The sudden closure of Thusong District Hospital in the North West has left healthcare workers and patients confused and frustrated with some patients still turning up at the hospital gates, not knowing where to go for medication and other healthcare services.
The North West Department of Health closed the hospital due to “safety concerns” following the detection of underground heat from the pharmacy’s floor. Investigations into the cause of the underground heat and a de-commissioning process to formally shut down the hospital are underway.
According to the provincial health department, the hospital was built on dolomitic soil, which they say put the buildings at risk of collapse. Dolomitic soil is associated with an increased risk of sinkholes due to the mineral’s high solubility.
A total of 21 patients were evacuated from the facility on 13 January. One healthcare worker told Spotlight that the closure has caused chaos because some healthcare workers do not know which hospitals they have to report to for work and patients unaware of the closure are still presenting at the facility.
‘No ordinary closure’
The department has admitted that this was not an “ordinary closure” since it was unplanned.
During a visit to the facility last week (21 January), Health MEC Madoda Sambatha was surprised to see that there were still healthcare workers at the hospital. He accompanied Health Minister Dr Joe Phaahla on a site visit. Sambatha told the healthcare workers that they must take all their belongings and leave.
"You must even take your family photo. We don't want anybody here," he said. Entering the hospital, Sambatha jokingly said that anyone who enters the hospital will be doing so at their own risk.
Sambatha said he was closing the hospital due to concerns for workers’ and patients’ safety. “I am closing this hospital because I do not want to put the lives of workers and patients at risk. The de-commissioning of this hospital has been on the cards for over five years but because of several management and community issues, it has been delayed.
Last year, I officially signed off papers to finalise the process.” The Health MEC said although the de-commissioning was still underway, they had to act fast and close the facility to protect staff and patients.
Built in 1968, Thusong District Hospital provided healthcare services to communities who could not afford to travel to General De La Rey Hospital in Lichtenburg. Located between Mahikeng and Lichtenburg along the R503 road, the hospital serves a population of over 200 000 people from towns including Lichtenburg, Coligny, Biesiesvlei, Verdwaal, Sheila, Bodibe, and Itsoseng. Now, following the closure, the health services will be provided by General De La Rey Hospital and Itsoseng CHC.
‘It’s just chaos’
A group of pharmacists who are employed at Thusong District Hospital said they were told to go and work at the Itsoseng Community Health Centre, but that they could not legally do so.
“We cannot go and work at the Itsoseng CHC because it is not registered with the SAPC (South African Pharmacy Council). It is important that our employer meets the requirements of all regulatory bodies before we assume any responsibilities. The pharmacy at Itsoseng CHC is only registered for clinical care, so we must first wait for registration with the relevant authorities,” said one pharmacist.
Sambatha told the group of pharmacists that the department will address the issue of registration and they will see where they can be placed.
According to Tshegofatso Senna, a radiographer who worked at the hospital, they were only aware of a temporary closure until departmental officials came to tell them that the hospital had been closed.
“We were not aware that the hospital was being closed for good until there were management meetings and the MEC visited the hospital. Patients come here looking for their files and medication on a daily basis. It’s just chaos,” said Senna.
Patient files can’t be found
One healthcare user who says she suffers from a heart condition, hypertension, and Type 2 diabetes told Spotlight she went to the hospital to collect her chronic medication but was told it has closed down. “I was then referred to the Itsoseng Community Healthcare Centre where administration staff said they could not find my file,” she said.
Another patient, who also spoke to Spotlight on condition of anonymity, says she was turned back at the Itsoseng CHC because her patient file could also not be found. “I was told by nurses to go and check my file at Thusong District Hospital.
I had to pay an extra R30 just to go to the hospital to check [for] my file. Security guards told me to go back to Itsoseng CHC because the hospital had been closed by the health department and all files were sent there. I had to go home on that day without receiving any treatment because I was hungry and had spent the entire day on the road.”
Eliza Masigo (73) says she has been a patient at the Thusong District Hospital for over ten years and she does not know where to go to collect her medication.
“I was collecting my medication at Thusong District Hospital every month for over a decade and also seeing specialists there for a while. I heard through some community members that it was closed. I do not know where to go so I can access specialised treatment for my aching knees.
"Transport costs are expensive and I will now have to fork out an extra R60 just to go to the nearest hospital in Lichtenburg, which is General De La Rey. I walk on crutches, so from my home to Thusong Hospital it was easier to access transport services. Now the taxi rank is far from the hospital in Lichtenburg, so I am going to struggle,” Masigo says.
‘A change we all have to manage’
CEO of Thusong District Hospital, Gaborone Seleke told Spotlight that patient files are being sorted and sent to the nearest health facility where a patient resides. Regarding the closure of the hospital, he said the health department had conducted occupational health service assessments which found that the facility was not fit for the occupation of patients and workers.
He said the facility will be handed over to the Department of Public Works once the de-commissioning process was completed.
Seleke said they have issued communication alerts in the form of radio adverts and will also be putting out newspaper adverts to inform the public about the hospital closure.
On the issue of staff placements, Seleke said they are compiling a staff list and healthcare workers were being placed at facilities they are closest to. “This is a change we all have to manage,” said Seleke.
Facility already being vandalised
As health authorities scramble to manage the fallout of the sudden closure, the facility has already been vandalised - one week since its closure. Two borehole pumps had already been stolen and security guards at the facility told Spotlight that they had been chasing some criminals who were carrying geysers.
“We fear for our lives because criminals have opened the fence at the back and they are looting hospital property. When one security guard approached a group of men who had entered the hospital, he was attacked and bricks were thrown at him,” a security guard told Spotlight.
According to Seleke, they are now beefing up security, and six security guards were deployed at the facility. He also instructed the head of security to open a case against those involved in the theft.
Lack of proper planning?
According to Ntombi Moepeng, Provincial Secretary of the National Education, Health, and Allied Workers’ Union (NEHAWU) in the province, there are cracks in implementing the hospital closure and de-commissioning process.
“Although the department started the de-commissioning process in March last year, there are still some delays in placing staff at various hospitals. We are aware that the hospital closure was sudden but we feel that the department has delayed planning the whole process because they knew about it for a long time. It is evident that there was a lack of proper planning on the side of hospital management.”
Moepeng went on to say that some workers have been placed far from where they reside and plans to convert Itsoseng CHC into a district hospital have not unfolded as stipulated in the de-commissioning document.
“While we agree that worker and patient safety is a priority, some workers have been placed far from where they reside and this will cause an inconvenience because some will have to pay more for transport and others will have to relocate.
"Some hospitals have problems of their own like dilapidated infrastructure and we do not want to frustrate workers. We are really not happy with how the process unfolded because some meetings relating to the de-commissioning process were held without worker representatives.”
According to Gavin Edwards, DA spokesperson on health in the province, the hospital closure is unfortunate but there was no alternative. “We are aware that the North West Health Department is generally slow in terms of implementing some decisions and it has experienced some difficulties in terms of service delivery, but we were at a crossroads and the hospital had to be closed down,” he said.
“It is also sad that this hospital was poorly maintained, and this resulted in its detriment. This is not the only hospital in the province that has been poorly maintained,” said Edwards.
“The hospital closure is an inconvenience to patients, workers, and the whole community at large and we believe that the process could have been managed better.”
Meanwhile, the North West Health Department says it is awaiting a final report about the cause of the underground heat which came from the pharmacy at the hospital. Sambatha also indicated that costing for the de-commissioning process is being finalised.
This article was produced by Spotlight - health journalism in the public interest.