Category: Hospitals

Categories : Hospitals Surgeries & ProceduresTags :

Groote Schuur Hospital Clears Backlog of 1 500 Surgeries

On By ModernMedia
Photo by Quicknews

By Elri Voigt for Spotlight

Much of South Africa’s public health sector is plagued by long waiting times for surgery, a situation that was made much worse by the COVID-19 pandemic. Now, an inspiring project at Groote Schuur Hospital in Cape Town has reached the target of slashing its backlog by 1 500 elective surgeries – two months ahead of target.

At the end of March, a small team of healthcare workers completed the project called ‘Surgical Recovery’. The project ran from May 2022 and was originally planned to conclude 12 months later.

While this hasn’t cleared the entire backlog of people waiting for surgery at Groote Schuur, it has helped the hospital return to about the same waiting list level as it had before the COVID-19 pandemic, according to Professor Lydia Cairncross, the head of general surgery at Groote Schuur. (Spotlight previously reported on the human cost of surgical waiting lists and on what could be done about it.)

The surgeries took place mainly in the E4 Surgical Day Ward at Groote Schuur. Cairncross explains that ward E4 was built as a Day Ward – meaning it handles surgeries where patients don’t require an overnight stay pre- or post-surgery – with the aim of increasing daycare surgery capacity for the hospital. And for the last 12 months, it has been the host of the Surgical Recovery Project.

E4 has 16 patient beds, four recovery beds, and two theatres, which were completed just as the COVID-19 pandemic hit the country. During the third wave of the pandemic, it was used as a COVID High Care Unit.

According to Dr Shrikant Peters, a public health specialist and the medical manager of theatre and ICU services at Groote Schuur, the hospital’s CEO Dr Bhavna Patel “had the foresight to request provincial use of COVID funding to develop the space as COVID High Care, and eventually to be used long-term as an Operating Suite and High Care Ward in line with prior hospital plans”.

The Surgical Recovery Project

By the end of the third wave of the COVID-19 pandemic, according to Cairncross, there were discussions about how to catch up on the surgeries that had to be postponed because of COVID-19.

“The backlog in surgery comes on top of a pre-existing backlog. So, it’s not that the backlog was created by COVID, but it made it much, much, much worse,” she says, “In November 2021, we did an audit of how many patients were just physically waiting for surgery at the hospital. It was around 6 000 plus. We don’t actually have a baseline for pre-COVID, but we knew that we lost about 50% of our operating capacity,” Cairncross says.

“So, the idea was really to find a way to utilise this theatre space so that we could catch up with some of that backlog.”

From here, the Surgical Recovery Project for Groote Schuur was born with the ambitious target of performing 1 500 surgeries in 12 months.

Funds from the project came from three sources. Kristy Evans, head of the Groote Schuur Hospital Trust, tells Spotlight that fundraising for the project was kick-started by a R5 million donation from Gift of the Givers. The recently established Groote Schuur Hospital Trust focused on Surgical Recovery as their first project to fundraise for. An additional R1 million was raised by the Trust from over 500 corporate and private donors.

“People are always willing… [they] give what they can. We had donations from people who would transfer R10 into the account, sometimes people transfer R180 000,” Evans says.

She adds that the Project will continue into its second year, but the details regarding targets had not yet been finalised by the time of publication.

The Western Cape Provincial Department of Health also donated around R6.5 million to the project from their budget for surgical recovery post-COVID-19. According to Mark van der Heever, the provincial health spokesperson, this money was part of the R20 million that the department allocated to various surgical backlog recovery initiatives.

“[The] COVID-19 pandemic meant that elective surgical services had to be significantly de-escalated, as staff were deployed to COVID services, and this resulted in an increase in the backlog of operations. Hence, a specific practi[cal] plan to address this backlog in the short and long term has been developed,” says van der Heever. “Similar projects and initiatives across hospitals have already taken shape and also yielded success, such as at Karl Bremer Hospital, which also received a portion of the R20 million from the department. The hospital was able to perform an extra 328 procedures since August last year.”

Working around difficulties

At Groote Schuur, the project had to find a way to work around the difficulties of surgical catch-up. According to Cairncross, with any surgical catch-up, the challenges don’t just come from needing a physical space to operate in but also from having the appropriately trained staff. Not having enough trained staff in the public health sector, like theatre and surgery nurses, makes it hard to implement a surgical catch-up programme, even if there is money to do so.

To work around these difficulties, they came up with a centralised model for surgical recovery, where one theatre team of nurses could be employed on a contract rate for the 12 months. This team, led by Sister Melinda Davids, the nursing operations manager for the E4 theatre, would work Monday to Thursday in one of the E4 theatres and occasionally other theatres in the hospital for each of the 1 500 surgeries.

According to Cairncross, many surgeons, herself included, would come and operate on patients in addition to their normal surgeries and other duties. The funds, a total of about R 12.5 million, were used to pay the staff involved in the surgeries. The day-to-day operations were run by Davids and Peters.

According to Peters, the 1 500 operations occurred across all surgical specialities, ranging from cataract to cardiothoracic.

Success factors

Cairncross attributes the success of the project to the existing systems at Groote Schuur, supportive management, and the dedication of the surgical team and surgeons that gave their time to the project.

