This hospital used to be one of the best in the country; a place where medical students wanted to do their training. However, after decades of neglect and lack of maintenance, infrastructure is crumbling.
An investigation report released by the health ombud this week revealed that the 70-year-old Rahima Moosa Mother and Child Hospital had not received any substantial upgrade since it was built.
Health ombud Professor Malegapuru Makgoba said the situation at the hospital was worrying.
The hospital, which was named in honour of Rahima Moosa, an anti-apartheid activist who participated in the 1956 march protesting against the pass laws that restricted the movement of non-white women, came into the spotlight last year following allegations that expectant mothers were sleeping on the floor and that the hospital’s CEO, Nozuko Mkabayi, had only spent 182 days there since her appointment in January 2021.
Another complaint was that patients’ health and dignity, as well as the wellbeing of healthcare workers were severely affected. The hospital also saw an increase in patient load, with no concurrent increase in infrastructural development.
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“During the investigation into allegations against the hospital, the most striking thing has been the fact that the hospital had been neglected to such an extent in almost all respects for several years. The ageing infrastructure and sewage reticulation system is failing, leading to pipe spillages and toilet blockages,” he said.
He said an inspection in loco by the ombud investigators confirmed crumbling infrastructure in the majority of the hospital, including damp walls, corroded flooring, damaged ceilings in various departments, free-flowing sewage between buildings, rusty leaking steam pipes and overgrown gardens filled with long grass and weeds.
Makgoba said the hospital’s laboratory and blood service did not operate 24 hours a day.
He said that, with regard to blood and blood products, Rahima Moosa currently relied on an emergency fridge, where a maximum of three units of whole blood were stored.
“When these units are depleted, they are replaced by the SA National Blood Service within 12 hours and this poses a great patient safety risk,” Makgoba said.
He said there was no intensive care unit (ICU) for adults at the hospital.
“Any adult patient requiring ICU services is placed in an operating theatre, which is then closed until a vacant ICU bed is found. The lack of dedicated ICU facilities at Rahima Moosa hospital has been described as a long-standing challenge which has led to the development of a vicious circle; the closure of theatres for use as ICU facilities leads to the cancellation of scheduled operations, which in turn lengthens the surgical backlog and leads to patient and healthcare worker dissatisfaction and unhappiness,” Makgoba said.
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He said the cancellation of scheduled, elective cases led to overcrowding in the ward, with the compromise of some cases that required emergency treatment.
There is also the issue of security, which is very poor and security personnel are not adequately equipped with the tools they need.
“In December 2021, an intern doctor was hijacked in the car park within the hospital premises. Even security staff said they felt unsafe at the hospital because the area surrounding it was unsafe, and that nurses had to be accompanied to board taxis in the evening, as some had been robbed,” Makgoba said.
One of the recommendations is that the Gauteng health department prioritise the review of Rahima Moosa staff establishment and appoint staff in line with their skills in all departments to ensure compliance with norms and standards regulations.
Also, the provincial department has to ensure that, within two months, the hospital has laboratory services and blood bank services available 24 hours a day.
“A clear plan is to be developed within one month regarding the safety of healthcare staff over 24 hours, both within the hospital premises as well as within the immediate areas of the hospital periphery,” read the report.
Gauteng Health MEC Nomantu Nkomo Ralehoko said the department would study the report with a view to consolidating an implementation plan to address the issues raised in the report in the immediate and long-term period.
“The department has already started acting on some of the recommendations and, as part of ensuring that issues raised in the report are followed through, the department will provide periodic reports on the matter to the ombud, as required.”
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Health Minister Joe Phaahla said the department noted the issues raised in the complaint and the breaches substantiated by the investigations.
“We will engage with the provincial department to secure the necessary funding to allocate for the infrastructure refurbishment of Rahima Moosa hospital. We would also need to study the report in detail before we are able to respond comprehensively to the matters identified in it,” he said.