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Everall Bronwyn Taljaard
 
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Is compassion on life support?

06 January 2014, 20:19

I have always believed that the health care profession attracted people who believe that the career path they had chosen was a vocation – something that gave purpose and meaning to their life beyond securing a monthly income.

I recently found out that in the New South Africa (really? Are we still calling it that?), this is a false premise.

Due to personal circumstances I am forced to make use of the Government Health Care system for my medical needs. Up until recently it has been an infrequent necessity but a recent visit to the Physiotherapy and X-Ray Department for a back problem, revealed that I have severe degenerative disc disease. This required admission to Cradock Hospital for traction. I had heard stories of how hospital care had deteriorated over the last 20 years but had assumed it was a case of staff being over-worked and underpaid and also due to budgetary constraints.

In some cases this appears to be true but after my experience in a state funded hospital, I felt the need to write about it. I know this is probably just another link in a long chain of complaints but maybe, just maybe, when the politicians understand that despite their rhetorical arguments to the contrary, their noble initiative to provide free and equal health care for all South Africans is slowly deteriorating into a “tick all the right boxes” system that largely ignores the compassionate aspect which, in my experience, has generally always been an innate part of nursing. But read on and you judge.

On Tuesday, 3rd of December I was admitted to the Cradock Hospital female ward at about 4pm for 3 day traction treatment. I expected what I got in terms of linen, threadbare but adequate. All the right boxes were ticked and my blood pressure, sugar levels and temperature were checked and recorded. Upon asking about the traction system which had not made an appearance, I was informed that the Doctor would need to do it the next morning. Fair enough. So far so good.

That evening the night shift staff who were predominantly coloured, showed interest and compassion for all the patients and kept us very entertained while they went about their routines. They mentioned that they were off for the rest of the week and I was sorry that I wouldn’t see them again.

The next morning, the Doctor arrived and noted to the attending Sister that according to my file, I should be on traction. I’m not 100% sure what was said but I ascertained that it would be done later that morning. Indeed later that morning, the traction paraphernalia was dumped on my table and I assumed that I would be strapped in shortly. By 3pm nothing had happened so I queried it. I was told that the Doctor had to do it.

Eventually at about 4pm I was finally in traction after the Doctor and Nurse spent 30 minutes trying to work out how it should be put together. That doesn’t worry me – it may just mean that they have had no previous experience with patients requiring traction. But it did mean that I had effectively lost one full day of my traction treatment.

On the 5th December my hygiene and bedpan woes began. Early that morning a dish of hot water was placed on the chair next to my bed and I had to wiggle my way to my suitcase to find my soap and cloth and then twist around to try and wash myself. I knew the staff  were very busy so when I realised that there was no way in hell that I could extricate myself from traction, I asked for a bedpan which was brought to me quite promptly. At this point the staff got really busy and I was left to sit on the bedpan for about 20 to 30 minutes before I could get someone’s attention. At this point I should mention that there is no bell system. You have to shout to get assistance.

I must also mention with some embarrassment, that while in traction, the bedpan system is a bit of a hit and miss affair so I invariably dribbled a bit onto the bedding so it was somewhat humiliating when I realised that changing my bed linen was not part of the health care portfolio for nurses when caring for patients restricted to bed.

The day shift staff were good about leaving a bed pan near to my bed but when the night shift started, sadly a different night shift to the previous night, my bedpan was taken away and never returned.  The Sister on day shift had also asked me if I wanted my pain injection then or at lights out. I said it would be better later and she said she would let the night shift know. When I asked the night nurse about the injection she just said that she had given me my pills and left me on that note.

I woke up at about 11pm that night in some pain but with a more urgent need to urinate. I looked to the chair to see if by chance the bedpan fairies had miraculously made an appearance. Alas the chair was bedpan-less. I lay for a while considering how urgent my need was and concluded that I would probably soon be peeing out my eyes. So I called…….and called……and called. I have a big voice but clearly not big enough. Finally I accepted that I would probably have to pee in the bed and just endure it until I could get the attention of someone. But then I heard the Gogo on the other side of the ward who was very feeble and clearly worse off than I, feebly call for the Sister.

I knew that my great booming voice had gone unheard so she had no chance. I then resorted to desperate measures and sms’d a friend that works in the hospital administration system. I asked her to ‘phone the ward and get them to give me a bedpan and help the old Gogo. A few seconds later I heard the ‘phone ring and soon after it was answered the Sister shuffled through with a bedpan. I told them that the Gogo also needed assistance and so she also received attention. Strangely enough, it seems that because I “knew” someone, it warranted the afore-mentioned pain injection.

It was while the Sister was administering the injection that she heard on her cell phone and shared with me that Madiba had passed.

It was somber news and I felt very sad for our collective loss. But as I reflected on his life, his compassion and the many years of struggle to bring peace and equality to South Africa, I couldn’t help thinking that Madiba would surely have been saddened and even shocked at the contrast between the medical care he had received and that provided to the equally aged and feeble Gogo in the ward.

I must stress that this is my experience in one hospital. I cannot speak for the service in other state hospitals but I have since done some research and according to statistics, approximately 85% of South Africans receive equal medical treatment – equally poor that is from the state. Only about 15% have access to quality medical care.

Yes they pay a high premium but that only sends the message that compassion is not free. Most of the 85% have no voice and to some degree, are not even aware of the humiliation they are subjected to sometimes. But I do have the wherewithal to express my frustration and perhaps use my voice on their behalf.

I don’t know if there are solutions – the problem seems huge and has taken on a life of its own. I do believe that some small issues can surely be addressed and rectified. How expensive would it be to re-install the buzzers to call the nursing staff and surely nurses are still trained to make up beds for patients restricted to bed?

I was also very fortunate to have a tremendous support structure in my family and friends who made sure I was provided with little luxuries such as coffee, milk powder, soap, towel etc. and many messages of support.  I am extremely grateful to them all for their kindness and also for the help from the cleaning lady in the ward who provided the boiling water for my coffee. A small thing but it meant a great deal.

I am sad that Madiba has gone but I weep that the legacy he thought he would leave all South Africans has been so politicised and deconstructed into rands and cents which in turn have been subject to corruption at the cost of the most vulnerable people in this country – the poor, the sick and the helpless – both black and white.

"I have fought against white domination, and I have fought against black domination. I have cherished the ideal of a democratic and free society in which all persons will live together in harmony with equal opportunities. It is an ideal which I hope to live for, and to see realised. But my Lord, if needs be, it is an ideal for which I am prepared to die."

Nelson Mandela, defence statement during the Rivonia Trial, 1964. Also repeated during the closing of his speech delivered in Cape Town on the day he was released from prison 27 years later, on 11 February 1990.

How then can we expect Madiba to rest in peace?

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