She says that because the hospital has a relatively functional system to start off with and a supportive management team, it allowed for “enough of a regulatory environment to keep things safe and above board but not to the extent where you can’t move”.

It was also about having the right person in charge of the team, she adds, gesturing to Davids.

Davids, who started her nursing career in 1989 and qualified as a theatre nurse in 2009, started working at Groote Schuur six years ago. She explains that the surgical team at E4 consisted of about 18 people. This includes herself, five scrub nurses, three anaesthetic nurses, three floor nurses, a registered nurse who assists in recovery, and a clerk. Peters adds that there are also two surgical medical officers and two anaesthetic registrars.

According to Davids, when the project started, several of the nurses had not worked in a theatre before so had to be trained and upskilled by her and some of the specialist nurses who make up the scrub nurse team. She also had to get creative about having the right equipment for each surgery, which sometimes meant she had to borrow equipment from other theatres.

“It’s been a challenge, but it’s a good challenge that’s kept me going,” she says. “We’re a good team.”

“Trust [in staff] has been fundamental to this,” says Peters, “I mean, the ability to trust junior staff to upskill themselves to become scrub nurses, to hand surgeons the right instrument when they asked for it. That’s been really heart-warming.”

‘Behind every number on the list is a patient’  

When asked why it was so important to do this kind of catch-up, Cairncross says the surgeries that were postponed during the COVID-19 pandemic were ones that weren’t urgent or emergent, but those patients who were bumped still struggled physically because of the delays.

“Behind every number on the list is a patient with a story of either progressive blindness, invasive skull tumours, or tumours around the auditory canal that result in hearing loss, chronic pain from joint problems and urinary retention with recurrent infections and admissions or having a stoma bag [a colostomy bag] with them for months longer than needed,” Cairncross says. “Heart-breaking stories and often these were the patients who kept getting cancelled [on]. They would come in and if something urgent would come up, they would be cancelled or the COVID wave would come.”

She adds that at the time when the idea for Surgical Recovery came about, the morale amongst the surgical teams was at a real low. Patients would be coming to the outpatient clinics and asking, for the umpteenth time, “when am I going to have my operation?” to which the healthcare workers had to keep responding that they don’t know.

“It’s just a terrible thing and so people [staff] started to feel disempowered and disillusioned and I really think that the project helped them to at least see some progress. That there were some changes or some shift in what they were dealing with,” Cairncross says. “It hasn’t cleared our entire backlog, and a once-off project will not do that, but it has reset us pretty close to where we were pre-COVID-19.”

Peters adds that while the backlogs haven’t been fully cleared, “for every case that we’ve done in the project, it’s someone off of a waiting list”.

Health system at a ‘precipice’

While the COVID-19 pandemic caused many surgeries to be postponed and added tremendously to surgical waiting lists, it isn’t the only factor contributing to backlogs. According to Peters, the issue of a shrinking health budget for tertiary services is and will continue to add to the existing backlogs across the country.

“There’s this building backlog coming up against the shrinking budget. And that’s going to be with us for multiple years going into the future and if the clinicians aren’t protecting the budget for these patients that get missed, we’re going to focus on as we have been the emergency patients that come through the door,” he says. “But it’s always difficult for tertiary academic services because to keep up the skills of surgeons to maintain the quality of care, they do need to be managing waiting lists of booked patients. And so, I think across the country we’re going to be struggling with that across all tertiary services.”

Cairncross tells Spotlight that the project is just a temporary measure. In the long term, healthcare systems need to be fixed in order to address issues like surgical backlogs.

“The lesson, I suppose, is that these are temporising measures. We can do them, but fundamentally we need to fix the health system at a core, structural level. And we can’t work in isolation from the rest of the country because we are one health system and tertiary hospitals are only a part of that ecosystem,” she says. “The services at Groote Schuur Hospital, for example, cannot be sustained if the health systems from primary care to district health facilities, in urban and rural facilities, and across provinces are not supported and strengthened.”

The health system is at a precipice, according to Cairncross, and big academic hospitals need to be anchoring elective surgical services together with emergency services, as the problem with emergency services will only get bigger down the line if electives aren’t dealt with now.

“We know that postponed elective surgery just becomes emergency surgery over time, making cancelling elective surgery a false economy. We need to plan robust systems that ensure all types of surgical services are maintained,” she says.

“The strongest voice [in defence of the health system] is a conscious and motivated health workforce. So, where the nurses and doctors and managers are standing and defending patient services, they are supporting the health system,” she says. “I think this is an example of health workers standing up and saying, we can’t allow this deterioration in services. We’ve got to do more. We really want to tell the story, so that people can see it can be done.”

Republished from Spotlight under a Creative Commons 4.0 Licence.

Source: Spotlight

Categories : HospitalsTags :

Nurses Protest Against Staff Shortage at Hospital Treating Cholera Patients

On By ModernMedia

By Chris Gilili for Groundup

Almost 100 former nurses at Jubilee District Hospital in Hammanskraal are calling on the Gauteng Department of Health to employ them permanently. Originally contracted in July 2020 to deal with the Covid pandemic, their employment contracts were periodically renewed but terminated at the end of March 2023.

