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Cape Town - A shortage of beds in some provincial hospitals is so dire that patients are treated in passages and on trolleys.
This situation has been described by some medics as disastrous for clinical governance and quality care.
In some units, such as Tygerberg Hospital’s medical emergency unit, also known as F1, overcrowding is so bad that critically ill patients spend up to three days lying on trolleys with no adequate access to emergency equipment such as drips, or nebulisers to help them breathe.
Patients in the new Khayelitsha Hospital, GF Jooste and Somerset Hospital also reported overcrowding, which meant many patients spent their nights on hard benches waiting for beds. In Khayelitsha Hospital, patients had to bring their own blankets because of a shortage of bedding.
And the South African Medical Association has warned that things will get worse, especially when GF Jooste Hospital closes by the end of the year.
Dr Mark Sonderup, vice-chairman of the medical association, said although the province’s population was growing, “unfortunately the reality is that health services are not keeping up with the population growth we are experiencing”.
This meant that elective procedures - essentially non-emergency procedures - including surgery and investigations, tended to be postponed.
“Given our bed shortages I’m not sure if we will improve the patient experience that the Health MEC (Theuns Botha) so desperately wants,” he said.
Sonderup said although patient numbers usually increased in winter because of respiratory infections, putting pressure on the public health system, poor management of beds was “the reason we are bursting at the seams”.
During the Cape Argus visit to Tygerberg’s 27-bed emergency unit this week, more than 60 patients had been admitted, resulting in scores slumping in chairs and trolleys, hoping to get a bed. Some said they had been sitting on chairs, still waiting to see a doctor, almost 24 hours after being admitted.
Medical staff complained that they were often overwhelmed by the workload and could barely cope. The ward’s high care unit, meant to accommodate only five beds, had admitted 12 patients.
At least 17 patients, some with high blood pressure, diabetes and blood disorders, were on trolleys in the passage. Among them was a TB patient wearing a mask. A few metres from him an asthmatic patient, gasping for air, couldn’t be given a nebuliser because there was no oxygen supply for connection in the passage.
Leah Blaauw of Ravensmead, who had come to the hospital after her blood pressure became uncontrollable, sat in a small room with a swollen hand where a drip needle had been inserted. She had been put on the drip 17 hours earlier, but because it was not suspended from a stand, the liquid was pooling under her skin.
“My hand is all swollen up because I’ve had a needle stuck in my vein for so long. I’ve told nurses that this drip is not functioning, but they didn’t remove it. They said there’s nothing they can do as there is no drip stand. I am tired and hungry. All I want is to get a bed so that I can get proper care and get well. But I don’t know if I will be able to get that in this chaos.”
Another patient, Charmaine, said she had asked nurses for an oxygen mask to help with her breathing, but the high care unit with this equipment was full.
“The service is not great... The staff just look too overwhelmed by their work. They are running up and down and look so helpless.”
She said the worst part of her experience was having to walk to the X-ray department as there were no porters to wheel her there. “It’s difficult enough sitting on this hard chair with a swollen tummy, let alone having to walk to the X-ray department. I was already dizzy then… what if I fell on the way? Is this what we must call medical care?”
Patient Amanda Maganisa said she had lost confidence in Khayelitsha Hospital after she took her four-year-old daughter there for burns, only to be told after a 20-hour wait that the hospital did not treat burns.
“I spent the night on the chair with my child on the floor. It was so full that children with infections such as diarrhoea were mixed together with the rest… it was so chaotic.”
Faiza Steyn, spokeswoman for the provincial Department of Health said the bed shortages were because of demands on the service.
“It is true that public health services are under pressure at various facilities and at varying times. The emergency centres are the entry point into the public hospitals, and therefore face the brunt of the pressure.
“The department is therefore systematically improving the infrastructure within emergency centres over recent times. New Somerset Hospital, Khayelitsha and Mitchells Plain Hospital are cases in point.”
Steyn said emergency medicine specialists had been permanently placed within the centres to strengthen clinical governance.
Botha attributed the overflowing of hospitals to the growing burden of diseases in the province. He also blamed migration to the Western Cape as contributory factor, saying the province would approach the National Treasury for compensation so it could deal with the pressures.