A leading figure at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) reveals that nine months after a devastating fire ravaged the facility, nothing has been done to repair it. The fire last April forced the closure of key parts of the hospital which has had a devastating impact on the public health system, and other Gauteng hospitals.

Head of Internal Medicine, Professor Adam Mahomed, said the situation is frustrating. Several key areas such as the cardiothoracic intensive care unit and respiratory ward were affected and about 200 beds were lost in the blaze.

“Nothing to date has happened and when I mean nothing, I mean the word zero. They are still getting reports as well as engineering feedback. I don’t even think they have proper costing on how much it would cost to repair certain aspects,” said Mahomed.

‘It breaks my soul’

He added: “It breaks my soul for what we are doing to our patients in housing. And it’s not just about the patients. It’s about our colleagues at other hospitals that are taking the burden of us not being fully open.”

Mahomed said that the respiratory ward, which had a highly specialized cystic fibrosis clinic, has become non-existent. Patients that were rotated in a very warm, encouraging environment are now put into other wards where they are exposed to high-risk infections. Another problem the hospital is facing is a shortage of beds for cardiothoracic surgery patients.

“There are only two centres, Steve Biko and Charlotte Maxeke. Our normal cardiothoracic ICU is not available. So, they are using limited beds in other ICUs, but that compromises the admission rates, and the waiting list for cardiac surgery was already quite high pre-COVID 19,” said Mahomed.

He continued: “Now, post-COVID-19 and due to the fire, there is a long waiting period. Morbidity and mortality from cardiothoracic surgery indications have gone up and patients are not getting the surgeries that they need.”

Treatment alternatives

Disgruntled cancer patients have had to find other alternatives with some continuing their treatment at Chris Hani Baragwanath Hospital (Bara) in Soweto.

Sizeka Ntsele, 56, was diagnosed with breast cancer in January 2021 and was supposed to resume chemotherapy at CMJAH in March.

“I feel like the Department of Health is not taking our plight seriously.  I can’t even sleep at night because of the excruciating pains and now I have missed my treatment due to unnecessary delays since the hospital was closed. We also have to wake up in the early hours of the morning to go to Chris Hani and stand in long queues,” said the Kagiso resident.

The Department of Health confirmed that Charlotte Maxeke saw between 70 000 to 80 000 outpatients per month before the fire. However, that average has dropped to between 30 000 and 40 000 patients per month.

‘Government has failed us’

Victor Molefe from Alexandra said he can’t travel to Bara every time needs to fetch his treatment because he is currently unemployed.

“I was diagnosed with lung cancer in March 2019. I’m sick and tired of this up and down and having to travel a long distance because I depend on my pension grant. Our government and the health department have completely failed us because there was no proper planning and communication,” said the 63-year-old.

Noluvo Abraham, 35, a cervical cancer patient from the Mohlakeng informal settlement, said she defaulted on her treatment several times.

“I was very disappointed when I first came to Bara because I did not know where to go or who to talk to. The staff weren’t helpful. I returned home because my name was still on the waiting list. I only got the call to come to the hospital in January this year. This is very frustrating because some of us are not working and we come here every Wednesday,” said Abraham.

Mental health compromised

It is reported that 16.5% of South Africans suffered from depression and anxiety in the last year. Mahomed said that mental healthcare users have been compromised in Gauteng because there is no active healthcare system for these patients. The hospital lost 40 beds meant for mental health patients.

“We heard about Life Esidimeni which has become a token phase. But, nobody has really stopped and said, people died as a result. And the sad part is, mental health care and housing have not improved. A total of 40 beds were lost in this fire,” said Mahomed.

CMJAH is a 1068 bed quaternary-level academic, central public hospital. Since the hospital saw 75 000 outpatients in over 100 highly specialised outpatient clinics, other hospitals have had to absorb the pressure. Unfortunately, many of these facilities are unable to offer such specialised services.

“The Charlotte Maxeke hospital has tried to support these facilities as much as possible by redeploying staff, transferring equipment, or sending the appropriate medication for patients. However, it remains a challenge for both staff and patients,” said Gauteng Health spokesperson, Kwara Kekana.