The nurses have been sitting outside the hospital since Monday.

“They want us to work under agencies, and we don’t want that,” said a nurse.

“This hospital is very understaffed, but they are being stubborn. Inside the wards there are only two nurses working, and they are overstretched. They are struggling but the department doesn’t want to employ more nursing staff,” she said.

“It’s heartbreaking to see our people in distress, and I know I am a qualified person and could help. We are told there is no budget for us,” she said.

In a statement on Monday, the Democratic Nursing Organisation of South Africa (DENOSA), said as a result of the cholera outbreak “Jubilee Hospital is now experiencing an influx of patients, which is stretching the facility to breaking point.”

“Nurses in the facilities in the area will also be made to perform duties that are outside their scope of practice where they may be expected to carry water buckets to the water tankers. DENOSA does not encourage that nurses perform duties that are outside their scope.”

DENOSA Gauteng provincial secretary Bongani Mazibuko said there was a shortage of nurses and that it had been agreed at the provincial level to extend the contracts of Covid contract nurses.

Mazibuko said the contracts were due to end on the 31 March 2023 and the Gauteng health department was supposed to have given the nurses new contracts for 1 April 2023 to March 2024.

He said nurses whose contracts had been terminated should contact the union.

GroundUp made several attempts, all in vain, to get comment from the Gauteng health department.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : HospitalsTags :

Loadshedding Hits Clinic Waiting Times

On By ModernMedia
Photo by Jarl Schmidt on Unsplash

By Peter Luhanga for GroundUp

Loadshedding is affecting waiting times at the Dunoon Community Health Centre in Cape Town, with patients saying they queue for hours and are still sent home without their medication.

Dunoon resident Mavis Matomane, 54, said she woke up early on Thursday 11 May to be at the clinic in time for an appointment made five months ago.

When she arrived at 7am, she joined a long queue standing outside in the rain. Matomane needs medication for arthritis and high blood pressure. She said the clinic was serving people who had arrived the day before but had not been seen to and had been told to return on 11 May.

She was seen by nurses for diagnosis after 11am and only left the hospital with her medication at 3pm.

Neliswa Bobotyana, who lives in Ibaleni informal settlement in the township, said she accompanied her boyfriend to the Dunoon centre on Monday 8 May. He was seen by a doctor and told to wait to get X-rays, but the X-ray facility closed while he was still waiting. On Tuesday his condition had deteriorated and she took him back to the health centre where he was told to open a new folder. He was sent back home and returned on Wednesday 10 May and was taken to the New Somerset Hospital where he was finally given medication.

Other residents have complained on a neighbourhood online group.

Western Cape Department of Health spokesperson Natalie Watlington said as a result of loadshedding and problems with the data centre in George, pharmacy applications for patient medication were offline on 10 May.

“Our pharmacist therefore requested patients to return the next day for their medication. We acknowledge that at times loadshedding may affect our phone lines and IT systems. It may take more time to draw your folder or process your details as a patient,” said Watlington.

She said on average 150 adults and 180 children arrived without appointments every day. This was on top of about 120 clinician appointments and 100 family planning appointments per day.

She said there were problems when patients who did not arrive on their appointment day arrived as walk-in patients on other days. There were an average of 80 missed appointments a day, Watlington said.

Watlington said patients sticking to appointment times did not need to arrive early. Waiting times differed according to the nature of the complaint and the treatment.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : HospitalsTags :

Opinion: Why I Became a Nurse and What’s Needed to Fix Nursing in SA

On By ModernMedia
Photo by Hush Naidoo on Unsplash

By René Sparks for Spotlight

Today we celebrate Nurses as we do every year on 12 May. The International Council of Nurses proclaimed this year’s slogan as ‘Our Nurses, Our Future’, but what is the future of nurses in South Africa?

During the height of the COVID pandemic, we saw a huge campaign launched by the World Health Organization, uplifting the stature of nurses and midwives and showcasing them as the backbone of health systems at a global level. In the South African context, the story goes that they will also be central to the health system once National Health Insurance is implemented yet there are many red flags raised as we continue the planning discussions in preparation for this change with little to no answers about that future.

“I will never be a nurse”

By the time my mother had to decide on a career, nursing was one of those professions that provided stability and security to black and coloured women during Apartheid. You had two choices – become a nurse or a teacher. That’s how my mother began her nursing journey, but she was so passionate about it so that it would probably have been her choice, regardless.

Her passion was not what spurred me on to become a nurse, though. I looked at her long hours and tireless devotion to her community and the mental health fraternity and literally uttered the words, “I will never be a nurse”. Then I met a young staff nurse during a youth weekend away. She was so proud of her profession. She just oozed pride, and at that moment, I went from a potential engineering student to a nursing student.

My father was livid. He could not comprehend why his only daughter would observe the work hours of her mother and still choose to become a nurse. But in many ways, I believe nursing chose me. Once I made the decision, I never looked back. I remember being mocked and berated for my choice in social circles, but feeling a deep connection to this calling.

