In April it will be two years since the fire at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), with still no progress on who started it. Police have apparently abandoned their investigation, despite a preliminary finding of arson.  

Read in Daily Maverick: “Devastating Charlotte Maxeke hospital fire was an act of arson — police forensic report”  

Since then, the hospital has been plagued by allegations of corruption and maladministration as well as two further fires.  

For the second-largest public hospital in Gauteng, and a vital teaching hospital for Wits University, the legitimate expectation is that everything possible would be done to protect the hospital and ensure the smooth running of its services. 

The minister of health, the premier of Gauteng and others have all visited the hospital and made promises, but have not delivered. 

As a result, 2023 has begun with doctors at the beleaguered CMJAH once again facing the problems created by the Gauteng health department’s (GDoH’s) inefficient oversight and the hospital management’s seeming inability to protect the essential asset they are in charge of from vandalism and crippling theft. 

Over the weekend of 7 and 8 January, doctors informed Maverick Citizen, R3-million worth of copper piping was stolen from above an operating theatre inside the hospital. The result, they say, was to disrupt operations in several theatres.  

Although not as debilitating as the thefts at Chris Hani Baragwanath Hospital over the holiday period, it is still devastating.

A crisis in the ICU

Then, at the beginning of this week, doctors reported a crisis in the hospital’s Emergency Department and Intensive Care Unit (ICU) as ICU-trained staff refused to work overtime because they hadn’t been paid since last year. The doctors alleged the nursing agency from which temporary staff are recruited was unable to provide nurses because they too had not been paid. 

The result is that emergency theatres cannot be utilised, because there are no ICU beds available for post-op recuperation and care. Doctors said that the hospital has 23 vacant ICU and high-care beds, with 32 patients on its emergency waiting list. 

Security guards and paramedics in Charlotte Maxeke hospital. (Photo: Shiraaz Mohamed)

The CEO, Gladys Bogoshi, was asked to comment but did not respond. Motalatale Modiba, the head of communications at the GDoH, confirmed: “There was a theft of gas copper pipes estimated at R3-million, and a case of theft was opened at Hillbrow Police Station. The impact of the theft was minimal as there was no postponement of any operations in the theatres except for delays in starting times.” 

Modiba said the GDoH was responsible for security services at the hospital. However: “The day-to-day management of the function has been outsourced to a private company (Mafoko Security Patrols).” 

It is not known why Mafoko failed to prevent theft in such a critical area of the hospital or if any action will be taken against the company for failing to do its job.    

On the issue of the nurse shortage, Modiba said that given that overtime is voluntary, it was not correct to say that nurses had refused to work. 

“With regards to overtime not being paid,” he said that because “the hospital received late and incorrect submissions” there were “delays, as some submissions had to be redone and resubmitted. Nevertheless, the management of CMJAH is finalising the process to pay the affected employees. 

“Whenever there is a need for overtime, employees are requested to voluntarily avail themselves to work overtime. In a case where employees are not available to work overtime, a request is made to nursing agencies to provide the facility with nurses.” 

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Dr Aslam Dasoo, the chairperson of the Progressive Health Forum, noted that despite the fire and disruption, “dedicated health workers and Wits medical faculty academics have somehow managed to keep its services going”, but that “the latest breakdowns have now impacted these services, necessitating diverting patients from CMJAH to other overcrowded facilities”.  

Dasoo noted problems with “the GDoH’s sister department, [of infrastructure development], to whom it falls to fix these issues” (all of whose senior officials responsible for health are still suspended due to allegations of corruption).

“Cable theft is a result of atrocious security management, often outsourced to companies that can’t do the job, but get the contracts nevertheless,” said Dasoo. 

“This is no way to run the most complex system of health services on the continent, but we are left at the mercy of the same officials who have been responsible for serial failures in the system for years, with no consequences of any significance.”  

Security at Gauteng health facilities came under the spotlight in recent months, sparked by the theft of copper cables worth R30-million and equipment to the value of R200,000 at Charlotte Maxeke hospital. (Photo: Gallo Images / Sharon Seretlo)

The GDoH did not comment on the claim that desperately needed ICU beds were being left vacant as a result of nursing shortages. 

However, Professor Shabir Madhi, Dean of the Wits University Faculty of Health Sciences, told Maverick Citizen: “The scarcity of specialised nurses has been an evolving issue over the last decade and is multifactorial. This includes lack of investment in training, non-replacement of specialised retired nurses, loss through emigration, reduction/freezing of nursing posts and competing demands between the private and public sectors. 

“The issue is not unique to ICU nurses, but also other specialities such as dialysis/nephrology. The situation is being exacerbated by the reduction in training posts for medical specialists as well.  

“Unfortunately, there does not appear to be any strategy in place to address the human resource needs of the health sector in SA, which is uniformly applied across provinces. Overall, specialised medical care — more so in the public sector — remains under severe duress, with the shortage of specialised nurses being a threat to the quality of care.” DM/MC