Open letter to Ramaphosa

Last year, Mahomed wrote an open letter to President Cyril Ramaphosa pleading for funding to fix the hospital, not only for the damage caused by the fire, but also for a flood damage in November. He failed to receive a response, which he finds disappointing and heartbreaking.

A call for help from Charlotte Maxeke Hospital staff.

A flashback of President Cyril Ramaphosa pledging support for the hospital in a fight against Covid 19.

Months later, Professor Adam Mohamed writes an open letter to the President in desperation for help. #POWERTalk pic.twitter.com/9MoKvaeMh7

— POWER 98.7 (@Powerfm987) December 7, 2021

“That absolute frustration, heartache, sadness for what I see has forced me to speak out and it’s just not me. I’m representing so many young doctors, seniors, and students. It’s just not about internal medicine, it’s about the different specialities. Everyone is broken and it breaks my heart,” said Mahomed.

He believes that a lack of financial resources has been the main reason for the delay. There also seems to be no plan in place or a sense of urgency from public officials.

No money, vision or urgency

“The crux of it is no money. There is no vision, no plan, and no sense of urgency about the dire situation. The inability of this hospital to function is impacting the rest of housing and all the patients,” said Mahomed.

He continued: “There just seems to be such a lack of initiative. There’s so much apathy and we don’t realize that the most vulnerable are receiving shockingly bad service.”

The Public Protector and representatives from the South African Human Rights Commission have visited Charlotte Maxeke. However, these visits did nothing to improve the situation.

“They visited and complained to me about why I wrote a letter that didn’t follow the correct procedures. But no one’s speaking about the patients,” said Mahomed.

Fire wasn’t a ‘disaster’

Kekana said that the Department of Health did not escalate the fire as a disaster because according to the Cooperative Governance & Traditional Affairs (CoGTA), the incident did not meet the requirements to be deemed a disaster.

“When the fire occurred, hospital management tried to have the facility classified as a disaster, but failed,” said Kekana.

She added that to fix the building, the department needs to ensure that they comply with the fire prevention requirements of the City of Johannesburg. They’d also need to obtain a health and safety certificate and all of this can be costly.

“To repair the damage and comply with all the requirements is a very expensive multi-year project that requires a substantial budget allocation which we currently do not have,” said Kekana.

Staff losses

Mahomed said the hospital has experienced the loss of skilled nurses because of the emotional and psychological impact it had on them. The trauma unit will face a huge challenge when it reopens next month.

“We’ve lost highly skilled professional nurses and other staff from the hospital environment. Patients and nurses scattered across Gauteng are coming back. But the emotional and physical impact hasn’t been acknowledged. If we open a trauma casualty in February, one of our biggest challenges will be the lack of highly skilled trauma nurses. We have huge problems,” he explained.

‘Refocus our energies’

The pandemic caused major setbacks for public hospitals because it shifted its focus away from other healthcare problems.

“COVID-19 has taken the focus away and that’s our challenge now, we need to refocus our energies. We can’t just be put in lockdown, have restrictions from a COVID point of view, and not do our other health care work. Social distancing and vaccinations are important but we need to address chronic illness, tuberculosis, diabetes, hypertension, and cancer. We are failing dismally in catching up with all these people who haven’t received appropriate care for almost two years,” said Mahomed.

Kekana said that to ensure the hospital catches up, they have launched an initiative to bring theatres online in 14 facilities to address surgery backlogs.

“CMJAH has taken a cluster approach initiative which includes specialists going to other hospitals to operate so patients can have their surgery closer to where they live rather than having to come to Charlotte Maxeke,” said Kekana.

Patients come first

Mahomed said that the problem is that we are not adapting to waves but reacting to the circumstances. He said that it is important to always put the patients first and give them the care that they need.

“Life is not defined by COVID-19. Life is defined by giving people the care they need. And that’s our problem right now. We are not adapting to the wave going down nor ramping up our healthcare services for the next wave. We are not proactive and that’s my sense of what I’m seeing,” he said. – Health-e News