I have not entered it blindly though. I was aware of my privilege and the weight of caring for people at their most vulnerable. The experiences I have made while holding the hand of someone taking their last breath, supporting a mother delivering a stillborn baby, to engaging with my first person living with HIV, or watching someone slip away after a huge battle with cancer have been deeply embedded in my consciousness. I do not believe these experiences to be without life-altering potential and believe it has shaped me into the healthcare worker I am today.

Threats to nurse autonomy

It is often believed that nurses are the handmaiden to the doctor and we should not think but do. Those sayings were so wrong, but even today, the inferiority of the quality of nurse training, lack of supervision, and only very limited mentoring all threaten the autonomy of the nurse.

Nurses, despite having a day and even a week dedicated to celebrating them, are still, for the most part, underpaid, overworked, and professionally stunted. By stunted I am referring to the lack of mandatory continuous professional development and upskilling. Somehow, as the backbone of primary healthcare, they are often unable to take time out for much-needed training.

One often hears of nurses being rude and impatient. Though some may very well display these horrible traits, for the most part, people have entered this profession to improve healthcare services to individuals, families, and communities at large. In my 21 years of experience, the issue is hugely exacerbated by the healthcare system, which does not support nurses. The hours are long and gruelling – exacerbated by staff shortages in facilities. The environment is hostile, the workload unequal, and the pay shoddy. Many nurses find themselves moonlighting to make ends meet.

Advocate for us

Though not an excuse for unprofessional behaviour, I do want activists and health advocates to fight for better working conditions, upskilling opportunities, and a larger health workforce in our public health sector.

The mental health of our clients and communities appears topical at the moment, but what about the nurse? The trauma of loss, observation of patient suffering, and abuse by many of the actors in the health space can take its toll on the mental health and well-being of our nurses, too. When we plan for the public, we must remember to include the healthcare workers and their health and well-being.

This is even more critical now as we embark on establishing the National Health Insurance (NHI) system.

As NHI looms, the threat that nurses will be ill-equipped to render quality healthcare services is a glaring reality. The South African Nursing Council (SANC) notes that 47% of the nurses on its database are older than 50 years of age. This narrative of aging nursing personnel started years ago and if we had a proactive plan to address this, South Africa may in fact have had some fighting chance to implement NHI smoothly.

In a damning article published in February, the Democratic Nursing Organisation of South Africa (DENOSA) highlighted that the South African public health sector has a deficit of 27 000 nurses and yet there are 5 000 nurses currently unemployed. How can this be acceptable? It further noted that the South African government has placed certain nursing specialities on a scarce skills list in the hope of recruiting from other countries instead of planning to upskill and uplift domestically.

Part of me wants to speak about accountability, collaboration, and change management, but the other part bleeds for nurses as the workload and responsibilities increase and the work environment becomes more hostile. All this makes it hard to see the silver lining.

I do, however, believe that if the South African Nursing Council and National Department of Health actually engage the people on the ground, those at the coal face, those with expertise, and review their current implementation plans, they will see the same glaring gaps that we see every day.

There must be a call to action for all nursing leadership, nursing activists, nurses, and nursing education establishments to collectively take a stand and demand that we revise our current approach to the nursing curriculum and work on making nursing more appealing to the youth. This could be one step in the right direction.

When I qualified as a nurse, it was a four-year course. The nursing degree I completed included Community Nursing, Psychiatric Nursing, General Nursing, and Midwifery, and although I might not practise it all, I am able to fall back on that knowledge during client or patient engagements. Now it is a five-year course with one qualification with the nurse trained as a generalist. The fear is how does that serve our communities? We need midwifery, for example, to do NIMART (initiate people on HIV treatment) and you need community nurses to be working in primary healthcare, If you come out with one general qualification – how exactly will this pan out?

We need a rethink of how we train nurses and how we can strengthen the curriculum so that we can get nurses who can address HIV and all issues in primary healthcare. In my programme – HIV testing, for example, nurses don’t get trained on HIV testing. It is just monkey see, monkey do and unfortunately, that doesn’t translate into quality service.

Very often nursing practice is see one, do one, and then you’re the expert. I’m arguing that these things must be part of the curriculum. For example, why must a nurse come out of nursing school and then only learn IMCI (Integrated Management of Childhood Illness) Why is IMCI not being done practically in the facility and the theory in class, as part of the curriculum?

Nurses, today, are expected to know everything, which is impossible but we are not upskilling them and making sure the curriculum is so robust that it addresses all disease profiles and our communities’ healthcare needs. We are talking about integrative and holistic healthcare so we cannot be only training nurses in one way. There is a malalignment of what our communities need and what nursing schools are churning out.

We must fix that.

We need an urgent change in the curriculum of nurses to ensure we can support the needs of the health system and communities,  build great leadership for the future, and ensure quality health services for all.

* Sparks is a nurse, health equity advocate, and Tekano and Aspen New Voices Fellow with 21 years’ experience working across South Africa with a focus on ensuring equitable and just access to quality healthcare for all. She is also a Quote This Women + Voice of the Year Award Winner.

Republished from Spotlight under a Creative Commons 4.0 Licence.

