Working for access to quality public healthcare in South Africa since 1998
11 December 2017

Hospital Horrors

By Lotti Rutter and Leonora Mathe

The hospital is full. Two young girls lie on trolleys in the main hallway. They are wrapped in pink blankets and drips come out of their arms and hang on the walls. One looks in severe agony. She calls out for a nurse again and again. Their mother tells us that they arrived at the hospital seven hours ago and have yet to leave the hallway. Laughter comes from the nurses’ break room. It is situated directly opposite her trolley but no-one ever emerges to help her.

An old man with only one leg sits next to them. His drip is attached to the same set of hooks. He stands in pain. He struggles with his crutches, his drip and his file in order to slowly move down the dusty passage to the toilet. The toilet will not flush and is dirty after people have tried. A poster haphazardly taped to the wall in the bathroom informs patients to “always wash their hands”. Yet the soap dispenser is empty and there are no taps to provide water. The floor is filthy.

Overcrowding, dirty facilities, bad services and poor attitudes. This is what awaits public healthcare users at Prince Mshiyeni Hospital in Umlazi, the largest township near to Durban.

TAC branches monitor the state of healthcare at hundreds of clinics and hospitals across the country.

They are the people who need the public healthcare system to work, so they are the first to notice when it does not. Prince Mshiyeni Hospital is not alone in its dysfunction. A TAC fact-finding mission in recent weeks has showcased the crisis in several public hospitals.

We visited hospitals in KwaZulu-Natal, Limpopo, Mpumalanga and Gauteng. And the situation in each is as dire as the next.

In Limpopo, at Malamulele Hospital people began queuing at the old and run-down facility from 5.30am. The corridors were full. At each turn, brightly dressed women filled the hallways. Around 200 people were waiting to be attended to by only two doctors. The waiting was unbearably long. We were told that there had been no constant water supply at the hospital for three years. Patients were unable to wash themselves and there was only a small amount of container water available for using the toilets. As we walked through the wards during visiting hours, the patients had no privacy. There are no doors or curtains. The wards smelt and the bed linen was dirty.

In Tshilidzini Hospital more than 75 patients waited for files. Each time a shrill voice screamed out a name the chain of people patiently moved one seat across. People had been waiting in this queue for over five hours. A few people waiting were already wearing Tshilidzini hospital gowns. One was a young man with an open wound on the back of his neck – the wound and stitches were uncovered and he used a wad of toilet paper to stop it seeping. The file room was only the beginning. Once leaving, patients were faced with more long queues to be attended to by a doctor.

In Elim Hospital patients waited for files for around five hours. After collecting files, they entered the hospital and joined the long queue to be seen by a doctor. In a corridor around 100 metres long, patients in back to back benches filled the entire hall waiting to be seen. Those with bad coughs sat amongst them in a corridor with windows on just one end. Walking around at each turn a new queue appeared. More faces raised in hope at our sight. In the main hallway, one man was sitting under a blanket in a trolley. A drip came out of his arm. He told us he had been admitted six hours prior but nurses had yet to find a bed for him to be moved to.

In Mpumalanga, at KwaMhlanga Hospital the corridors were full. One old gogo lay in severe pain in the corridor on a trolley. She struggled to move but had not yet been attended to. People in wheelchairs were stacked together, one man’s knees were squashed into the chair in front of him. Hundreds of people waited to be seen. Their eyes followed us as we passed through the corridors. One man sat at casualty with a homemade sling on his arm. After being attacked by thugs he had attempted to access services at the hospital. An x-ray was taken the night before – yet a day later his file had been lost. He was told to go and submit an affidavit at the police station and return. He had no money and had received no painkillers. Another young man who had waited for five hours sat next to him. A baseball cap on his head covered a bloody stain on the back of his head.

In the most well-resourced province, Gauteng, the recently refurbished Thelle Mogoerane Hospital still suffers from the same level of neglect. Casualty was overcrowded and the queues lasted for hours. People slept in the corridors. Patients bleeding and in critical condition sat amongst everyone else. A psychiatric patient was seen wandering around the wards. We were told that patients had been fed porridge for every meal for days. One woman showed us an X-ray of her broken jaw. She had been sent home with just a panado for the pain. Another woman told us that post labour the doctors had sewn her vagina shut – when she returned to question them they told her she must have been born that way. Another woman explained how during labour doctors took another woman into her space in theatre. Eventually after waiting the whole day to be seen she gave birth to her baby. The baby was green and died six days later.

In order to expose these crises and hear from the people who need to use these services, TAC will be holding public hearings and showcasing people’s stories in the run up to World AIDS Day. Poor management, budgetary constraints and a lack of care for the needs of patients plague these public facilities. And it is the people who suffer.

As we left Prince Mshiyeni Hospital through the abandoned trolleys, a woman sat sobbing in a wheelchair. Under a blanket her feet were badly swollen and she was struggling to breathe. You could see the fear in her eyes. She had just been discharged. A nurse leaving the hospital passed by, while we tried to engage her to re-admit the woman, instead she informed us that she would let the security guard know to look for her friend as she rushed away. After TAC intervened she was re-admitted. Upon examination, she was diagnosed with pneumonia and cryptococcal meningitis. She was moved to a cold and overcrowded ICU ward. Beds mere centimeters apart. She wasn’t allowed to take her blanket and was visibly shaking when we visited.

As we eventually left the facility, the young girls cocooned in pink remained hopeless where we found them in the dirty corridor, still awaiting help.

A litany of atrocities at Prince Mshiyeni Hospital

–       A wheelchair lies abandoned on the pavement and trolleys are scattered across the casualty entrance of the hospital. Dirty rags line the floors as we enter. Dust, dirt, and dirty chip packets greet us.

–       Family members push patients up and down the hall on trolleys. One patient looks in severe pain lying on her side on a trolley, she rests her head on a water bottle that acts as a pillow.

–       A diabetes patient waits to collect chronic medicines. Last month she waited throughout the day until 11pm only to have to return the next day. Today they had already waited for over eight hours before she spoke to us.

–       Paper files lay on the unattended counter for anyone to look at. One woman had waited for eight hours until they located her file.

–       More than 100 people still needed to be seen at 4.30pm. Each alley of the hospital had more and more patients sitting waiting to be attended to.

–       One small room had at least 25 or more beds haphazardly squashed in the room. Another with a few centimetres between each bed. It seemed that psychiatric patients were put next to other patients.

–       A woman with her leg in a cast had come to the hospital seven hours prior in an ambulance in agony. The previous month they had cast her leg without an x-ray. At 4.30pm she was told x-ray had closed and she should return tomorrow. The doctor did not see her. She remained in agony as she left the hospital in a wheelchair. Coming to this hospital in her opinion is a waste of time.

–       Three people struggled to get an unconscious person who had been discharged into the back of a car. They used a piece of material to get them off the trolley and eventually onto the back seat of the car. Cleaners watched on during this 20 minute challenge.

–       An old man looking gaunt and sick left the hospital. A TB mask was pulled down by his neck.

–       A hungry man eventually caught a lift with strangers to leave the hospital, he had been there for eight hours. He had no money for food or a taxi.

–       A white van sat outside the accident and emergency entrance at the hospital reading “21st Century Funerals”. A trolley was brought out the back and taken inside the hospital. A while later the man returned pushing a corpse in a body bag past patients entering the hospital to put in the back of the van.