The Eastern Cape’s ticking psychiatric time bomb

One of the rooms for patients at the Tower Hospital in the Eastern Cape.
One of the rooms for patients at the Tower Hospital in the Eastern Cape.

The government is facing yet another ticking bomb involving psychiatric patients in an Eastern Cape psychiatric hospital.

On Friday a psychiatrist resigned citing the “degrading and inhumane” treatment of patients.

Dr Kiran Sukeri, a psychiatrist at the Tower Psychiatric Hospital in Fort Beaufort said he could no longer “remain silent” about the treatment of patients at the institution.

“I know what I’m going to tell you will jeopardise my safety, as well as that of my family, but I don’t care. Those patients urgently need to be helped.”

Sukeri said a far greater number of people have recently died at the hospital than the government is officially admitting.

In recent reports in the Eastern Cape daily, The Herald, the Eastern Cape heath department was quoted as saying that 25 patients died at Tower hospital between 2012 and 2017.

Sukeri told City Press’ sister newspaper Rapport that the hospital’s deaths register recently “disappeared” and was replaced with a new one.

He showed Rapport copies of the “lost” register indicating at least 90 patients died at the institution since 2010 and four patients died in January alone.

Only two of the four deaths in January were signed off by a medical doctor, he added.

Other claims include:

  •  That some patients are sometimes kept in solitary confinement with just a bucket for a toilet if they become “restless”. Psychiatric guidelines stipulate that a patient may never be kept in solitary confinement for more than four hours;
  •  That a patient who was last month locked up in solitary confinement panicked, wrapped his legs in a sheet and set himself on fire; and
  •  Medical doctor Theresa Nodliwa was forced to amend the notes she had made on a patient’s medical file by hospital CEO Ntombizandile Ngcume and other managerial staff, to make it appear that the patient had been examined twice. Nodliwa has since asked for a transfer and did not want to discuss the matter with Rapport;
  •  Patients’ clothes are tattered, despite a clothing budget of millions of rands;
  •  Patients have to pay staff a R5 levy per withdrawal from the hospital account, to access the money their families send them; and
  •  The food patients are served is of poor quality. This includes a sardine stew that is served twice a week. It contains 36 cans of sardines, about one for every 10 patients.

Sukeri said there was no doctor on duty at the hospital on weekends. Last year, he began recommending that patients with serious medical conditions not be sent to Tower because of the lack of specialised medical care. However, Ngcume refused to implement this because the hospital would “get too few patients”.

The conditions at Tower Hospital come just 18 months after Rapport wrote about the Life Esidimeni scandal.

In his reply to the debate on the state of the nation address last month, President Cyril Ramaphosa apologised for government’s handling of the Esidimeni tragedy.

A total of 143 mentally ill patients died after the Gauteng health department sent them to unaccredited non-governmental organisations in an attempt to save money.

Sukeri said the government did not seem to have learnt any lessons from Esidemeni.

“We’ve been struggling with the same kind of problems in the Eastern Cape for years. I’ve been fighting for the rights of psychiatric patients for 12 years,” said a tearful Sukeri.

He said more than 20 clinical personnel at Tower Hospital had resigned, asked for transfers or taken early retirement in the past five years.

On February 11, Sukeri laid complaints about the hospital’s conditions with the health ombudsman, the SA Human Rights Commission and the SA Society of Psychiatrists.

As a result, the hospital chief executive told him to vacate his office.

Ngcume referred Rapport questions to Sizwe Kupelo, the provincial department of health spokesperson, who said the allegations of a falsified deaths register were untrue and the correct death figure was 63 for the period. Patients died from serious illnesses such as respiratory diseases, heart illnesses, cancer, tuberculosis and HIV.

In respect of the poor quality food, Kupelo said a dietician at the nearby Victoria hospital could help out if the food was not up to standard.

Kupelo said the food given to patients every day “is calculated by the food service manager and no complaints were raised on the shortage of food.There are daily reports submitted in a written form indicating whether food was sufficient  or not,” he said. Kupelo supplied account statements to Rapport showing the purchase of vegetables and other food items.

“The institution followed the provincial menu ... The menu provides for users with special needs e.g. vegetarian and those who eat meat. Patients who buy from supermarkets buy snacks as a form of treats not due to starvation. On a monthly basis users attend occupational therapy, are given opportunities for outings, and do shopping at Spar and other shops. The institution has never had challenge of food fortunately. We utilise food contracts which makes it easy for us to have food available all times.”

Kupelo said the clothing budget for 2017/2019 was R2.7 million of which R1.2 million had been spent.    

“The institution has a three-year contract for patient clothing and linen. The hospital is facing no challenges relating to patient clothing and linen. We have a clothing and linen bank system to control the flow of clothing between the wards and laundry. It is totally not true that the current status of patients clothing is unacceptable,” Kupelo said.

Kupelo said the reason patients paid an R5 levy when withdrawing cash was because deposits into the hospital accounts cost the department R12.95 and withdrawals cost R11.95.

Professor Zukiswa Zingela, president of the South African Society of Psychiatrists in the Eastern Cape, said Sukeri’s complaints had been received and would be investigated.

With regards to the death register, Kupelo said: “A new register was developed following the sudden disappearance of the old register. The stolen register was miraculously found in the matron's office on Tuesday 27 February 2018. It is now clear that there are elements within the hospital who are hellbent on causing disruptions within the service. We suspect the same person who reported this information kept the old death register to him/herself  is behind the malicious allegations against the institution. The report of 90 deaths during that period is incorrect. There are 63 deaths documented in our register during that period.”

Kupelo said Dr Sukeri “has a tendency of defying authority and continues to discharge patients outside protocols”. 

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