Source: Spotlight

Categories : HospitalsTags :

Food Shortages at Chris Hani Baragwanath as Suppliers Fail to Deliver

On By ModernMedia

Chris Hani Baragwanath Academic Hospital (CHBAH) has been hit with shortages of essential foods as contractors fail to deliver the quantities of food tendered for, Daily Maverick reports.

Last week, a head of department at CHBAH notified Daily Maverick of the developing crisis, saying “So once again there is a food crises at Bara – suppliers weren’t paid, also no soap and hand towels and as a result infections spreading 😡.”

The unnamed healthcare worker said that the crisis was due to small suppliers being unable to fulfil the quantities for tenders they secured. Dry goods were particularly affected, and protein substitutes were having to be purchased from petty cash which was now depleted. This was verified by another healthcare worker, who described a situation of hospital kitchens having to borrow from one another.

This comes after new details into Gauteng health department tender corruption have emerged thanks to a whistleblower.

One doctor spoke of elective surgeries being cancelled due to financial pressure, and an atmosphere of intimidation. Motalatale Modiba, spokesperson for the Gauteng Department of Health, denied that there was a food shortage situation, but said that delivery of some protein food items, such as chicken and fish, had been withheld due to administrative payment delays.

Read the full story at Daily Maverick.

Categories : Healthcare Politics and Regulations HospitalsTags :

People’s Lives are ‘Not Our Responsibility’ Says NEHAWU Leader

On By ModernMedia

By Vincent Lali, Chris Gilili, Liezl Human, Tariro Washinyira, Nombulelo Damba-Hendrik, Thamsanqa Mbovane, and Mkhuseli Sizani

“You have shown the power of the people by closing all the hospitals,” National Education Health and Allied Workers’ Union (NEHAWU) Western Cape provincial secretary Baxolise Mali told striking union members on Wednesday. “The employer says people are dying. It is not our responsibility to keep people’s lives.”

Mali was speaking to strikers outside the Khayelitsha District Hospital in Cape Town, as NEHAWU members continued a wage strike which has disrupted hospitals and government offices across the country. The government considers the wage negotiations for 2022 to be settled but NEHAWU and several other unions are still demanding up to 12%.

Police presence outside the hospital had kept protesters away, said hospital CEO David Binza. He said the situation was “better than yesterday”, when “things were bad”.

Binza said services at the hospital had been severely affected by the strike on Monday.

Protesters had prevented people coming in and out of the hospital. Staff had ended up working 24 hours because there were not enough nurses to relieve them, and there was a shortage of nurses in childbirth wards. “Yesterday they prevented night staff from gaining access into the facility. It was mostly doctors that they allowed in. Doctors alone can’t work properly,” he said.

Today things had been better, he said, as the police had arrived early and kept protesters away from the hospital.

Western Cape health spokesperson Mark van der Heever said shift changes at the hospital were being closely monitored after patients in critical condition had to be transferred to other hospitals such as Helderberg, Tygerberg, Mitchells Plain and Karl Bremer.

Striking workers outside Khayelitsha District Hospital on Wednesday. Photo: Vincent Lali

“On Tuesday night, 7 March, protesters disrupted services and blocked staff from entering Khayelitsha District Hospital until 11pm. The ongoing disruption has directly resulted in staff shortages as they are prevented from entering, backlogs building up and other operational challenges.”

He said protests had been reported at Karl Bremer and Tygerberg hospitals, but services had not been disrupted.

Mali said NEHAWU’s intention was to “collapse the provision of government services” to force the government to the negotiating table. “Our tactics involve closing workplaces, to force workers to get out and switch off their computers.”

Home Affairs offices in Khayelitsha were closed. Disappointed, Luthando Tiso said he has been going to Khayelitsha Home Affairs to collect his ID since Monday. “I can’t get a job without an ID,” he said.

In the city centre, the Home Affairs office in Barrack Street and the offices of the Department of Labour were closed and there was a strong police presence.

One man said he had been to the Mitchells Plain Labour Department offices on Monday and Tuesday only to find them closed because of the strike, and had come to Cape Town hoping for help. “I desperately need to claim from the Unemployment Insurance Fund. I lost my job in January. My rent and children’s school fees are already behind,” he said.

Eastern Cape

In the Eastern Cape, Department of Health spokesperson Yonela Dekeda said hospitals were being run by skeleton staff.

“We had an incident early in the morning where striking workers blocked the Cecilia Makiwane Hospital’s entrance in East London. But police were called to remove them.”

Dekeda said unions which were not supporting the strike action had raised concerns that their members were being intimidated and denied access to workplaces.

“We do appreciate responsible shop stewards who have called their members to order, where necessary, and ensured that critical services continue and that our patients receive necessary care,” she said. “However, we take very seriously those employees who intimidate others, and cause services to be affected negatively.

“Appropriate action will be taken in all such instances, and law enforcement agencies are being deployed.”

At Laetitia Bam Day Hospital in KwaNobuhle, Kariega, Eastern Cape deputy secretary of NEHAWU, Busiswa Stokwe told about 100 striking workers: “We know we will be attacked even in the community, accused of not caring for patients. But the same community when you are doing the work of ten people, whilst you are four, would insult you, saying you are lazy. We must put ourselves first.”

