Eastern Cape’s biggest emergency unit shuts down over shortage of staff and PPE
After three days of the casualty unit not being cleaned and faced with a shortage of staff as well as personal protective equipment, the biggest casualty and emergency unit in the Eastern Cape, South Africa, was shut down at Livingstone Hospital on Wednesday, 3 June 2020. State ambulances in Nelson Mandela Bay also stopped operating after a crew member was stabbed in the chest during a robbery. The Eastern Cape’s largest casualty unit, which is also a dedicated COVID-19 isolation site at Livingstone Hospital, had to be shut down on Wednesday, 3 June 2020 due to personnel absences, a shortage of sterile gloves and after doctors complained that the Accident and Emergency Unit was last cleaned three days ago. In their own spreadsheet provided to the provincial command council, the Department of Health indicated that no sterile gloves were delivered to the Nelson Mandela Bay district. But, on Tuesday, 2 June 2020, Mvusi Sicwetsha, the spokesperson for Premier Oscar Mabuyane, said the premier had directed the department of health to attend to this matter.
“He has directed the department to ensure that issues raised by the workers are resolved, provision of healthcare to patients is prioritised and all the matters raised by healthcare workers are addressed with urgency so that we can protect and save lives,” Sicwetsha said. The shutdown came as the Eastern Cape bypassed Gauteng to register the second-most confirmed COVID-19 cases in the country with 4 324 cases, 88 deaths and 2 123 recoveries.
Kitchen services, laundry services, porters and porter services at the hospital have also ground to a halt. The hospital has been without a permanent CEO or a management committee after they were all suspended by the superintendent-general of the department, Dr Thobile Mbengashe in November 2018. Despite promises that the investigation and subsequent disciplinary procedures would be finalised by March 2019, it still hasn’t happened. Four of the six-member management team have since resigned.
Five hospital sources and a senior member of the medical fraternity in Port Elizabeth confirmed on 3 June 2020 that the hospital, as a last-resort measure, had to close down the entire Accident and Emergency Unit, including the casualty unit, the physician-on-call unit, the surgeon-on-call unit and the orthopaedic-on-call unit. Desperate patients were left lying in the casualty unit as there were no porters to take them to wards.
Food service became extremely limited as kitchen staff did not arrive for work and the hospital is currently experiencing an urgent linen shortage as the laundry department is also not working. Doctors opened two theatres at the hospital on the evening of 2 June 2020 as a desperate measure but expressed their extreme concern over working conditions as the casualty unit was last cleaned on 1 June 2020.
Seventy-one health workers, many from Livingstone Hospital, have tested positive for COVID-19 in Nelson Mandela Bay, some are seriously ill and one nurse died on 31 May 2020.
Health spokesperson Sizwe Kupelo said the department’s head office signed off on more appointments for the hospital a few weeks ago to address possible staff shortage due to COVID-19 infections. “The hospital has been given a total of 59 appointments for nurses and nine appointments for doctors and 100 appointments for general assistants. The situation is unacceptable. If those people have not started work, that process will have to be fast-tracked to ensure that they render a service there. Such a situation cannot be allowed. Bisho has signed everything – not yesterday, a few weeks ago.”
He also said that more personal protective equipment (PPE), including sterile gloves, will be dispatched to the hospital tomorrow. “It is a huge mess,” one of the hospital sources said. “The cases are beginning to increase and for the next two weeks, we are facing an unprecedented disaster,” he added.
Nelson Mandela Bay currently (at the time of writing of this article) has 1 275 confirmed COVID-19 cases and an infection rate of five percent.
State ambulance services also shut down after an emergency medical services (EMS) crew member was stabbed in the chest while on call in Walmer Township. “Now the managers are forcing us back to work but they haven’t kept a single promise to keep us safe when we are on call,” one of the union shop stewards said.
The shop steward said the EMS crew had loaded a patient in the township and were going to get another one. While the one medic attended to the patient, he was shot at and his phone and wallet were stolen. His colleague was stabbed in the chest and he was also robbed. “He drove his colleague to safety. He stopped when he was out of there and put a drip on and then, he drove him to Livingstone. We were lucky, the doctors told us, if it was 1cm to the other side, we would be speaking the language of mourning today.” EMS crews were planning to meet on 4 June 2020 to decide a way forward.
Meanwhile, the MEC for Health, Sindiswa Gomba, went to Matatiele on the other side of the province. “The MEC is still in Matatiele,” her spokesperson, Judy Ngoloyi said. “She can’t be expected to just drop everything and respond to every crisis. [Dr Thobile] Mbengashe must also take leadership. There are other senior leaders in the department.”
No response was received from Mbengashe but Ngologyi said he was in meetings. She said the “only reason” why the MEC previously responded to shutdowns in places like King William’s Town was because she was “close by”.
An oversight visit by the national Department of Health earlier in the week also bypassed Nelson Mandela Bay despite the metro having the highest number of cases and the highest infection rate in the province.
In May 2020, when President Cyril Ramaphosa visited the facility, Mbengashe assured him and Health Minister Zweli Mkhize that while the department made mistakes in the early days of the pandemic, they had put a system in place to ensure that hospitals would have adequate PPE going forward.
Source: Daily Maverick