Dire shortage of ambulances in KZN

2014-04-22 00:00

A DIRE shortage of provincial ambulances is impacting on patient care to such an extent that a Sweetwaters woman was forced to give birth at home recently while waiting for an ambulance that never came.

The Witness was told that Pietermaritzburg and the rest of the uMgungundlovu District Municipality has only 18 ambulances, to serve a population of more than a million.

And in eThekwini Metro there are only 35 to 40 ambulances on duty each shift, serving 3,5 million people.

The numbers paint a grim picture when the national norm expects there to be one ambulance to every 10 000 people.

Currently, the ambulance to population ratios in uMgungundlovu and eThekwini are 1: 56 500 and 1:87 000 respectively. According to a report in the South African Medical Journal (February 2014) relating to the helicopter air mercy service, ambulance coverage in greater KZN is 1: 44 000 people.

National Education, Health and Allied Workers’ Union (Nehawu) Harry Gwala regional secretary, Zimasile Giyama, said the lack of vehicles on the road puts significant pressure on their members, who he claims are struggling to serve the various communities in their district.

“If we use the national ratio then we should have 117 ambulances servicing the community [in uMgungundlovu],” he said.

Giyama was responding to questions about a woman from the Payipini area of Mpumuza near Sweetwaters who gave birth at home two weeks ago, while waiting for an ambulance that never arrived.

Londiwe Dlamini was eventually transported to Edendale Hospital by DA councillor Glenn McArthur.

KwaZulu-Natal Health Department head Dr Sibongile Zungu did not respond to detailed questions on the matter sent by The Witness, but denied there was any shortage of ambulances. Zungu called Pietermaritzburg “one of the most resourced districts” in the province.

“In this district there are even more ambulances than there are in eThekwini,” she said, but was unable to confirm exactly how many ambulances served the area.

Answers to the questions submitted two weeks ago are awaited.

A paramedic, who spoke on condition of anonymity, said, “Every day there are a maximum of four ambulances servicing the whole of Pietermaritzburg because there are shortages. We used do about 10 call-outs, but these days if I do three, I consider that I have worked hard. I earn so little, why should I work any harder?” he said alluding to the fact that they were on a go-slow.

Another paramedic said the normal maximum number was just five ambulances at the Imbali base. “Most of the ambulances are broken down and some are faulty due to the newly installed trackers,” he said.

He said the Emergency Medical Rescues Service (EMRS) fleet consists of Mercedes and VW vehicles but they are sent to “bush mechanics” for repairs and they always come back with the same problems while the mechanics claim big money for doing nothing. Instead, paramedics are forced to drive un-roadworthy ambulances to accumulate more kilometres so the ambulance will be sent to another bush mechanic for the same problem.

A Durban paramedic said they spend about 60% of their shift completing transfers.

“The transfers take time. Only once we have handed over the patient to the hospital can we attend to emergency calls. Daily we have about 35 ambulances working in the city but there may be shortages due to them being serviced or in for repairs,” said the medic.

McArthur said he was getting used to playing ambulance for the people in the informal settlement he lived near. “I have this scenario regularly at my Peace Valley 111 [Entabani] informal settlement, and the paramedics normally claim they could not find the place because there are no named streets and no lights,” he said.

He said the other excuses include that there were no police to escort them to the informal settlement.

McArthur said he had reported the incident in which he assisted after the baby’s birth to the provincial legislature and it was being investigated by the ombudsman, because it was unacceptable.

The baby’s father, Ayanda Mthethwa, said he was angry because if anything had happened to his girlfriend, Londiwe, and the baby, the department would have been held liable for negligence.

“This was not the first time paramedics refused to help and some people die in the area while waiting for ambulances,” he said. Mthethwa said the baby and Londiwe were fine but needed regular checks.

Zungu said management was unaware of what the problem was in this district because workers seemed to be unhappy. “We don’t know what else needs to be done because the issue of overtime was addressed. We seem to have a problem with paramedics not willing to do their jobs,” she said.

Giyama said the department should prioritise instead of spending millions of rands for lawyers to conduct internal disciplinary hearings, which was wasteful expenditure because there are internal structures designed for this exercise. He said some of the ambulances do not even have oxygen tanks and they often broke down, which is causing poor service delivery.

EMRS staff workers temporarily downed tools for the second time in a month, last week.

The paramedics who spoke on condition of anonymity for fear of being victimised said the department of health owes them thousands of rand in unpaid overtime on holiday, Sunday and night shift work.

“We are temporarily back at work but whole district did not work this morning because of this issue, said one. “We are owed overtime from as far back as May last year.

We had a meeting with management this morning and nothing came out of it. We were told to wait because last year’s financial year ended in March and the extra money from that year went back. They are waiting for the start of this financial year.”

Previously, paramedics said they were suffering huge financial losses.

“My wages have declined by more than R3 000. I only get the basic salary and housing allowances that comes up to just above R4 000. I cannot pay or settle any of my debts with that money; this has put me in a terrible position”.

This was echoed by another paramedics who said the situation was threatening their families. “We leave at night to say that we are going to work overtime and yet there is no money; this creates conflict within our families as they suspect we might be lying about working.”

They said the issue was impacting on service delivery. There was no comment from the Health Department on the matter.

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