A patient who did not want to give his name said he had arrived at 5am to have three teeth removed but had been ordered out by striking workers at 7am. “They came by car and on foot and sang in the corridors. We realized that we should go back home, with aching teeth.”

“We were about ten and have no money to remove teeth at a private doctor, who charges R350 per tooth,” he said.

Gauteng

In Tshwane, striking workers closed down the offices of the Department of Public Service and Administration, shouting and insulting some workers who were inside the offices.

There was a stand-off between the striking workers and police, as the workers closed off Hamilton and Edmond Streets with huge stones and turned cars away. Police moved the workers away.

Phumuzo Malahleni, a registry clerk at the Department of Agriculture, said his R12,000-a-month salary was too low to cope with the soaring cost of living. “As public servants we can’t afford anything. Violence and going to the streets is the only language our government understands.”

NEHAWU Gauteng provincial chairperson Mzikayise Tshontshi told GroundUp that the battle for a wage increase was far from over.

He said NEHAWU had been called to the Public Sector Bargaining Council on Thursday. “Our negotiators will be there, but the rest of us will continue shutting down public services.

“We believe our strike has been resoundingly successful. From Monday to today, the numbers have been growing. Tomorrow we want to intensify the strike,” said Tshontshi.

Addressing the crowd outside the department, Tshontshi called out those who were still at work.

“We are also aware of ‘amagundwane’ (rats). Some are sitting in cosy offices, and then when we win this battle they are going to be first in the queue because they think they deserve what we have fought for. There have always been traitors in every struggle; this is no different.”

At Tembisa hospital, striking workers blocked the entrance with burning tyres and debris while chanting slogans. Calm was later restored.

Free State

Free State health spokesperson Mondli Mvambi said the province had obtained an interdict on Wednesday morning to prevent strikers from disrupting services at hospitals and clinics. “The order does not stop the strike but stops acts of intimidation, violence, disruptions and instigating.”

Mvambi said hospitals hardest hit were National District Hospital, Universitas, Pelonomi and Medical Depot in Bloemfontein. “There were no nurses at work and patient care was seriously compromised.” Mvambi said calm had been restored but services remained strained as nurses were still not at work.

“At Manapo in QwaQwa they are not allowing nurses into the hospital. At Boitumelo in Kroonstad, picketers were singing at the gate but services are said to be continuing. At Pelonomi Hospital, nurses in ICU were forced out by the strikers.”

North West

In the North West, services at least six hospitals were disrupted by the strike: Klerksdorp-Tshepong, Potchefstroom, Taung District, Moses Kotane, Ganyesa District, and Gelukspan. There were pickets outside several other clinics and hospitals.

Mpumalanga

In Mpumalanga, spokesperson Christopher Nobela said that all health facilities had been affected and hospitals were working with skeleton staff in hospitals.

Limpopo

Limpopo health spokesperson Neil Shikwambana said, “We do not have reports of disruptions in any of our facilities so far.”

KwaZulu-Natal

Workers stopped work at Inkosi Albert Luthuli Central Hospital in Durban for several hours on Wednesday morning, singing outside the hospital. Patients were allowed to enter.

NEHAWU branch secretary Sikhumbuzo Gumbi said workers decided to go back to work at midday so they could assist patients. “As workers we decided to protest in the morning then attend to patients around lunchtime.”

Gumbi said the staff would continue protesting in the mornings until the strike ends.

Prince Mthalane, Durban NEHAWU regional secretary, said clinics had been closed in KwaMashu and at Polyclinic workers had burned tyres. Police had been called but workers had talked to them and no-one had been arrested.

“The aim is to have a peaceful strike,” he said.

GroundUp was unable to reach the health department spokespersons in KwaZulu-Natal or the Northern Cape.

Police

“Innocent patients have been caught in the crossfire and inconvenienced by something which has nothing to do with them,” said Department of Health national spokesperson Foster Mohale. He said the Minister of Health had asked the Minister of Police to strengthen the police presence in areas affected by the strike.

“Skeleton staff has also been available to give care to patients who could not be discharged,” said Mohale.

South African Police Union spokesperson Lesiba Thobakgale said the union had joined NEHAWU in the protest. “As SAPU, from today we have served a strike notice and we are joining the other unions,” said Thobakgale.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Healthcare Politics and Regulations HospitalsTags :

NEHAWU Says Strike Action is Growing

On By ModernMedia
Striking members of the National Education, Health and Allied Workers Union (NEHAWU) blocked the department of Home Affairs offices in Cape Town on Tuesday. Photo: Thomas Kachere

By GroundUp Staff

Patients were turned away from some hospitals as members of the National Education, Health and Allied Workers Union (NEHAWU) and other unions pressed forward with their wage strike, in spite of a court interdict.

Many government offices were closed for several hours.

NEHAWU has approached the Labour Appeal Court to appeal against a decision to enforce the interdict against the strike granted by the Labour Court to the Department of Public Service and Administration.

In Cape Town, police intervened after a scuffle broke out after a member of the public who was queuing for service at the Department of Home Affairs office in Cape Town called protesters names.

The police warned the protesters not to engage in any violence.

