Health system betrayed usComment on this story
My brother has just died. I am aggrieved because I believe the public health system failed him badly. Am I the right person to write about it? Can I be objective? Frankly, I don’t know. However, for his sake and millions of our compatriots who depend on the public health system, silence would be a disservice.
My brother, Mashaole, was 74 years old. He was healthy. He had none of the typical old-age issues. Suddenly, on April 15 this year, he develops jaundice. As he had discontinued his medical aid after going on retirement, his doctor refers him to the Polokwane Provincial Hospital for tests to discover the cause of the problem. That’s the beginning of his nightmare.
He is to undergo ultrasound, urine and blood tests of various specifications as well as X-rays.
I pick him up from his village home, about 50km from Polokwane, to take him to hospital. I would do this many times in the subsequent seven weeks.
The situation at the hospital is over-crowded, not user-friendly and unwelcoming. Each time, one of his daughters joins us at the hospital to help him navigate the long and winding queues. I collect them when they are done. It is a whole day affair.
In early May, when all the results are finally available, a doctor tells him gall stones are blocking the flow of bile. The doctor orders him to come back to hospital on June 4, 2012, to be seen by a physician – a date that is roughly four weeks away.
Mashaole is getting worse. He has unbearable pains; itchy skin; terrible hiccups; he can’t sleep or eat much and has difficulty passing urine.
I take him to his private doctor who expresses shock at the fact that Mashaole is not admitted to hospital and has not received appropriate treatment after so long. He gives him medication to alleviate some of the symptoms, but says he needs urgent surgery.
As Mashaole deteriorates further, I take him to a physician in private practice. His first question after examining him is: “Why is this man not admitted to hospital?”
Considering Mashaole’s age, the physician suspects the real cause of the blockage might be cancer of the liver or pancreas. He orders more tests. So, off we go for another battery of tests.
Blockage of the bile duct is confirmed. The cheerful physician tells him he is a lucky man and that with the removal of the stone, Mashaole should be able to do the toyi-toyi within two weeks.
In good spirits, we drive to a private surgeon’s rooms in the next street. He phones the provincial hospital to have what they call ERCP procedure done to remove the offending stone. The surgeon is told that the equipment to perform the procedure has been out of order since February. There is no such equipment in Limpopo.
He speaks to colleagues in Pretoria in both private and public practice. They can do the procedure, except that the latter can only do it if the patient is referred to them by the Polokwane Hospital.
The private doctors are not getting anywhere in their contacts with colleagues at Polokwane Hospital. This is now Friday, May 25.
Mashaole deteriorates fast during the weekend. He hardly eats and he can only sleep in a sitting position.
Monday morning, May 28, we realise we can no longer carry Mashaole by car to Pretoria. Tuesday morning, we call an ambulance to take him to Polokwane Hospital. He joins the long winding queues going round and round on benches, getting admitted only after 10.30pm.
That same evening, my son, who is a young doctor who had worked at Polokwane Hospital for several years, but is now in Cape Town working towards specialisation, arrives.
On Wednesday morning, we go to hospital together. After a phone call, a doctor from surgery arrives. Three doctors go through the results of various tests and agree that Mashaole requires urgent intervention.
My son goes back to hospital on Thursday morning. Still nothing is done. He is completely flabbergasted. He can’t understand why doctors could diagnose the illness in a patient and then do nothing.
His voice over the phone, as he speaks to me, is close to breaking.
He phones a senior liver specialist in Cape Town who tells him the patient might not survive if he is not unblocked immediately. The specialist phones the MEC of Health in Limpopo and pleads for urgent intervention. I phone the minister of health, but he is unavailable.
When we arrive at the hospital on Friday morning, June 1, several doctors are huddling over Mashaole’s medical records at his bed. The hospital CEO joins them for a moment and then comes to tell me the MEC has ordered that Mashaole be transferred to George Mukhari Hospital in Ga-Rankuwa.
After telling me Mashaole does not look good, my son and two others drive off to Mkhari to wait for the ambulance there.
A few hours later, I answer the phone, only to be greeted by wailing sounds from Mashaole’s wife in the ambulance. A paramedic takes the phone and explains that he had just died on the N1.
Back at the hospital, the widow is made to wait for more than forty minutes in the ambulance while hospital staff are arguing loudly about what to do with the body.
We are shocked and livid. I go inside and ask those who seem to be in charge if it is the first time a patient has died at Polokwane Hospital. How come they don’t know what to do with a corpse?
When we eventually leave the hospital, the minister of health returns my call, some 48 hours later. He had been snowed under. He is dismayed and saddened by the Mashaole story and frankly admits that it is not the only one. I wish him well in his drive to fix the public health system.
I ask the question:
Do you need the intervention of an MEC to get Polokwane Provincial Hospital to serve patients? No. But the Mashaole story represents what millions of our people face at our public health facilities.