On the cusp of the Human Rights Commission's three-day inquiry into public health services starting on Wednesday, a team from The Star has found cockroach-infested toilets, bloodied linen and an alarming lack of security at six Joburg hospitals.
Journalists gained uninterrupted access to wards at Chris Hani-Baragwanath, Leratong, Natalspruit, Johannesburg, Helen Joseph and Tambo Memorial hospitals and found unlocked equipment rooms, filthy toilets, smelly wards and, in some instances, used stitches and syringes in corridors.
The findings, while shocking, will come as no surprise to about 50 concerned South Africans and healthcare organisations who have submitted more than 1 000 pages of submissions to the HRC, covering everything from the prohibitively high cost of transport to the "homo-prejudiced" attitude of some health workers.
Breast cancer patients who die while waiting for treatment, abuse of psychiatric patients and a lack of emergency hospital transport are some of the problems at public health facilities that could benefit from a health ombudsman after a call for one by the HRC.
Provisional conclusions by the commission following a three-month study of health facilities around the country say there is a need for an independent office, perhaps within the HRC, which can monitor healthcare facilities. The study was conducted as part of preparations for the three-day public inquiry.
A panel comprising HRC chairperson Jody Kollapen, his deputy Zonke Majodina, and Charles Ngwenya from the University of the Free State will listen to submissions over the next three days.
Submissions have been received from several leading universities and lobby groups like the Aids Law Project and the Tshwaranang Legal Advocacy Centre.
A submission by the Wits School of Public Health, the Agincourt Health and Population Unit and the London School of Hygiene and Tropical Medicine deals with the South African Costs and Coping Study, which was conducted in Limpopo last year.
The study rated the community's access to healthcare and found that of the respondents with health problems, 33 percent did not seek treatment because they could not afford either transport or treatment.
The National Working Group on Sexual Offences raised attention in its submission to the stark lack of specialist staff to deal with rape survivors 24 hours a day at an "overwhelming majority" of public clinics and hospitals.
"Some categories of rape survivors are subjected to additional sub-standard care by the healthcare system. One such group includes lesbian, gay, bisexual and transgender people whose treatment by some health workers is characterised by subtle or not so subtle homo-prejudiced or heterosexist attitudes," they add.
The submission by the SA Medical Association says the three-month waiting list for radiation treatment at Groote Schuur in Cape Town is found all over the country, with women suffering from breast and cervix cancer most affected.
The submission also says, shockingly, that there are just seven child psychologists in the public health service in the country.
The hearings were scheduled to start at the HRC offices in Parktown at 9:30am.
Johannesburg
Bloody toilets, thick layers of dust and other rubbish lying around greeted The Star at the city's public inner-city hospital.
The list goes on to include dirty floors, broken locks on doors and no toilet paper.
Security at the hospital was of grave concern - it was astonishingly easy to get around unchallenged.
The Star visited the maternity ward, general wards, and the eye and casualty wards. The toilets were terrible, with no sanitary bins to speak of, no toilet seats or lids, and blood-smeared toilet bowls.
On Saturday night The Star found a used injection needle in a men's toilet.
The bed linen was old but clean. A massive waste bin, filled to the brim, is the first thing you see upon entering the Hospital Road main entrance.
Leratong
In the process of a major upgrade, facilities at Leratong leave a lot to be desired. Security appears to be strict on entry, although leaving doesn't necessarily entail vehicle searches.
Broken windows abound in various sections of the hospital, and the staff. on the whole, seem unfriendly.
There is a horrible stench in both the general and surgical wards. Tellingly, equipment and linen rooms were left open in most wards, although the medical supplies rooms were usually locked.
The kitchen is next to the mortuary, so that transparent, plastic bags of meat are ferried into the canteen through the mortuary entrance on trolleys. Many patients had food on side tables in the wards.
The children's wards are ill-equipped, with patients on rickety, sometimes rusty beds. Bloodied baby clothes were in the bathroom. Toilets were in a shocking state.
Helen Joseph
Helen Joseph Hospital looked clean and the staff seemed alert and friendly.
Access to the wards was relatively easy, although The Star was prevented from going near the ICU.
Nurses often asked if they could help with directions.
Paint was peeling off the walls and many floor tiles were broken. The canteen seemed clean and easy to access, although signs warned that the area was meant only for staff.
There were no security checks at all, especially at the exit, where guards looked uninterested.
The TB isolation ward could be accessed easily, and despite signs warning visitors to wear face-masks, none could be found.
The hospital uses a budget-type of wheelchair, plastic garden chairs attached to sets of wheels.
The toilets were filthy and many of them sported broken seats and no toilet paper.
Old, bloodied mattresses lay in the corridors.
Natalspruit
Sizeable cockroaches greet visitors in the patients' toilets at Natalspruit.
Piles of used toilet paper were also found in the cubicles, along with an assortment of other rubbish.
While there were security guards at the pedestrian entrance who conduct hand-held metal detector and bag searches, it is possible to walk through the vehicle entrance and not be searched.
Furthermore, there are no security checks done when exiting the hospital, which means that criminals can easily walk out with objects obtained in the hospital.
Entry into the casualty ward was easy and not a single nurse or orderly questioned our presence in the ward, even though a sign above the door said that no unauthorised people were allowed in.
Chris Hani-Baragwanath
If Health Minister Manto Tshabalala-Msimang wants to know where all her missing linen is, she should pay a visit to Chris Hani-Baragwanath Hospital.
Filthy piles of linen have been stuffed, together with dirty crockery, into staff lockers near the mortuary. Disused showers were also full of bags of unwashed laundry. The four security guards at the entrance acted more like traffic officers, directing cars and not searching anyone either exiting or entering the premises. We gained access to most wards undetected.
It was particularly easy to get into the maternity ward, where the filth was noticeable. Used stitches lay on the floor along with dirty gloves, and a bucket full of used syringes was left in the hallway outside. Naked women in labour could be spied through open doors almost directly accessible from the visitors' parking lot.
Although two nurses kept watch at a room where several babies were fighting for their lives in incubators, we gained access to the other rooms also containing highly specialised ventilators containing babies. Reception offices contained computers that were left unattended and easily accessible. The toilets were disgustingly dirty and smelly, with many of them broken.
The hospital is currently being upgraded.
Tambo Memorial
On the face of it, Tambo Memorial Hospital looks reasonable, but there is room for improvement. The cleaners could do with some training as the corridors and floors are grubby.
The women's public toilets have no paper and the lids and basins are in need of a good scrubbing. There were no bad odours in the toilets or in the hospital.
Security is above average and the women officers are assertive, but quite friendly.
The linen in the wards is old but clean, and there appears to be a sufficient supply, as none of the patients have had to bring sheets and blankets from home.
The section for prisoners looks reasonably secure and the lifts appear to be in working order. The hospital needs painting.
"Probe is not accurate"
Gauteng Department of Health representative Zanele Mngadi responds:
"We acknowledge the challenges faced by our department and have started the following programmes in an attempt to address them. We've started a unit called Quality Assurance, with a focus on customer care.
"On issues of untidiness and security, we are strengthening policies to ensure centralisation of the management of these areas. This will improve our monitoring system, thus ensuring appropriate corrective measures.
"Your investigation was done during the 'go-slow' period, and that has made your findings less accurate."
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