JOHANNESBURG, 3rd MARCH 2017 - The Treatment Action Campaign (TAC) in Gauteng is alarmed at the collapse of an entrance to the Charlotte Maxeke Hospital in Johannesburg yesterday. Hospitals are a place of safety and shelter, not a place where people are hurt. Our thoughts go out to those injured and we are thankful that there was no loss of life. However, we are unequivocal that urgent steps need to be taken by MEC Ramokgopa to audit the infrastructure all Gauteng health facilities and ensure this does not happen again.
Today TAC Gauteng launches a fact finding mission into the state of hospitals across the province. Not only will we monitor the state of infrastructure but also the state of service delivery. Are there enough doctors, nurses, porters, security guards? Are people sent home without medicines? How long must people wait to be seen in the facilities? Are the facilities clean? Are there enough beds? Do people get the service they need?
On 16th March TAC Gauteng will be meeting for the first time with new MEC of Health, Gwen Ramokgopa. We are committed to engaging with her constructively to bring an end to the crisis in the public healthcare system. In addition to other issues, we will raise our concerns over the state of our facilities. We urge MEC Ramokgopa to undertake an urgent audit of health facilities across the province. The results of which should be made public together with a plan to address any failings. The department must strengthen the Infrastructure Unit (in conjunction with the Department of Public Works) to address backlog maintenance, routine maintenance and the building of new health facilities – as well as ensure better monitoring and oversight of material procurement processes – in order to prevent any further disasters in our health facilities.
Since 2012 we have been raising concerns about the dire state of health facility infrastructure in the province. A report issued by TAC and SECTION27 at the time highlighted in part the poor condition of buildings, the power failures, the lack of safety features, the potholes, the non functioning lifts and the impact of these failures on the provision of healthcare. As recently as last September, TAC Gauteng picketed outside Thelle Mogoerane Hospital in Vosloorus noting – among other issues – cracks and leaks in the hospital building that have yet to be addressed.
Reports that doctors at Charlotte Maxeke Hospital have been complaining for years about the structural problems are especially alarming. Even worse is that they feel the need to remain anonymous in making these reports. We urge MEC Ramokgopa to ensure a new era of openness, engagement and accountability from the provincial health department. No healthcare worker should fear victimization or job security as a result of speaking out. In order to ensure better communication flows, accountability structures such as hospital boards and clinic committees should be fully functional to ensure the concerns of health workers and community members are addressed effectively. A system should be established to take management teams out of their offices and into the community to listen to the needs of the people on a regular basis.
Proper maintenance of existing infrastructure and the development of more suitable infrastructure is essential to ensure safety, suitability, cleanliness and the proper functioning of facilities across the province. While Treasury cuts the health facility revitalization grant, the onus is on the MEC Ramokgopa to ensure enough money is put towards maintenance projects through the equitable share. National cuts must not impact negatively on the quality of our health facilities.
For more information, contact:
Fikile Mtshweni 072 130 9217
Stephen Ngcobo 073 846 0910
An excerpt from TAC and SECTION27’s report “Monitoring Our Health: an analysis of the breakdown of healthcare services in selected Gauteng facilities. A report for the period January – December 2012”.
“Hospitals and clinics in Gauteng are being seriously affected by unsuitable infra- structure. This primarily relates to a lack of maintenance of existing infrastructure and failure to meet the needs for new infrastructure. In particular, we have noted the following key problems.
- Power: There have been repeated power failures at various hospitals, notably Chris Hani Baragwanath Academic Hospital. In tandem, generators have not been a steady backup and have tripped repeatedly in instances in which they should have provided backup power. This has had predictably serious consequences including the cancellation of many operations (during one episode in a single hospital alone, 40 surgeries were cancelled). The power outages have led to instances in which surgeons operated using headlights and cellphone light.
- Buildings: In many hospitals the buildings and infrastructure have not been maintained. Wards are in a poor condition and are sometimes dangerous (for example, medicine storage rooms without burglar bars; a temporary psychiatric ward in which male and female patients are separated only by cubicles). Passages are often potholed. Doctors’ quarters are often decrepit and uncomfortable. Various hospitals in Johannesburg have lifts that are often non-functional. This makes the transportation of patients within the hospital (ward to ICU, ICU to theatre, ward to X-ray facilities, etc.) extremely difficult. In one hospital, children who require oxygen on admission sometimes need to be carried to the third floor without oxygen because of broken lifts.
- Temperature control: Patients are generally vulnerable and more susceptible to temperature variations. However, the equipment necessary to maintain temperature control in many hospitals is sometimes non-functional or non-existent. It is necessary for hospitals to ensure that wards are reasonably heated in winter. In addition, certain parts of a hospital such as theatres and x-ray facilities require air conditioning to ensure that temperatures do not get too high either. There was an incident this year in which the air conditioners serving the theatres at a large central hospital stopped working. Staff were faced with the difficult choice to either operate on patients in unsafe temperatures of over 30 degrees or cancel operations. Steamers and boilers are essential in hospitals. They are used for heating, cooking, washing linen and importantly, for sterilising equipment. In 2012, steamers and boilers broke down due to a lack of maintenance in one hospital. While they were ‘patched up’ there are serious concerns that they will break again, leaving wards and theatres unheated.
- Beds and linen: There are generally insufficient beds for patients, who are sometimes lined up on stretchers and in one reported case, were even made to share a bed. Insufficient linen and problems with laundry machines and steamers and boilers mean that patients have to lie naked on beds for hours at a time. Some hospitals have a shortage of blankets.
- Medical infrastructure: Problems experienced include difficulties with oxygen supplies and sufficient water filtration to ensure that sterile water is available to be used in haemodialysis. In one hospital, this has led to the cancellation of haemodialysis on occasion.
- Sanitation: Bathrooms and toilets for patients, visitors and staff are often not maintained and remain out of service for long periods.”