Sfx’€¦ (Patients talking/babies crying in background)

EPHRAIM MARUTHA: I arrived here at the clinic at 05h15 early in the morning.

KHOPOTSO: When you got here at 05h15, how many people were here?

EPHRAIM MARUTHA: I think, 20.

KHOPOTSO: Right now, how far are you from being attended?

EPHRAIM MARUTHA: On the queue I’€™m number 11’€¦ After me, I think it’€™s more than 30.    

KHOPOTSO: It was 11h02 when I spoke to 27 year-old Ephraim Marutha. Almost six hours later, he was still waiting to be attended to. Sister Mabel Letsoalo, a nurse with 15 years’€™ experience, is the acting facility manager.

SISTER MABEL LETSOALO: Basically, what we have is what you’€™re seeing now: Over-crowding. Shortage of staff is what we battle with every day at the clinic. Presently, we have four sisters at the clinic, including myself, a health promoter and a clerk and cleaner’€¦    

KHOPOTSO: As Acting Manager, Sister Letsoalo is supposed to dedicate most of her time to the administrative functions of the clinic.

SISTER MABEL LETSOALO: But now, seeing that we have shortage of staff, I’€™m even functional. I do child health services and the ante-natal clinic as well as the admin that is needed.

KHOPOTSO: O.R. Tambo clinic opened eight years ago and, until October last year, was the only health care centre in the area. A medical doctor works at the clinic for four hours from Monday to Thursday. Since it was established, it has been serving a growing population, which the census of 2001 put at over 82 000 residents.

SISTER MABEL LETSOALO: Diepsloot is a very big area. And presently, it has only two clinics. The one in Dieplsoot South has recently opened’€¦ It needs, maybe, roughly two to three clinics to be opened. The next clinic is plus-minus 5kms from this one. It’€™s in Extension 5. We are in Extension 2.

KHOPOTSO: O.R. Tambo and Diepsloot South clinics fall under the Johannesburg city council’€™s Region 2 district. I spoke to the Deputy Director of Primary Health Care services in the council, Jabulile Shabalala-Rakosa, about the work load nurses face at the clinics.

JABULILE SHABALALA–RAKOSA: Their nurse-patient ratio at the moment is about 60 patients per nurse per day’€¦

KHOPOTSO: But, the normal nurse-patient ratio should be one nurse: 35 ‘€“ 40 patients.

JABULILE SHABALALA–RAKOSA: Ja, no, it’€™s a very huge work load. If you look at our patient complaints’€¦ a lot of complaints that come from that region is long waiting times because nurses have to go through and check each person thoroughly. And this takes massive time and people get very unhappy. So, we get 10 -15 complaints just about long waiting times.

KHOPOTSO: The dreadlocked Shabalala-Rakosa added her voice to promise that the staffing issue will be addressed.

JABULIE SHABALALA–RAKOSA: Luckily, during the budget adjustment, the mayoral committee approved the budget for us for staff for primary health care ‘€“ the R6.5 million for us to employ additional primary health care nurses and doctors. So, we’€™ve advertised. Now we are hoping the situation will get better. It will not be addressed 100%, but it will go a long way in relieving the staff shortage and the long waiting times.

Sfx’€¦ (Ambience at clinic)

KHOPOTSO: Back at O.R Tambo clinic, sister Mabel Letsoalo looks forward to having more staff, but it would seem that a bigger staff component might bring another problem.

SISTER MABEL LETSOALO: It’€™s unfortunate that with the infrastructure that we’€™re having here the number of people that we are hoping to get won’€™t even fit into the rooms. The rooms are quite small. And given the confidentiality and privacy of the patients you just cannot have two nurses in one room to see different patients. So, much as we’€™ll be having staff, space will be a problem. Where are those nurses going to work from?

KHOPOTSO: Johannesburg city is divided into 11 districts, from Diepsloot in the north to Orange Farm in the south. Once the city acquires new staff for primary health care, it will be allocated to various facilities according to where the greatest need is. O.R. Tambo and Diepsloot South clinics could be anywhere on the list. But, in the meantime, Ephraim Marutha will continue to make an early morning start to queue up at O.R. Tambo for his health care needs.

EPHRAIM MARUTHA: Because there’€™s no money, I can’€™t go to private hospital’€¦ I don’€™t have a choice because I don’€™t have the money.