Twenty-nine pregnant women who were sleeping on the floor at Dora Nginza Hospital in Nelson Mandela Bay and were not given any food had to be evacuated to other hospitals on Friday after the maternity unit became overwhelmed with the number of patients seeking medical assistance.

The unit, which delivers more than 8,000 babies a year, has only 75 beds. There have been desperate pleas from medical teams for more beds and more staff.  

The Eastern Cape Department of Health spokesperson, Yonela Dekeda, said the 29 patients were transferred to Uitenhage Provincial Hospital and Port Elizabeth Provincial Hospital. She said clinical teams at the two hospitals would be supported by specialists from Dora Nginza Hospital.

A patient lies under a blanket in a passage at Dora Nginza Provincial Hospital. (Photo / Shiraaz Mohamed)

“Following a similar situation late last year, the department identified and allocated budgets for staffing and equipment to activate an additional 30-bedded maternity ward and theatre to ease the pressure in a sustainable way. Despite all those efforts, demand for maternity services in the Bay continues to increase.

“The department is continuing with our efforts to create additional trauma and maternity services at sites like Empilweni Hospital and PE Provincial Hospital,” she said. 

She did not respond to information from clinicians that the absence of other specialist teams, like neonatal services, makes it impossible for doctors to handle maternity emergencies at these sites.

Electricity crisis

Dora Nginza Hospital also faced an electricity crisis on Friday after several failed attempts to have the hospital’s generator fixed. Clinical teams had to face the weekend without a working generator. 

On Friday, clinical teams suggested that only emergency operations and short elective operations be performed, lasting no longer than the hospital’s uninterruptible power supply system can handle — about one hour.

The crisis at the hospital has been ongoing since 2020. In 2021 a report from the Public Protector found that neither Dora Nginza Hospital nor Uitenhage Provincial Hospital complied with the Constitution and other legislation. 

The report on Dora Nginza Hospital highlighted that newborn babies had died in overcrowded and understaffed wards; that medical waste management was lacking; and that there were insufficient ambulances, severe staff shortages and unhygienic conditions.

On 12 October 2022, Health Ombud Professor Malegapuru Makgoba recommended that Dora Nginza Hospital be visited by the Parliamentary Portfolio Committee on Health to assess progress made in implementing the recommendations of the Public Protector as “conditions were bad”. 

The committee visited the facility at the end of last year. It found that there was “an ever-increasing demand on maternity and neonatal services that far outweighs the physical and human resources available”.

It also found that pregnant women had to sleep on chairs and mattresses, and patients were waiting several days for elective caesarean sections.  

Shortage of medicine

The department is also scrambling to address a shortage of medicine in the region, including ARVs, antibiotics, some chronic medications and vaccinations.

Several patients have reported that they can longer get three-month supplies from clinics and some of their medication is being supplemented. 

In April, a large truck delivering medicine to the NU 8 Clinic in Motherwell was hijacked in Nelson Mandela Bay.

After the hijacking, the Department of Health admitted that it had become dangerous to work in parts of the medicine depot because the roof was collapsing.

“This space had ceiling panels falling off a height of about 50m and this was considered a potential risk to staff,” said Health MEC Nomakhosazana Meth’s spokesperson, MK Ndamase.

“The department is on record about the financial constraints that have been worsened by the Covid-19 pandemic, outward migration (reduction in budget allocation because of the number of people leaving the province) and lump sum payments in medico-legal settlements, in recent years. 

“As a result of the cash flow challenges, some of the big accounts had not been paid within the stipulated 30 days in the previous financial year. The department engaged the suppliers, requesting an extension of the credit line into the new financial year. A few suppliers continued to supply the department with lifesaving medicines with the promise the department would settle the accounts in the new financial year.

“Indeed, the department settled some of the accounts — a total of R361-million has been paid to date since the beginning of the financial year. This is equivalent to 73% of the total amount owed at March 31, 2023. 

“Just as the department has been open about its financial challenges, we have been upfront about the staff shortage challenges. Though there is a shortage of staff at the depot, which affects the operational output at any given time, efforts are continuously being made to address this.  

“As such, the department received support in the form of 10 warehouse pickers from partners such as the US government. The department is also looking at obtaining additional support from other partners to assist in warehouse operations. These are short-term interventions.

“The department will further bolster our staffing capability in the medium to long term as part of the organisational capacity-building for medicines warehouse operations in the province.” DM/MC