Opinionista Rev Lawrence Mduduzi Ndlovu 14 July 2015

Public healthcare: I have a story to tell

A Naledi man was refused treatment in a Soweto Hospital because he could not pay R20. Bheki Mazibuko died after waiting more than two hours with his son Bongani who ran around trying to raise just a mere R20 so that his father would receive what was his – the right to healthcare. It is so sad that such stories no longer surprise us.

The state of our public healthcare system (clinics and hospitals) is so dire that one has to experience it in order to believe it. Granted, there are hospitals and healthcare professionals who try their best and they deserve our gratitude and support.

However when my cousin fell ill recently I saw and felt what many South Africans go through in public healthcare. I received a call that my cousin was unwell and that the ambulance services had been called. By the time I arrived at my cousin’s home, the ambulance was already there. The paramedics were very kind and professional. We then proceeded to the recently opened hospital in Jabulani, Soweto.

It was there our baptism by fire began. The casualty was so full there was hardly room to stand.

We were told that they could not treat my cousin there but that we could not take him to Chris Hani Baragwanath as the casualty department there was closed for renovations or upgrades. I never thought in my lifetime I would hear that the casualty at Chris Hani Baragwanath would close because Baragwanath is a very busy hospital. We were told we’d have to take my cousin to South Rand Hospital. We drove past Baragwanath to South Rand Hospital. On arrival we were pleasantly surprised that the casualty was so empty. There were no more than 30 patients there.

Logic told us the fewer the patients, the quicker the service. We soon discovered that public hospitals are not the best place to look for logic. We were directed to a cubicle in casualty as we waited for the doctor to attend to us. The staff comprised about five people and to our surprise, they carried on as if there were no people waiting for assistance. They often congregated in a group and went on with their own discussions.

A young woman then came to assist us. To this day we do not know whether she was a nurse or a doctor as she did not introduce herself to us. There was another person, busy with her phone in her hand, who was not seeing anyone but remained seated in one of the rooms. At first I thought she was a patient but later I saw a stethoscope around her neck so I figured she must be a doctor or a nurse. I spent more than two hours there; I don’t remember her assisting anyone.

In the main hallway of the casualty ward there was a young boy no more than eight-years-old seated on a bench with his grandmother and another child. He had such a terrible cough and was often gasping for breath. He sat there unattended for the entire period and was still there when we left. In another cubicle was a man with a wound and was connected to a drip. In that freezing night he lay there without even a T-shirt on and was shivering.

Then came an ambulance with a woman who looked pregnant. There in the hallway, the staff asked her some rather personal questions. I cannot tell how embarrassed I was for her. I cannot understand why she was not ushered into a private cubicle where she did not have to suffer the indignity of answering personal questions in public. Patients in public healthcare facilities are so vulnerable to abuse and they are afraid of demanding good service because they might not be attended to.

We were told that our cousin would have to be admitted and we were to accompany him to ward seven. Upon arrival in ward seven the gates to the ward were locked. We rang the bell and no one came. Until a security person passed by and we asked her to assist us. She opened the gates and let us in. It is unclear as why the gates were locked in the first place. There is a conversation to be had about safety in the event of an emergency like a fire.

As soon as we walked into ward seven we knew we could not let our cousin spend even an hour there. In the middle of the night the windows were open and it was ice cold. It was so old and so dilapidated that I thought they had sent us to a section of the hospital that was no longer in use. The nurse greeted us and read my cousin’s file, then she uttered the words that made my mouth dry with shock: “We do not have this drug in stock.” I had heard those words before, in August 2011 to be precise.

In August 2011 when my grandmother took ill we took her to Chris Hani Baragwanath Hospital. From there she was transferred to Selby hospital near the city of Johannesburg. On arrival, the staff notified us that she was supposed to come from Baragwanath with her treatment. This meant that the vital medication she needed she was not getting because Selby hospital did not have the medication. She spent a week at Selby Hospital without proper treatment and her condition deteriorated. She was then transferred back to Chris Hani Baragwanath Hospital where she died. Now, I am not a doctor and therefore could not tell whether the medication would have made a difference or not. However I know what I felt then as I do to this very day – saddened by what many South Africans who use public healthcare have to go through every day.

I have recently worked in the chaplaincy at the University College London Hospital. Even though that hospital and indeed the British National Health Insurance have their own challenges, at least if a patient lodged a complaint something would be done about it. If anything, systems could fail but the patient has to be happy and comfortable. I know that it is perhaps not fair to compare South African Hospitals to British ones, but fundamentally the offering of healthcare should be about the sick. It is therefore not unreasonable to demand that our healthcare system to provide the most basic service like attention and medication.

At the core of the problem is the complete disregard of the inherent dignity that every person has. It was Mother Teresa of Calcutta who said that nursing people is about restoring their health and their dignity. In the process those who help them are also dignified by the very virtuous act of serving the other. When human dignity and the importance of every life is ignored, when the urgency is missing then casualties turn to waiting rooms for mortuaries.

Another key problem in our public healthcare system is that those who have the ability to change it are not the ones who use it. Therefore public hospitals become that inferior product that is used by those who have no money to take themselves to private healthcare. Government and hospital officials should be forced to be on the receiving end of the incompetence they preside over. I do not think they would tolerate it. Not even for a day.

I suppose we were fortunate because we had the choice to remove our cousin from South Rand hospital that night and take him to private healthcare. However most South Africans do not have that option. We knew that if we left our cousin in that hospital we would not have been able to sleep because we would have been so worried about him. Many people who have family members in public hospitals are forced to take leave from work because the visiting hours tend to be in the afternoons and because of their knowledge of the state of public hospitals they cannot even consider skipping a day lest their loved ones are neglected.

Healthcare, like education and safety, are key areas for a thriving country. A healthy nation is a working nation and a working nation is a thriving nation. I know that perhaps my experience of public healthcare sounds like an old story to many people but we have to pull our experiences out of their normative complacence so that their horrid nature can be seen and thus embarrass someone into action. Public healthcare is to be dealt with urgently because the absence of proper healthcare means the infringement of human dignity and the denial of the fundamental right to healthcare. DM

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