AFTER THE FIRE
Charlotte Maxeke hospital casualty unit open, but not for ‘walk-in’ emergencies
The casualty unit at the Charlotte Maxeke hospital has finally been declared open again — but the hospital’s critical trauma and emergency unit remain closed to ‘walk-in’ emergency patients.
A big-guns walkabout announced the reopening of the casualty unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) on Monday.
Health Minister Dr Joe Phaahla, with a senior-level entourage from the national government and Gauteng provincial government, announced this “key milestone” reopening, but he also said the hospital’s critical trauma and emergency unit remained closed to “walk-in” emergency patients.
It was obvious that the emergency unit is a long way from being 100% ready, as the area outside the unit, designated for “ambulances and emergency vehicles only”, was used for regular parking on walkabout day.
Ambulances stopped arriving here a year ago when the hospital was forced to close after a fire caused extensive damage and the closure of the key public health facility.
“At the current moment, there will be no walk-in patients into the accident and emergency unit. For now, it’s only [open] for [the] arranged transfer of patients who have been seen in other centres. This is a way to relieve pressure on other facilities,” Phaahla said.
He said the trauma and emergency unit would be reopened in phases, with completion of the rebuild scheduled for November 2023.
Currently, only two of the seven accident and emergency areas in the unit have reopened. Dr Jayshina Punwasi, the clinical director at Charlotte Maxeke, who was part of the walkabout, said she expected another one of these areas to reopen by Wednesday and the remaining areas to become operational as soon as the long-awaited repair and calibration of the unit’s CT scanner takes place.
She also outlined the hospital and unit’s Covid-19 plan should a fifth wave come with high numbers of hospitalisation cases.
Phaahla said a missing part required for the CT scanner repairs that had been sourced overseas had finally arrived in South Africa on Monday morning, suggesting that reopening of these areas could happen in days. The National Department of Health acknowledged in April that there had been vandalism and theft at the unit.
Phaahla said the hospital was currently at between 75 and 80% of full operation with about 800 admitted patients and is serving some 50,000 outpatients monthly. He said that as of 4 May, CMJAH had admitted 15 psychiatric patients from Helen Joseph Hospital.
Helen Joseph Hospital buckled in the past year after having to take on additional psychiatric patients from CMJAH with its own already stretched resources.
Concerns remain that even as units and departments come back into full operation, there have been no plans made to clear patient backlogs. This pressure has added to sinking staff morale, resulting in large numbers of resignations from Joburg’s key public sector hospital.
Gladys Bogoshi, the CEO of CMJAH, confirmed that the hospital had 11% staff vacancies, with 643 positions needing to be filled out of a total staff complement of 5,500.
Bogoshi said security was being modernised and would include CCTV monitoring.
The reconstruction work had focused on “compartmentalising”, she said, which would see the hospital block off direct access between some departments. This was intended to limit access, for enhanced security, and also to act as a firebreak by sectioning off and isolating key infrastructure such as piping and cabling.
The rebuild of the casualty department is part of the Block 1 oversight that has been funded by the Solidarity Fund, and this unit has been issued an occupational health and safety certificate for fire safety by the City of Joburg.
Professor Maeyane Moeng, the head of trauma at CMJAH, said the rebuild in this unit had seen the use of reinforced walling that can withstand heat for longer, and new fire doors to contain fire and smoke.
“It will give us time to evacuate patients,” Moeng said. An upgraded fire detection and alarm system had also been installed, which could “pinpoint exactly where a fire is coming from. We have also already trained 2,700 people on this new system and will continue the training as the system is installed in different departments,” he said.
Addressing the parking crisis that seriously affects the functioning of the hospital, Phaahla said about 300 bays would be made available shortly, but he did not specify when. The parking floors are where the fire started and for more than a year, 1,000 parking bays have remained cordoned off.
The parking floors are part of the levels that have been supported only by scaffolding struts for more than a year. The renegotiated multimillion-rand contract with the private company that is charging by the month to keep the scaffolding in place runs out on 15 May. The plan beyond this deadline was not part of the briefing update.
Questions were asked about corruption plaguing the rebuild, politicking, departmental infighting and interference, and a lack of accountability on why the hospital was not maintained in the first place, which allowed a fire to burn out of control. These still unanswered questions fuel growing public outrage and distrust in the government’s competence and commitment to return the hospital to full operation on schedule.
Phaahla said he believed the move to hand over responsibility for the rebuild to the National Department of Health’s facilities and infrastructure arm in February had put the remedial work back on track.
“We accept the fact that there have been a lot of delays and there are a number of things which we have highlighted, and it’s where we need to close gaps.”
He said the arrest of three officials from the Gauteng Department of Infrastructure and Development in connection with theft and vandalism linked to the CT scanner demonstrated efforts to improve accountability.
The updated building target deadlines include remedial work for Obstetrics and Gynaecology by March 2023; Paediatrics by July 2023; Surgery by October 2023; and Block 3 and Internal Medicine by November 2023. MC