The main operating theatre in the Mapulaneng Hospital in Bushbuckridge has no functioning theatre light.
“We operate with a torch and when the batteries run out, with a candle. It’s extremely dangerous. What would happen if we cut the wrong tissue because we couldn’t see well enough?” asks Dr Franz Maruma, an intern at the hospital.
“If you have an interest in rural medicine as a doctor in South Africa, you need to be prepared to work at the most poorly managed hospitals in the country,” says Dr Patrick Rogers from Mpumalanga.
More than half the doctors where he works, at Tonga Hospital close to the Komati River, have been striking since last week. “Our hospital was built 10 years ago with capacity for 250 beds, but the best we’ve managed so far is 134 beds because the Health Department hasn’t managed to recruit the required number of nurses and doctors.”
Both Rogers and his wife, Dr Mampho Mochaoa, are senior doctors at the hospital. He moved to the area in August last year to take up a registrar position to qualify as a family physician. “I was meant to start in January this year, but I’m still waiting for that post and am now working in a different position.”
The Mangweni Community Health Centre, attached to the Tonga hospital, has a limited water supply. Rogers says the government contracted a private supplier to put in a borehole, but the contractor eventually removed the pump because he was not paid. “We use a five-litre water bottle to wash patients, as taps only run one hour a day,” he says.
The hospital has run out of HCTZ, a drug used to treat hypertension. Recently the hospital’s stock of methyl dopa, prescribed for pregnant women with hypertension, ran out.
And a clotting agent, which Rogers says is “a lifesaver if a woman is bleeding to death after delivery and is ideal in rural hospitals because it has a long shelf life” has been out of stock for months. “But the depot in Bronkhorstspruit is short because of suppliers not being paid or being paid late,” Rogers says.
For Maruma, things aren’t much different. “This year we’ve been running out of simple things, such as Panado. I have to tell patients: ‘I know what is wrong with you, but I can’t treat you, even though I know how, because the government doesn’t have the drugs or equipment.'”
Maruma says his hospital is supposed to have 95 doctors, but there are only 35, which means each doctor does “the job of at least three doctors, often leading to mistakes and extremely long shifts”.
At Temba Hospital in White River nurses support the striking doctors.
“When doctors who weren’t striking tried to operate at the hospital this week, the nurses refused to assist them,” says Dr Desmond Lamula, a community service doctor at the hospital.
Says Dr Thomas Bredenkam from Shongwe Hospital near Komatipoort: “Most nurses have family around the area where they work, so they’re concerned about the quality of public health services. Their families are not like parliamentarians who are on medical aid.”