Cape Town - Patients are being moved down the priority list at Groote Schuur Hospital as surgeons and theatres struggle to deal with the influx of emergency gunshot wound victims.
There has been a massive increase in shooting victims who are on the brink of death and in need of immediate surgery. With a limited number of doctors and restricted theatre time, patients with non-life-threatening problems like broken bones have to be put on the waiting list - sometimes for as long as two days.
Provincial MEC for Health Nomafrench Mbombo said trauma surgeons at Groote Schuur were practising “battleground medicine”.
“The health budget goes to crime,” she said. “Patients are going to wait more, especially with the budget cuts.”
In 2012, Groote Schuur saw an average of 36 gunshot wound patients per month. Now, they deal with an average of 73 per month.
It’s not only the number of patients but the number of wounds in each patient that has increased, according to the head of the Trauma Centre, Professor Andrew Nicol.
He said they were seeing more cases like a 52-year-old woman who came to the hospital with 37 gunshot wounds from a house robbery, or the 17-year-old with 13 bullets still inside him.
“Multiple gunshot wounds makes the surgery incredibly complex,” Nicol said.
Seeing patients arrive in the emergency room in such a bad state has forced Nicol to develop his own methods of Mbombo’s so-called battleground medicine. This includes using plastic tubing as shunts to temporarily restore blood flow to limbs where the blood vessels have been destroyed by a bullet. Nicol even cut open a man’s chest outside theatre to find and fix damage to his lung that would have killed him within minutes.
“We perform what’s called damage control surgery,” Nicol said. “It’s to try to keep the patient alive, whatever the cost. We try to perform rapid short surgery essentially to stop the bleeding and control any contamination that’s occurring and get that patient to the intensive care unit. Then after 24 hours, once the patient’s been resuscitated, the patient will return to theatre where we complete our surgery.”
Nicol said the full cost of treating gunshot wounds was still not certain and would include the initial emergency treatment, repair surgeries, months of physiotherapy and occupational therapy in the rehabilitation centre, and often the loss-of-income cost of being disabled or impaired for the rest of the victim’s life.
Gunshot victim Mary Bruce, from Hanover Park, said had it not been for the help she received at Groote Schuur, she would not be able walk. The 48-year-old mother was struck in the knee by a stray bullet while in her backyard.
“I was busy hanging the washing when I heard the first gunshot,” Bruce said. “I just ducked, and when I turned around to run the second bullet got me and I fell down. I lay there for 10 minutes and nobody knew I was shot.”
Bruce broke down in tears, recalling the terrifying moments she spent bleeding on the ground in her yard.
“I had to pull my leg and go for shelter under a bakkie because he kept on shooting,” she said. “I could have been gone.”