrives too late.

“The way it stands at the moment, when a flood of patients hits us next week, we will not be able to protect our health-care workers.

“Livingstone had until now survived on donations, especially from the Muslim community, which continued to be supportive, but it was not enough.”

The doctor said insufficient staff was a major problem.

“Bhisho has whittled down every department.

“They know they can rely on the goodwill of some of us but we cannot do it on our own.”

The virus had thinned staff out further.

Some staff memberswere not at work because they had tested positive or were in quarantine due to being in contact with an infected  worker, others because they could no longer tolerate being overworked, and some  because they were in the vulnerable age group.

The result was that there were many wards that had patients but no sisters to manage them, the doctor said.

“Bhisho says they have sent us more staff but it does not come close to covering even the deficit that existed before Covid-19, let alone helping to bolster our ranks in the present desperate situation.”

The provincial health department had, for some time, continually sought to cut back on “non-essential workers”, but these kitchen and laundry staff, porters and cleaners were in fact vital, the doctor said.

“We need to feed our patients, we need clean linen for their beds.

“At Livingstone, there used to be 100 workers running the laundry and now there are only 34.

“That means there is always a backlog and the laundry team is always super-stressed.

“There are so few porters that our doctors and sisters are portering just to try to keep the flow going.”

At Uitenhage Provincial, the situation is much the same, with the nurses feeling overworked and ready to give up.

A nurse at the hospital said theatre nurses and midwives found themselves having to mop floors and sweep after cleaning staff failed to show up.

“There was a C-section performed in the week and the theatre staff stayed behind to sweep and clean up.

“This is not their job.

“Our staff shortage is an issue because you have an entire shift of people who are isolating at home because one of their colleagues tested positive.

“When this happens, it creates a strain on everyone else.

“We are tired and overworked,” she said.

The nurse said a shortage of clean linen was an issue that needed to be addressed.

She said they were taking in patients from the Sarah Baartman district following the closure of the Humansdorp hospital.

Another Uitenhage nurse said she was considering resigning.

“I’m not resigning because I hate my job but I just want to work in a place that has ... staff because I’m exhausted.

“Never mind PPE and the rest, I just don’t think I can carry on working like this,” the nurse said.