From trauma to Aids
‘Hello, can I have a bed for a female?’ the harassed nurse barks down the phone. ‘Oh, you are full as well?’ She shrugs, replacing the receiver and looks helplessly at the young woman who has been wheeled into Tambo Memorial Hospital’s casualty ward.
Unable to stand, her body weak from incessant coughing, the woman stares blankly at the nurse who sets up a drip to relieve her dehydration.
‘We get so many patients with AIDS-related illnesses in casualty because they can’t walk to the clinic, so the ambulance picks them up,’ says Nurse D, her well-groomed appearance belying the 12 hours she has just worked at the Boksburg hospital.
Most of the beds in casualty are already occupied by a racially diverse group of patients reflecting the hospital’s community of 800 000 residents from Gauteng’s Brakpan, Actonville, Benoni and Boksburg.
Five years ago when Health-e first visited the hospital, casualty was over-burdened by alcohol related cases. Today the pressure is primarily related to HIV and AIDS.
Over the past two years Tambo Memorial has received a shake-up in the form of Dr Vis Naidoo, the chief executive officer tasked with overhauling the administration of the hospital after years of clinical and administrative botch-ups.
Naidoo’s ‘out of the office’ policy makes him a hard man to pin down as he believes in walking around the hospital to check on everything.
On the way to the ARV clinic, he explains that before he arrived health professionals all worked in silos. ‘We are more integrated now. I also don’t believe in people working from their office. You have to be at the coalface of what’s happening.’
But despite the positive developments, the 540-bed hospital is struggling to cope with the patient load brought on by HIV.
‘The problem is with primary health care (clinics),’ explains Naidoo. ‘Failure to treat patients at primary health care results in our casualty being clogged up.’
HIV is also resulting in a revolving door syndrome ‘ with between 10 and 15 percent of discharged patients are being re-admitted for various opportunistic infections.
In the women’s medical ward two doctors are completing their ward rounds.
‘Of the 32 patients here today 26 of them are sick because of opportunistic infections,’ says a professional nurse while restocking a trolley.
‘It is very sad that most of them don’t know their HIV status.’
Opening up a big blue registration book, she points out the HIV infection rates in a column. ‘Last night we had 3 positives in this ward. When a patient is admitted to the medical ward that appears to have opportunistic infection, a doctor will refer them to the ARV clinic for testing. Most of the women who are already sick, don’t know their status,’ said the nurse.
But ARV treatment seems to be having an impact: ‘Before we used to have 10 people dying in a week. Now we only have three or four,’ adds the nurse.
Stepping into the Enthonjeni Clinic is like entering another world, that is no more than a few meters outside the hospital wards. A bright sign over the door and stuffed animals hanging from the window gives it a cheerful ambience compared to the medical ward. Healthy patients line up on chairs in the newly built clinic where 1100 people are on ARV treatment, the youngest of whom is 14 years old.
‘We have a fashion parade now with all our patients who have been on ARVs who are healthy,’ laughs Nurse Ruth Zulu, project manager of the clinic.
Giggling over coffee in the canteen where the room still smells of fresh paint, the nurses’ camaraderie is a far cry from the harassed and defeated look of those working in the medical wards.
‘Our first patient, Sipho was here and I looked at his card. You know his CD 4 count was one when he got here ‘ today it is way above 300,’ proclaims Sister Rose Zondo.
According to the nurses, many of the critically ill patients do not know that they are HIV positive and 80% of those who test are positive.
‘When we first started we wanted to reduce the number of patients dying in the hospital and also reduce the cost. We reduce the burden and frustration on nurses and manage to save lives and encourage couples to come forward. This is better than it was,’ says an upbeat Zulu.
Author
Republish this article
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Unless otherwise noted, you can republish our articles for free under a Creative Commons license. Here’s what you need to know:
You have to credit Health-e News. In the byline, we prefer “Author Name, Publication.” At the top of the text of your story, include a line that reads: “This story was originally published by Health-e News.” You must link the word “Health-e News” to the original URL of the story.
You must include all of the links from our story, including our newsletter sign up link.
If you use canonical metadata, please use the Health-e News URL. For more information about canonical metadata, click here.
You can’t edit our material, except to reflect relative changes in time, location and editorial style. (For example, “yesterday” can be changed to “last week”)
You have no rights to sell, license, syndicate, or otherwise represent yourself as the authorized owner of our material to any third parties. This means that you cannot actively publish or submit our work for syndication to third party platforms or apps like Apple News or Google News. Health-e News understands that publishers cannot fully control when certain third parties automatically summarise or crawl content from publishers’ own sites.
You can’t republish our material wholesale, or automatically; you need to select stories to be republished individually.
If you share republished stories on social media, we’d appreciate being tagged in your posts. You can find us on Twitter @HealthENews, Instagram @healthenews, and Facebook Health-e News Service.
You can grab HTML code for our stories easily. Click on the Creative Commons logo on our stories. You’ll find it with the other share buttons.
If you have any other questions, contact info@health-e.org.za.
From trauma to Aids
by , Health-e News
November 24, 2006