Nightmare at Baragwanath

February 3, 2011

~uDaily Maverick#www.thedailymaverick.co.za/article/2011-02-02-nightmare-at-baragwanath-refuses-to-end~

For two days this week, ALEX ELISEEV floated around like a ghost inside Soweto’s Chris Hani Baragwanath Hospital, investigating how it copes with two mortally wounded CT scanners. He spoke to doctors and patients, and heard horror stories of unnecessary surgeries and life-threatening backlogs. He left with an unshakable feeling that the hospital’s problems are, in many ways, identical to those of South Africa as a whole.

I drove up to the side entrance early on Monday afternoon. I discovered this gate during the violent public servants strike last year, and knew it was an easy way to slip unnoticed into the sprawling hospital. “The more arrogant the better,” my source had told me. “Just pretend you’re a doctor from the Gen.” I was never all that good at the covert stuff, so I rolled down my window, put on my best inpatient face and told the security guard where I was heading. How many journalists do you know who look like doctors anyway?

My first meeting was with a senior doctor, who has worked at the hospital for about a decade. I sat down, asked my first question and watched as an avalanche of complaints dislodged from the mountain top and thundered towards me. I was told the hospital has a pair of ancient and outdated CT scanners. One is always broken. One works from time to time. And this weekend, both were bust. This meant emergency cases had to be referred to other hospitals and out-patients (the ones that weren’t going to drop dead immediately) were sent away and given new appointment dates.

To put this in context, Bara is one of the largest hospitals in the world. It has around 3,000 beds and takes in patients from various neighbouring hospitals. It’s basically a small city… with streets, bus stops, cafes and apartment blocks. So the fact that it only has two scanners – which process up to 60 cases a day – is, in itself, a scandal. But doctors just shrug their shoulders. It will come as no surprise that promises about new scanners have been made. A shiny new radiology ward was built and was apparently due to be kitted out before last year’s soccer World Cup. The staff are still waiting.

Why the delay? Hospital management says there were “tender problems” with the purchase of three new scanners, which are due to be installed in phases. The Department of Heath had to intervene and – scout’s honour – the problems have now been sorted out. But while this bungle plays out, what is the situation on the ground?

The doctor says that not having CT scanners means doctors are forced to revert to diagnostic methods practised 60 years ago. Instead of using technology to glance inside a patient, some were subjected to invasive and dangerous surgery. To avoid leaving a “septic patient brewing”, some were rushed off to other hospitals – at times with a Bara specialist in tow. “People are being operated upon when perhaps a more conservative way of treatment would have been possible,” the doctor said. “In a nutshell, does it endanger people’s lives?” I enquired. The answer was clear: “Absolutely. Without a doubt.”

For outpatients, the broken machines mean more waiting. And possibly getting sicker. On Tuesday, I sat with around 20 such patients who had arrived at the diagnostic imaging unit for scans. Some had cancer, others mysterious pains and at least one a terrible cyst on his face. They sat quietly in a U-shape, waiting for the doctor. When he emerged, he told them they would all be sent home. The doctor was polite, apologetic and willing to help those who had questions. You could hear the frustration in his voice as he assured people there were enough doctors – but no equipment.

Read the full article on ~uDaily Maverick#www.thedailymaverick.co.za/article/2011-02-02-nightmare-at-baragwanath-refuses-to-end~

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