Provincial General Secretary of NEHAWU, Baxolise Mali said, “Today we have escalated matters”. He said hospitals including Khayelitsha Day Hospital and Somerset Hospital had closed, and the offices of Home Affairs and Labour were closed. “SASSA offices will close soon for social grants,” he said.

NEHAWU served the department with a notice to strike on 24 February after wage negotiations deadlocked. The department offered a 4.7% increase while unions demanded between 10% and 12%.

Ronald Ruiters had queued at the Home Affairs office in Cape Town for hours for a temporary ID, without getting help, he said. “Yesterday I was here at 4:30am. I am an old man. What about people who are suffering now including sick people in hospitals? There should be a better way of dealing with these issues.”

“Since morning the police were here but they could not control the protesters, nothing is working here.”

Mali said workers were angry at a statement by acting Public Service Minister Thulas Nxesi who had described the strike as reckless.

“The acting minister called people reckless and said they need to go back to work … go back to work on what basis? Come with an offer: we are willing to negotiate.”

“It is reckless for the government to impose salaries on people. It is reckless for the government to expect the people who have been praised during the time of Covid for having to work hard in very difficult conditions to serve our people to get peanuts.”

“The ‘no work no pay’ principle is not a new thing. Let them deduct the money, we are used to poverty. “

Mali said members of the public did not understand. “They stand in long queues because the government is refusing to employ more people to work for Home Affairs, [Department of] Labour and SASSA. Instead they increase the cabinet. Too many deputy ministers and what work do they have to do?”

“What needs to be done is to create employment so that people get served quickly. That is all we are fighting for. We are not going to compromise.”

In Pretoria, striking workers occupied the Department of Labour Head office, singing and shouting at workers inside to come out. They also closed entrances to the offices of the Department of Higher Education and Training, and disrupted traffic on Francis Baard Street.

A striking cleaner at the Department of Labour, Boitumelo Motaung said she earns R6000 a month and supports a family of four people. She says she spends about R1000 on transport from Ga-Rankuwa to Pretoria for work.

“We are suffocating, and we are earning peanuts. I have three kids that are attending school and their father is unemployed. I am taking care of everything and a few days after payday, I am left without a penny and survive off loan sharks. We need government to recognise our value as people. Sometimes I am forced to do the work of three people where I work because they are not employing enough cleaning staff. That is why I am supporting this NEHAWU strike,” said Motaung.

Motaung said she has been working as a cleaner for seven years.

In a statement, DPSA director general Yoliswa Makhasi said work stoppages and pickets by NEHAWU and its members would be contempt of court.

“We will strike until our demands are met”

NEHAWU deputy secretary-general December Mavuso

Spokesperson for the department Moses Mushi said the minister had called on unions to return to the negotiating table.

NEHAWU deputy secretary-general December Mavuso said the strike had expanded. He said the union’s lawyers and government lawyers were in discussion about an appeal to the Labour Appeal Court. “We don’t know when an outcome will be available . In the meantime, our workers are on the picket lines,” said Mavuso. “We will strike until our demands are met”.

Department of Health spokesperson Foster Mohale said the department was working with provincial health authorities and law enforcement agencies to monitor the situation to ensure rapid response and if necessary urgent intervention.

In Fort Beaufort in the Eastern Cape, community health care workers were ordered to stop their services at clinics and hospitals. Striking NEHAWU members blocked the entrance of the Fort Beaufort Provincial Hospital and turned away patients. Top management was allowed to enter but other staff were locked outside the gates.

NEHAWU also shut down several government offices in the Eastern Cape.

Mphakamisi Shooter, regional NEHAWU treasurer, told GroundUp the union had used its resources to put President Cyril Ramaphosa in power. “But now he is failing to give us what we deserve.”

“We have over 5,000 members in this region. Today we made sure that we shut down all government departments in this region until Ramaphosa gives us a decent wage.”

MEC for Health Nomakhosazana Meth condemned the unprotected strike. “We understand that workers have a right to demonstrate but when they do they cannot infringe on the rights of others. We cannot afford to have a situation where the lives of patients and staff not on strike are in danger as a result of the action of those who have embarked on this action.”

She said there were reports of disruptions and acts of intimidation in some areas.

In Makhanda, clinics were closed as were the offices of the departments of Home Affairs, Labour, and Social Development by a group of about 80 protesters.

Madoda Toni, who was part of the protest, said the government cannot continue to pay workers low salaries while prices of food and other items were rising so fast. “We need permanent jobs, decent wage increases, and contract workers should be absorbed to be full time government employees and paid decent salaries,” said Toni.

In Qonce (King Williams Town) it was also reported that SASSA and Home Affairs offices were closed down by the protesters.

In Durban, patients were prevented from entering Prince Mshiyeni Memorial Hospital by NEHAWU members. The protest started about 6am and ended just before lunchtime when workers dispersed and returned to work. By 1pm, everything was back to normal.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : HospitalsTags :

Our Hospital can’t Cope, Say Atlantis Residents

On By ModernMedia

By Peter Luhanga for GroundUp

People living in Atlantis, Cape Town, say they are struggling to access healthcare. There are two clinics run by the City – Saxon Sea and Protea Park – offering limited care, concentrating on family planning, child health, basic antenatal care, and HIV care. For any other health issues, residents have to go to Wesfleur Hospital. People queue for treatment as early as 5am.

