The damaged generation: Our kids pay the price

2013-08-24 14:00

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A mix of incompetence, training that is inadequate, overstretched staff and a shortage of equipment is having terrifying consequences.

Chumani Magwayi is an eight-year-old boy who cannot speak properly and drools on his mother’s lap.

His mother, Cynthia, says his grandmother called him a “snake” when he was born.

But in fact he is suffering from cerebral palsy – allegedly caused by a brain injury sustained during his bungled birth at Pholosong Hospital on Gauteng’s East Rand.

Chumani is the face of a damaged generation of children being produced by a toxic mix of incompetence, inadequate training, overstretched hospital staff and a shortage of equipment in state hospitals.

An access to information request by City Press and Media24 Investigations for records from the Gauteng Health department on litigation for alleged malpractice reveals the enormity of the problem.

The records suggest that by the middle of last year the department had been hit with at least R1.9 billion in medical malpractice claims.

Of the 336 individual cases – some dating back to as early as 2000, but with a significant spike in claims between 2010 and 2012 – 35% were claims relating to cerebral palsy, brain damage or mental retardation due to alleged negligence during birth.

And experts say the problem is getting worse.

One professor of paediatrics estimates that half the country’s child cerebral palsy sufferers developed the condition due to avoidable birth complications.

Just one personal injury lawyer – Olof Joubert of Pretoria – is litigating more than 80 cases of alleged negligence leading to cerebral palsy at just one hospital, Pholosong, where Chumani was born.

Records obtained in our access to information request show at least 54 cases involving cerebral palsy or brain damage occurred at Chris Hani Baragwanath Academic Hospital, at least 16 at Natalspruit Hospital and at least 13 at Charlotte Maxeke Academic Hospital.

Asked about declining standards and why nursing staff flouted maternal care guidelines, Health Minister Aaron Motsoaledi blamed a lack of supervision at hospitals – especially district hospitals – where there are too “few advanced midwives and obstetricians”.

Interviews with a number of mothers reveal that it is more than that.

Vacuums and forceps are being used by inadequately trained staff to deliver babies, leading to severe head injuries.

We also found cases where nurses and doctors insulted and humiliated mothers, and dismissed cries that their births were going horribly wrong.

Motsoaledi said his department was trying to address the problem by employing specialist health teams – consisting of an obstetrician, paediatrician, family physician, anaesthetist and advanced midwife – in all districts.

These teams will re-train nurses and doctors on proper maternal care.

Meanwhile government, buckling under a tsunami of medical negligence claims, argues that many of the claims are fuelled by personal injury lawyers who have moved on to medico-legal litigation after Road Accident Fund claims were capped.

Motsoaledi said the State was now considering a maximum pay-out limit for negligence claims (see page 7).

“If we allow the current situation to continue the way it is, it will bankrupt the health system,” he said.

But for the parents whose children have been left brain-damaged, the cost is already incalculable.

Chumani’s cerebral palsy nearly broke up his mother’s marriage.

Cynthia Magwayi said her mother-in-law refused to accept her son, saying that nobody in her family had ever given birth to a “snake”.

“I started blaming myself, thinking maybe it was true, that I was cursed or maybe I did something wrong which caused my son to be disabled.”

Now she, along with scores of other parents, are fighting back.

Gauteng health spokesperson Simon Zwane acknowledged the number of lawsuits they face, but said “underlying factors such as socio-economic challenges and pre-conditions of patients” were also to blame.

“It is also important to note that the number of children delivered in provincial hospitals is more than 200 000 per year, and almost of all them do not sustain any injury. Those who sustain injuries are a tiny minority,” he said.

The latest Saving Babies report by the Medical Research Council, which analysed data of infant deaths in 588 public health institutions across the country in the 2010-2011 financial year, found the top cause of baby deaths to be asphyxia and birth trauma, and said the quality of care was poorest in district hospitals.

“But not all babies subjected to loss of oxygen at birth die,” said one veteran state-employed paediatrician.

“Those that live suffer the consequences for the rest of their lives.”

Dr Popi Ramathuba, the SA Medical Association’s chair for public sector doctors, said resource shortages played a large role in birth injuries.

But she questioned the ethics of attorneys urging patients to lay complaints against their doctors, saying they should instead lay complaints with the Health Professions Council of SA, which can recommend remedial action for guilty doctors.

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