Strike outrage

2010-08-23 00:00

FORT Napier Hospital currently has approximately 200 patients. Most of these are state patients who have been charged with serious crimes and sent by the courts to Fort Napier for treatment having been found mentally unfit to stand trial. Wards 9a and 9b house up to 30 awaiting trial prisoners who have been sent by the courts for 30 days’ psychiatric observation.

On Friday, August 20, the gates of Fort Napier Hospital were again barricaded by striking workers — nurses and support staff from Fort Napier as well as strikers from outside who ensured no one entered and who intimidated, threatened and assaulted those who tried to enter the gates. The previous day, several individuals were sjambokked by strikers inside the hospital. Doctors who work at Fort Napier were barred from entering by the strikers and, fearing for their safety, remained outside the gates. Several police vehicles were parked at the gates, but the police did nothing to assist those wishing to enter.

I shudder to think what is likely to have been going on inside the locked wards of Fort Napier Hospital. Although privately outsourced kitchen staff were preparing food for patients, they are unable to take food into the wards as the wards are locked. No medication would have been dispensed, meaning that the condition of seriously mentally ill individuals is inevitably deteriorating. Under such conditions — no food, no medication and no supervision — it is likely that violence is breaking out, that patients have been hurt or worse and that incidents of sexual abuse are taking place. With wards locked there is furthermore a risk of fire as patients become increasingly frustrated and confused (most patients smoke and find ingenious ways of generating a flame). If a fire was to occur inside a locked ward, one can imagine the ensuing disaster.

At Town Hill Hospital on Friday a crowd of approximately 200 striking nurses, support staff and outside agitators toyi-toyied outside the locked gates. Despite doctors’ attempts earlier in the week to discharge all patients who could manage at home, approximately 150 patients remained on Friday inside the 10 wards in the hospital. Again police were present, but did not assist doctors and other health workers who wished to enter the gates. When “redshirts” (the outsiders) were not present, a small number of doctors were allowed into the hospital by strikers. Somehow, a handful of brave nurses made it inside also. At 9 am I picked up several colleagues (doctors, psychologists and an occupational therapist) outside the gates and drove through the crowd into the hospital. Throughout the day, a group of about six of us split up and made our way from ward to ward, dispensing medication, dishing out food and providing patients with cigarettes. In several wards, patients had not received medication for 48 hours as locked steel medicine cabinets could not be opened as keys were missing. Twice we smashed open medication cabinets to access medication to dispense to patients. In one ward we found a woman who had been fitting due to medication withdrawal. Most patients had not bathed or had a change of clothing for almost four days. In one ward we found that patients had broken into the nurses’ office, forced open a “tuck” cupboard to obtain tobacco and had burned an area of the linoleum floor — presumably trying to rig a light for their cigarettes. Two patients in the hospital had run out of anti-retroviral drugs the day before — we managed to get a pharmacist into the hospital to access refills of these and other drugs that had run out. At about 1 pm we received an urgent call from someone outside the gates to say that the strikers were entering the hospital to seek out the “rats” and expel them. This had occurred the previous day at Town Hill — in one case a nurse was threatened with a sjambok. We locked ourselves inside wards and ensured that others did the same in the pharmacy and other wards. The mob seemingly did not reach the ward we were in.

This is the reality of the strike at psychiatric hospitals in Pietermaritzburg. While personally I support the cause of the striking workers and support their right to strike, I cannot accept the intimidation, violence and barbarism that seeks to deprive vulnerable patients in our hospitals of food, medication and care and places their lives at significant risk. Those very few nurses and other health workers who have been working tirelessly day after day — in many cases with one nurse looking after 60 patients in four wards for 12 or 15 hours at a stretch — will probably never receive the official thanks and acknowledgement due to them. They have gone way beyond the call of duty. I would like to thank them publicly for their sacrifice and for risking their own safety for their patients. They have been the only hope for these desperate and incredibly vulnerable patients who have effectively been abandoned.

 

* Dr Jonathan Burns is chief specialist of Psychiatric Services in the Midlands region & deputy head in the Department of Psychiatry at Nelson R Mandela School of Medicine,University of KwaZulu-Natal.

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