In 2017, we wrote about the long queues and other problems at Wesfleur Hospital.

Community activists have set up the Atlantis Community Health Organisation (ACHO), which submitted a memorandum of grievances in August last year to Western Cape MEC for Health Nomafrench Mbombo, and resident Allison Adams, (not part of the ACHO) set up an online petition that has garnered over 1,275 signatures.

Adams and ACHO want the two City clinics taken over by the province so that they can be upgraded to offer primary and not just general healthcare. This would take pressure off Wesfleur.

“Clinics would serve as a conduit to relieve the hospital from everyday attendance. The hospital can’t cope. We have limited number of doctors available every day,” says Ashley Poole of ACHO.

Adams says the doctors can’t cope with treating patients, doing ward rounds and conducting medical assessments for residents seeking disability grants. It takes days for people to get help at the hospital, she says, and everyone with even a minor illness has to go to the hospital.

“We have people traveling to Dunoon Community Health Center to seek medical attention,” she says.

ACHO wants a new hospital built in Atlantis, which in the 2011 Census already had nearly 70,000 people.

Mayoral committee member for health Patricia van der Ross said the City is open to transferring the clinics, but “the Western Cape health department must have the requisite budget available to continue running the clinics”. Then a handover agreement can be concluded.

She said a task team was established and “numerous meetings” were held explaining to the community the challenges involved in doing such a transfer.

One interim measure is that stable, chronic patients are seen at Protea Park three days a week on Mondays, Thursdays and Fridays between 8am and 4pm, and at Saxonsea clinic on Mondays between 8am and 1pm.

Provincial health department spokesperson Natalie Watlington said since receiving the memorandum in August 2022, the department’s district team has implemented short and medium-term interventions to improve matters at Wesfleur Hospital.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : HospitalsTags :

Buckets to Catch Water in Free State Hospital’s Leaking Wards

On By ModernMedia
A theatre recovery room at Boitumelo Regional Hospital. The photo was taken in January. The hospital says leaks have since been fixed. Photo: Rethabile Nyelele

By Rethabile Nyelele for GroundUp

Crumbling infrastructure is hampering patient care at Boitumelo Regional Hospital in Kroonstad, Free State.

We first visited the hospital two weeks ago. Buckets have been set out on the floors of some wards and theatre rooms to catch water leaking from broken ceilings.

An extension of the hospital building and upgrades started in 2010. In July 2014, further renovations were done. But staff, who spoke to GroundUp on condition of anonymity, said conditions at the hospital are deteriorating, with leaking ceilings, and broken windows covered with cardboard.

Last week, nurses and other staff downed tools over the poor condition of the hospital. They also demanded to be paid for overtime. Most staff resumed their duties on Monday night, pending further negotiations with management on 17 February.

Boitumelo is the only regional hospital in the Fezile Dabi District and caters for patients from about 19 surrounding towns. The hospital has six theatres but we were told of at least 80 patients whose surgeries had to be rescheduled between October and December 2022.

“I’ve been going to the hospital for surgery since 2018 … They keep postponing,” said Langelihle Makhoba.

Another patient, Mamiki Mnguni from Oranjeville, who lives about 100km from the hospital, said, “I was scheduled for a gallstone removal on 19 January 2023, but I was told the theatre is not working. I was told to return in April.”

Hospital CEO Sibongile Mthimkhulu referred our questions to the Free State Department of Health.

The department’s spokesperson, Mondli Mvambi, responded to our questions with a screengrab from a memo sent by Mthimkhulu which details progress made on infrastructure repairs. The memo stated that ceiling panels had been replaced and two theatres had been painted, among other things.

But when we visited the hospital again on 6 February, ceiling panels were still broken and we were told that some of the theatres were not yet fully functional.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : HospitalsTags :

Evidence-based Healthcare Improves Patient Outcomes

On By ModernMedia
Photo by Andrea Piacquadio on Unsplash

A recent study found improved patient outcomes after receiving care based on scientific and clinical evidence, while also reducing costs. Published in Worldviews on Evidence-Based Nursing, the article also reviewed the extent and type of evidence-based practices (EBPs) performed across clinical settings. 

A total of 636 published articles addressing EBP and patient outcomes met investigators’ inclusion criteria. There were many differences in approaches, designs, and outcomes measured among the articles included in the review. 

Most articles (63.3%) were published in the United States, and 90% took place in the acute care setting. Various EBPs were implemented, with just over a third including some aspect of infection prevention, and most (91.2%) linked to reimbursement. The two most reported outcomes were length of stay (15%), followed by mortality (12%). 

“Although our study revealed that EBP improves patient outcomes and reduces costs for healthcare systems, there is much opportunity to improve healthcare quality and safety with EBP as healthcare executives still do not invest enough in their budgets to ensure that all clinicians take this approach to care and that all care is evidence-based, not steeped in tradition, or outdated policies or procedures,” said corresponding author Linda Connor, PhD, RN, CPN, of The Ohio State University. 

Source: Wiley