Doctors at Steve Biko Academic Hospital say they feel helpless and hopeless to help the scores of patients arriving at the facility daily.

Faced with gravely ill patients, a lack of personal protective equipment, overcrowding, increased pressure and poor working conditions, the doctors who spoke to Daily Maverick on condition of anonymity said more and more patients were dying on their watch.

Nurses stand at the entrance of the emergency unit at Steve Biko Academic Hospital where they conduct Covid screening on everyone who enters. (Photo: Shiraaz Mohamed)

“I don’t feel like I am being protected by our hospital right now. I am running around like a chicken without a head. I feel very hopeless. I feel like I should not care anymore. Caring is actually just hurting me and the patients because instead of me doing what I said I was going to do when I left medicine, I am treating these people like numbers. Someone dies and you have to shrug your shoulders and move on to the next. There is not even a minute to mourn a person or to figure out what went wrong. I feel completely hopeless,” said Dr Monica (not her real name).

“Well, we try to cope, we take it out on our family, we overeat. This is what we do to survive,” said Dr Felicia (not her real name) who spoke to Daily Maverick because she wants the public to know that the official picture being painted by authorities is “all smoke and mirrors”. 

The two doctors broke their silence after the circulation of authenticated pictures depicting scores of patients, some of whom were Covid positive, being treated in tents outside the Steve Biko Academic Hospital, as the province’s premier David Makhura and MEC for Health Dr Nomathemba Mokgethi visited the hospital on Monday.

Nurses and doctors working in the triage area. The has been a dramatic increase in the number of frontline staff infected. As the numbers of new confirmed cases rise, many hospitals are exceeding capacity, according to health officials. (Photo: Shiraaz Mohamed)

Dr Felicia is stationed outside the hospital’s Emergency Unit in the “fever tents”. The tents are an extension of the Emergency Unit and have been set up for Patients Under Investigation. These are people who are suspected to have Covid-19 and awaiting results. If they test positive, they are referred to Tshwane District Hospital.

“People are dying in the tents. We can’t take any of these patients into the hospital. So any patient that we think has Covid cannot go into the hospital, unless they are negative. That’s why they heap up here (in the tents). There’s patients that stay here for days. And then when we turn our back, they are blue, they [are] dead. The oxygen doesn’t work, the beds are horrible, there are not enough nurses and our doctors are overwhelmed. I don’t know what to say. I am so tired. There is equipment that is failing. 

A nurse walks past a patient in an isolation tent. Ill-equipped, under-resourced, high death rates, lack of PPE, overcrowding and working under pressure and dangerous conditions is the environment that doctors at the Steve Biko Hospital in Pretoria are faced with as they continue fighting on the frontlines of the pandemic. (Photo: Shiraaz Mohamed)

“Last Monday the guy from the mortuary came to me and said ‘Doctor, please help me. The mortuary is overrun.’ I filled out 15 death certificates. There were bodies everywhere, including the ground. These extra tents don’t mean sh*t. There is no nursing, there is no oxygen or beds in these tents. There is no oxygen in the tanks, we actually just do 10 minutes of CPR and many times we don’t have PPE to do it in. This is a show. They (health officials) are lying to you people. They are lying. They’re just covering up.”

According to Dr Felicia, there were 28 Covid positive patients in the tents, mixed with 15 who were awaiting results. 

Speaking to the media during his visit on Monday, Makhura said Gauteng was fast becoming the epicentre of the second wave of the pandemic. “Tshwane is a hotspot and as a region and as a metro it is the centre of (Covid-19) at the moment.” 

A healthcare worker talks to a patient in the triage area as he waits to be screened. (Photo: Shiraaz Mohamed)

Makhura said Covid-19 admissions to Gauteng’s public hospitals had jumped from 700 on Monday, 4 January to 2,000 a week later. “If private hospitals are included, admissions stand at 4,500.” 

Describing the scale of infections, Makhura said that at its peak, 6,500 people had been confirmed positive in a day during the first wave. “We have already surpassed that number in the second wave with 6,900 positive tests coming back on one day and we have not reached the peak yet.”

Hospital CEO Dr Mathabo Mathebula said the hospital was treating 80 very ill people in general wards and 75 people in the intensive care unit.

A nurse makes her way to collect an oxygen cylinder. (Photo: Shiraaz Mohamed)

“This area (referring to the fever tents) may not look optimal and dignified, but we did save lives,” she said, adding that capacity in terms of space and human resources would never be enough. 

Pictures that circulated on social media over the weekend and that have since been deleted show healthcare workers treating patients lying in beds on waterlogged floors as a result of a rainstorm.

“It’s so dangerous, these oxygen bottles fell on to the ground the other day. One of them opened up. There’s electricity right here. It was pouring with rain. And it all fell into the tent where we sit. I thought I was going to die that night,” Dr Monica said.

“You have to sit and push patients in and out of tents; the oxygen runs out. So now the question is, are our patients dying because of Covid or because we’re just leaving them out in the cold with no oxygen?

“We run out of equipment. We cannot resuscitate patients. There is not enough resuscitation equipment. There may be oxygen cylinders for days, but you are the one lugging it around. So now you have doctors and clerks lugging around oxygen cylinders because who else is going to do it? The oxygen in the cylinders gets depleted quickly, so you have to keep exchanging them. If you don’t, then the patient will suffocate to death. We don’t even have linen to supply patients.”

The doctors’ anger is palpable.

Doctors are calling for a better oxygen supply. (Photo: Shiraaz Mohamed)

“They are sitting in their flippin’ offices, while we are out here. Every day we take photos and send it to them, but nothing happens. All we hear is ‘Oh doctor, Oh doctor, we are so sorry’ but that’s it. 

The triage area where the tents are set up. The tents are an extension of the emergency unit and were initially set up for Patients Under Investigation for Covid but now houses Covid positive patients. (Photo: Shiraaz Mohamed)

“There is no budget and so many doctors have tested positive now. In July, there [were] only two. We are at risk. You walk past a tent and see a guy turn blue. We can’t just stand there and leave him, we have to help. There are no vents in the tents and there are not enough sisters. You are exposing yourself.

“The bottom line is, our health system is overwhelmed and many of the deaths could be preventable. Politicians want to cover it up and provide a rosy smokescreen. And we, the people on the ground, are traumatised for life,” Dr Felicia said.

A nurse pushes an oxygen cylinder into an isolation tent for a patient. (Photo: Shiraaz Mohamed)

When asked what she thought could help to curb the pandemic, Dr Felicia said, “Firstly there needs to be community education regarding the realities of Covid. People need to take the wearing of masks, hand washing and social distancing seriously. It affects all ages and even young people with no comorbidities are dying. Secondly, stop politicising this pandemic. Stop talking and do something; we need more nurses, better oxygen supply and patient monitors. And most importantly is for senior people (government officials that have the power to do something) to hear our voices and act.”

With tears in her eyes, she said: “Tell the people out there, this is serious. They must wear masks, they must social distance.” She was unable to continue her sentence as she was urgently needed elsewhere in the tents. DM