Floors covered in human waste, bags full of medical waste in the corridors, beds without sheets and naked patients covered in sheets being wheeled into theatres.
This was the scene at Livingstone Hospital in Port Elizabeth this week, supposedly a key institution in the fight again the Covid-19 coronavirus in the Eastern Cape.
“It’s a dirty place at the best of times, but now you get nauseous if you’re in there,’ said a doctor at the hospital.
City Press’ sister publication Rapport visited the hospital this week after its casualty department had to shut down because of a strike by nurses, cleaners and porters.
Some of the staff, who were still on a go-slow on Friday, said working conditions were deplorable because of a shortage of personnel and that of personal protective equipment (PPE).
“I understand why they are striking because our complaints to the department have fallen on deaf ears for many years. We are not in this situation as a result of Covid-19. [The pandemic] is simply highlighting all the problems,” said one doctor, who spoke to the newspaper on condition of anonymity.
“Our doctors and staff are scared. We don’t mind putting in extra hours and working under terrible circumstances. We’ve been doing it for years, we are used to it, but the pawpaw is going to hit the fan. We are at breaking point.”
The hospital will soon be unable to admit any patients at all, said the doctor.
“And they have nowhere else to go. We are going to have deaths soon,” warned a second doctor.
Livingstone is the referral hospital for the entire western region of the Eastern Cape. Work is currently under way to expand facilities, but doctors point out that there are no personnel to staff the additional capacity.
“At Livingstone, we have six isolation beds set up in the intensive care unit for Covid-19 patients.
"These are equipped with ventilators, but we don’t have personnel. To fight Covid-19, surfaces have to be cleaned every three to four hours, but we don’t even have personnel to clean urine on the floors. Where will we get the hands needed to manage the ventilators?”
In the hospital’s basement, there is room for fifty additional beds, but the tender to equip it was only awarded two weeks ago.
Thanks to private funding, a further 90 beds have been set up for Covid-19 patients, but this capacity can’t be utilised because there is no personnel, said a doctor.
Scores of posts have been advertised but, according to hospital staff, many of these posts have been vacant for years.
In Livingstone, management has obtained permission to fill 150 posts for the year.
In addition, staff are battling to get hold of the needed equipment.
“We currently have no non-sterile gloves (for general purposes). Now we’re using sterile gloves for everything and it costs a fortune,” said a doctor.
The hospital only has enough disposable doctor’s overcoats for another three days. Doctors are taking linen home to wash so that operations can continue.
But Livingstone isn’t the only hospital in the province whose capacity to deliver healthcare is questionable.
Wilhelm Stahl Provincial Hospital in Middelburg was closed this week, reportedly after 30 staff members contracted the virus. When Rapport visited the hospital on Thursday, it was told that the hospital was closed.
The staff members are in isolation at the hospital, and said that they had been left to fend for themselves. A doctor brings them food from time to time.
At Tafalofefe Hospital in Centane, staff staged a walk-out on Monday over a shortage of PPE. Three members of the hospital’s staff have contracted Covid-19.
“Never in our lives did we think we would close a hospital down and leave patients to their fate,” a nurse told DispatchLive.
At least 10 clinics around Nelson Mandela Bay and various departments in hospitals across the Eastern Cape were, at one point, closed this week.
In the meantime, the outbreak of the pandemic is accelerating in the province. More than half of new Covid-19 cases (4 504) have been reported since the beginning of the month, according to statistics for the National Health Laboratory Services.
By Friday night, 8 615 people in the Eastern Cape had tested positive, just less than the 8 781 cases in Gauteng. However, 208 patients have died as a result of the virus in the Eastern Cape, compared with just 57 deaths in Gauteng.
Experts warn that the number of infections in the Eastern Cape could be considerably higher, partly because of low testing figures. Nationally, a little more than 1 million tests had been done by Thursday – 338 211 in Gauteng, 237 037 in the Western Cape and 112 985 in the Eastern Cape.
In addition, there are backlogs in relation to the test results from various hot spots – 5 106 tests in Nelson Mandela Bay and about 8 000 in Mthatha.
During a visit to the Eastern Cape in the past week, Health Minister Zweli Mkhize expressed his concern about the rapid spread of the virus in the province. He warned that the infection curves in the Eastern Cape and in Gauteng were following the same pattern as that of the Western Cape.
Healthcare services are also being impeded by the increasing number of workers who are contracting the virus.
According to a report released by the Eastern Cape government on Friday night, titled Daily Epidemiological Report for Sars-Cov-2, a total 359 healthcare workers in private and state institutions had tested positive for Covid-19 by Wednesday. In the document, the department admits that it’s healthcare workers are not sufficiently trained.
According to the report, there was “minimal or no training” to prepare healthcare workers for the pandemic. This limited knowledge has led to “extreme fear of patients with Sars-CoV-2”, the incorrect use of PPE, and to healthcare workers failing to adhere to their oath to act professionally and to “serve humanity”.
The Eastern Cape government this week admitted that it was not prepared for the pandemic.
“Based on projections and the data supplied on May 14 2020 it would appear that the Eastern Cape does not have enough capability in place to manage the demand of the pandemic,” states a report that Eastern Cape Premier Oscar Mabuyane presented to Mkhize on behalf of the provincial command council.
“It would appear from the data that the lockdown did not produce the required increase in capacity in the Eastern Cape to deal with the future.”
According to the council’s most pessimistic estimates, the provincial death rate could be around 6 000 by November.
According to the report, there were just 72 beds available in intensive care units and 1 417 normal hospital beds for a population of about 6.7 million people.
The Eastern Cape government estimates that it will run out of space in hospitals early next month.
A significant number of beds will be added at a field hospital in Port Elizabeth next week, after the German government and Volkswagen donated more than R100 million to convert the company’s Neave plant into a hospital. The first 1 485 beds, including 250 beds for patients who need oxygen, will be ready by Tuesday. The Eastern Cape government will manage the facility.
The province’s healthcare facilities have suffered from personnel shortages and deficient infrastructure for many years, said DA member of Parliament Jane Cowley.
“The situation was already critical and it is going to get worse as a result of Covid-19.”
Sizwe Kupelo, spokesperson for the Eastern Cape health department, yesterday said that R281 million had been budgeted for PPE, which would be procured and distributed on a continuing basis.
According to Kupelo, at least 200 of the healthcare workers who have contracted the virus did not get it at work, rather from attending funerals.
He aid national guidelines for cleaning procedures were being developed so that hospitals would not have to close down when a Covid-19 case is reported.