Hospital’s daily battle with trauma
Cape Town -
It’s 2.30am on Saturday and a man, bleeding from the mouth, walks into the Khayelitsha Hospital emergency unit. His tongue has been so badly bitten it is as if someone tried to remove it entirely.
Teeth marks are also visible on his lower lip. The wounds are deep and his lip is almost hanging off.
He is accompanied by a friend, who also sports injuries - lacerations to the neck, face and head.
The men, both visibly drunk, are not keen to share how they got their injuries.
All the man with the injured tongue is prepared to mumble to doctors is that a woman bit him during a fight, and he desperately wants to have it stitched.
It’s not clear whether he was involved in a domestic dispute or whether he was attacking his assailant.
Hours earlier, an elderly woman was wheeled into the unit with her daughter by her side. The woman had apparently been gang-raped by her son and his friends after a drinking and drug spree.
On the same night, a gunshot victim was also admitted to the unit, as well as eight children with a range of symptoms from diarrhoea to upper respiratory problems.
These are just some of the cases doctors and nurses at Khayelitsha Hospital emergency unit have to deal with on a daily basis.
When a patient is classified “code red”, indicating a life-threatening emergency, they move swiftly to the unit’s resuscitation room. There’s no time to sit down or have a chat. It’s a unit with a mission - saving lives.
The 47-bed unit, which opened in 2012, is one of the busiest emergency units in the province, treating an average of 120 patients a day, or up to 200 cases on busy days.
The R600 million hospital is one of only two new district hospitals built by the province in the past 40 years. The other is Mitchells Plain Hospital, opened at the end of last year.
Khayelitsha Hospital is also one of the most overburdened hospitals with a bed occupancy rate of about 131 percent.
Health workers have their hands full dealing with traumas - mostly stab wounds, gunshot wounds and complications resulting from lifestyle diseases such as diabetes and high- blood pressure - in addition to treating diseases such as HIV and Aids and tuberculosis.
Dr Sa’ad Lahri, the emergency physician in charge of the unit, acknowledges that these cases are just the tip of the iceberg.
“We see a lot worse,” Lahri said. “We sometimes get patients who’ve had their throats slit like a sheep. The level of trauma we deal with can be so disturbing at times…
“Take the case of an elderly woman who has been raped by her own child. It is also a reflection of the ills of our society. It shows the level of alcohol and drug abuse in Khayelitsha, violence, poverty, unemployment, and hopelessness among residents. All these problems have health-related implications.”
On the streets of the township on Friday and Saturday evenings there is a jovial air, with music blaring from cars and shebeens. Young people are out and about, drinking and being carefree, but Lahri says it is this jovial mood and excessive drinking that gets many of them into trouble.
“Most of them end up here. Because of excessive drinking they end up fighting. Fights result in stabbings and sometimes shootings. We see a lot of penetrating trauma, particularly to the head and chest.
“Most trauma cases, if not all, are alcohol and drug-induced. We see a lot more of these on weekends that fall at the end of the month, because people have money to spend on alcohol.”
Despite these challenges, statistics show that the hospital has improved health services in Khayelitsha dramatically.
Of the 55 stabbed hearts treated at the hospital in the past two years, 45 patients survived. Complicated cases were stabilised and transferred to tertiary hospitals such as Groote Schuur and Tygerberg hospitals.
Trauma-related deaths have dropped by 80 percent since the hospital opened its doors, and paediatric mortality dropped by more than 50 percent.
Such is its success in treating trauma cases that it is even attracting foreign health workers seeking experience in emergency medicine.
Dr Seth Langsam, a family medicine registrar from the US, said he had chosen Khayelitsha Hospital because it gave him a good learning experience.
“It’s a fantastic hospital to learn from. Nowhere in the world does one get such wealth of experience concerning trauma, or at least nowhere in the US can a doctor be exposed to such level of trauma.
“I enjoy the adrenalin rush… it’s fantastic to be part of a team that saves lives.”