Seven years ago, the Eastern Cape Department of Health abandoned a plan to increase Frere Hospital’s capacity for orthopaedic surgery due to cost implications. Now the waiting list for joint surgery (arthroplasty) – operations to replace knee, hip and shoulder joints – is 10 years.

More than 60 children at East London’s Frere Hospital have been waiting for more than a year for their orthopaedic surgeries.

This emerged in a reply provided to the Eastern Cape legislature by Health MEC, Nomakhosazana Meth, explaining the extremely long waiting lists for arthroplasties at Frere Hospital.

Aside from Livingstone and the Bedford Orthopaedic Hospital in Mthatha, Frere is a major centre for orthopaedic surgery in the province. Orthopaedic services have been in crisis for months.

In February, the Eastern Cape health department agreed to pay staff three months’ overtime to catch up on the theatre list at the Bedford Orthopaedic Hospital in Mthatha. This was after the hospital was all but shut down due to a debilitating water crisis that has persisted since late last year. However, many patients are still waiting for their surgeries.

“We are being forced to leave the province or leave the town to have surgery,” a patient at the Bedford Orthopaedic Hospital complained. Operations there are hampered by water and equipment problems.

Another patient said he still hasn’t had surgery because of an “inconsistent water supply”. Also, the X-ray machine is broken. He said he has only received medication and shares a ward with people from as far away as Bizana. 

Implant shortage

At Livingstone Hospital in Gqeberha, there has been a shortage of orthopaedic implants, preventing doctors from fixing broken bones.

Meth said that seven years ago, plans were drawn up to double the number of orthopaedic theatres from two to four and replace a 40-bed prefab ward that had been condemned as unsafe.

Funds have never been available to complete these projects and this year will be no different.

She admitted that the waiting list for more than 1,600 patients in need of arthroplasties is long – nine, “but realistically”, 10 years. The only theatre time available is once a month and doctors can fix only three to four joints at a time.

One reason for this, said Meth, was a sharp increase in emergency cases that had to take priority.

The department is implementing a plan to train doctors to take over simple surgeries at district hospitals. This will include below-the-knee amputations, wound surgery, orchidectomies (the removal of one or both testicles), lymph node biopsies, drainage of abscesses, tendon repairs and ectopic pregnancies. Appendectomies and hernia repairs will also be handled at district level.

Plans are also under way to improve the anaesthetic services at hospitals across the province. DM/MC