State of local hospitals a bitter pill to swallow

Date: 27 February 2017 By: Isabel Venter

What is happening to Vhembe’s state-owned hospitals, the hospitals that the poor must turn to when they are sick and vulnerable?

Following recent media coverage of the death of an 83-year-old gogo at the Elim Hospital, government hospitals have been labelled “guaranteed ports to heaven”.

The Zoutpansberger/Limpopo Mirror set out in search of answers, following reports earlier in February that the MEC for Health, Ms Phophi Ramathuba, had suspended staff at the Elim Hospital. She suspended a unit manager and two nurses at the hospital, following the death of Mrs Mujaji Manganyi (83).

Mujaji allegedly succumbed to third-degree burn wounds she sustained after falling into a bathtub filled with boiling hot water at the hospital on Thursday, 2 February.  Investigations by Ramathuba’s office are still ongoing.

Managed by the Limpopo Department of Health (LDoH), the Elim hospital has been providing vital medical services to a predominantly rural community. Many residents in Vhembe also travel to this hospital to receive treatment from a variety of specialists.

Following Ramathuba’s intervention, many of the newspaper’s readers came forward with similar tales of horror from the Elim Hospital.

“Elim has now become a port of entry to heaven … if a family member is admitted there, chances of their making it or coming back are slim,” wrote Pitso MuMbedzi Ramushweu in comment to the article.

It would seem, however, that the struggles at the Elim Hospital date from long before the untimely demise of Manganyi. According to another reader, Mrs Hlamarisa Kubayi-Moloi, her elderly mother nearly passed away as a result of a lack of proper care. “Ten years ago, my mom WALKED herself into that hospital [Elim] because she had fallen and injured her rib. After two weeks, she wasn’t able to walk or talk and she [was] slowly losing her memory. She picked up infections. If she couldn’t take her medication, they would leave them there. She came out of that hospital in a wheelchair, because she forced one of my cousins to get her released,” wrote Moloi.

It took plenty of convincing to get her mother to receive treatment from another hospital, but ultimately, she was admitted to a private hospital where she received proper treatment and recovered to full health.

Three other readers also lost family members as a result of what they claim a lack of proper care. Zwido Lloyd Mulaudzi said both his grandmother and sister passed away at the hospital because of “incompetency.”

Reporting for Health-e News, Ndivhuwo Mukwevho recounted the situation at the Elim Hospital shortly before Manganyi’s death. They found dirty nappies scattered around one of the waiting areas and the hospital was grimy with filth. At the time, December’s drought was blamed for the filth.

Incompetence is apparently not solely to blame for the horror stories coming out of local state hospitals.

According to the most recent independent reports that the Zoutpansberger/Limpopo Mirror could uncover, the first cracks were noted in a report published by the Health Systems Trust. They published a Performance Assessments Report for the term 2008 to 2010. Only two of Vhembe’s six district hospitals received satisfactory scores in line with the national standard, namely the Malamulelele and the Donald Fraser District Hospital.

The remaining four district hospitals in the Vhembe District - Elim, Louis Trichardt, Siloam and Messina – received appalling scores. Criteria that were applied included the average length of stay of a patient, cost per patient per day equivalent, usable bed utilisation rate (measures occupancy of beds that are available) and facility crude death rate (the number of patients who died over a specific period measured against the number of patients admitted). Other outcome indicators, such as the proportion of deliveries for which a C-section was performed and the stillbirth rate of newborn babies, were also included.

Elim scored negatively on all the criteria and the report recommend that the situation should be given immediate attention. During 2011, the LDoH suffered another setback whenElim was one of five provincial departments to be placed under administration because of poor governance and financial mismanagement. During that time, the National Department of Health (NDoH) compiled a diagnosis report to understand the underlying causes that might have led to poor financial management.

The then spokesperson for the DoH, Mr Joe Maila, confirmed that the report pointed to poor procurement systems that were in place, which resulted in irregular expenditure. Hardest hit were the maintenance and supply of medical equipment and the procurement of pharmaceutical supplies, said Maila, areas in which tender processes had not been followed.

The situation did not improve when the LDoH regained its responsibilities in 2015. The year after, the Sunday Times quoted MEC Ramathuba as acknowledging the fact that the high mortality rate was not the result of a lack of hospital equipment, but because of the attitude of doctors and nurses. She was of the opinion that the hospital management needed to be held accountable.  

Ramathuba explained to the newspaper that money was taken away and centralised from hospitals that were not buying equipment. Ramathuba also indicated, however, that a further R450 million was needed to fill critical vacant posts in the province’s hospitals but that it would be impossible to get that money from the National Treasury.  

In more recent reports, the Limpopo branch of the South African Medical Association (SAMA) noted during their provincial executive committee meeting on 26 January this year that it was still worrying that Limpopo hospitals were operating at a vacancy rate of 75%. “This has a significant impact on the working conditions and delivering of quality health care to the people, in particular the poorest of the poor,” said the association.

Apart from this, SAMA has a list of doctors who had not received their salaries for December and January. They are of the opinion that it is a case of local medical practitioners who have lost faith in the administration of the LDoH, rather than mere “incompetence”.

Despite all the reasons, conditions remain poor at local hospitals, and many can only hope and pray that the both the LDoH and NDoH will intervene urgently to prevent the loss of more lives.

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Isabel Venter

Isabel joined the Zoutpansberger and Limpopo Mirror in 2009 as a reporter. She holds a BA Degree in Communication Sciences from the University of South Africa. Her beat is mainly crime and court reporting.

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