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In 2017, an assessment commissioned by Tambo Memorial Hospital in Boksburg in Gauteng reportedly found the hospital building was “unsuitable for human habitation” and was considered “an occupational hazard”.
Five years later, patients and healthcare workers at the hospital continue to receive and provide healthcare services under unusually difficult conditions. According to Democratic Alliance (DA) MP Haseena Ismail, she found during a monitoring visit earlier this year that conditions had not improved.
A bad smell hangs over parts of the facility and much of the infrastructure remains substandard. Some healthcare workers are now resorting to wearing masks as the stench of leaking sewer pipes has become unbearable.
The Gauteng Department of Health is aware of the problems at the hospital and some maintenance work has been done, but among other things it says there is currently no money to build a new hospital.
The evaluation report has also not been published.
When Spotlight visited the hospital last week, the stench was noticeable from the hallway leading from the reception desks to the dispensary. Paint was peeling off the walls of the hospital, cracks and dampness were clearly visible and some windows were broken. There were workers on the premises who took care of the plumbing for some toilets.
The collapse of the hospital walls is just one of many infrastructural problems at Tambo Hospital. Photo: Thabo Molelekwa/Spotlight
Patients and hospital staff are calling for urgent intervention as the hospital falls to pieces. Photo: Thabo Molelekwa/Spotlight
Photo: Thabo Molelekwa/Spotlight
Photo: Thabo Molelekwa/Spotlight
A nurse told Spotlight that conditions at the hospital are bad and there is nothing they can do as healthcare workers but wait for the department to fix or build a new hospital. “This hospital is very old. I understand why he has all these problems. This is because the building needs to be maintained or replaced,” the nurse said.
We work under stressful conditions. The sewer is another problem. As you can see, I’m wearing my mask to protect myself from the sewage smell.
Opened in 1905, the hospital would be among the oldest in the country. It first started as a joint hospital of the government and the East Rand Property mine until 1984 when the government took over full ownership.
A healthcare user said she arrived at the hospital at 6 a.m. and was still waiting for her mother’s medicine at 2:15 p.m.
She says that when the door to the emergency room opens at the clinic on a hot day, the smell coming from the sewers is unbearable.
“This dispensary is always full. You stand in line for a long time carrying the smell of this sewer. It’s horrible.”
The waiting room was packed with patients when Spotlight visited – many looked visibly frustrated. Due to renovations in the restrooms, the floors were covered in dust and some patients had to navigate their way through dimly lit hallways.
A constant struggle
According to Monwabisi Mbasa, Gauteng chair of the Treatment Action Campaign (TAC), they have been advocating for the construction of a new hospital in Ekurhuleni for years, but “it’s an ongoing struggle”.
“Residents of Ekurhuleni, particularly those residing in Boksburg, Benoni, Kempton Park and Germiston, are severely undermined and their lives continue to be subjected to hazardous conditions,” he said.
Mbasa said the hospital was “extremely unsafe and unfit to provide health services”.
It does not comply with safe construction standards and must be replaced. It’s an old building and the people who use this hospital and the lives of the employees are in perpetual danger.
He acknowledged that there had been periodic maintenance, but said that does not change the fact that the hospital is not safe. “As TAC, we dismiss repair work, meaningless renovations and alterations with contempt. The hospital, he says, [remains] a threat to human beings and it is a violation of human rights.
Multiple parties involved
According to DA Health Spokesperson in Gauteng, Jack Bloom, the sad reality is that there is no budget to build new hospitals in Gauteng in the near future.
“Staff have valid concerns about workplace safety at Tambo Memorial, but only remedial work is likely to try to mitigate the risk. The whole East Rand region is under pressure with inadequate health facilities for the growing population,” he said.
Meanwhile, the South African Medical Association (Sama) has also raised concerns.
Sama’s chairman, Dr Mvuyisi Mzukwa, told Spotlight that the organization is concerned about the infrastructure at Tambo Memorial and other public health facilities. He says the poor infrastructure poses a great danger to the safety of healthcare workers and patients.
The quality of infrastructure at OR Tambo Memorial Hospital and all other hospitals in the country is important to us. The Gauteng Department of Health has promised to fix the problem at these facilities, but that process has been extremely slow.
“This creates an ethical and moral dilemma for doctors and other medical professionals who ultimately have to sacrifice themselves by working in suboptimal conditions in order to save lives,” Mzukwa said.
Following complaints, the Office of Sanitation Compliance (OHSC) inspected the facility in early February this year. According to the OHSC spokesman, Ricardo Mahlakanya, the final report of this inspection is however still undergoing internal processes, which involve the health establishment. “Therefore, the CSST is not able to disclose the status of the healthcare facility before issuing and finalizing the report with the healthcare facility.”
Department: Work is in progress
Following the monitoring visit, Ismail in July this year asked the South African Minister of Health, Dr Joe Phaahla, why the building was still in use given that the hospital had been deemed unfit and what were plans to replace the hospital.
In response, Phaahla said the province “is aware of the poor state of infrastructure at Tambo Memorial Hospital.” “The province had undertaken a feasibility study to revitalize the entire facility. Initially, the Gauteng Provincial Department of Health wanted to construct two new facilities – a 350-bed district hospital and an 800-bed tertiary hospital respectively at different sites. However, the Gauteng Department of Infrastructure Development (GDID) currently has no land (site) allocated for the two facilities,” he said. Then, “following peer review meetings in July 2016, it was decided that the Tambo Memorial would henceforth be a single regional hospital with 600 beds, but no site was available”.
According to Motaletale Modiba, the Gauteng Health Spokesperson communities of Boksburg and surrounding areas have shown resistance to moving the hospital during previous public engagement engagements. “It is therefore necessary to continue to use the facility while developing alternatives. The continued use of the hospital building is managed with due regard to compliance with legislative requirements,” he said. “Maintenance and renovations continue to keep the facility usable in the interim until an alternative hospital is commissioned in consultation with the community and interested parties like local government.”
Modiba said the facility’s renovation and occupational health and safety program aims to address concerns about unsafe infrastructure. He said there are plans underway to build a new orthopedic section as parts of the hospital built with asbestos are being decommissioned.
Modiba also confirmed that Tambo Memorial’s maintenance projects include renovations to Kangaroo Maternal Care Ward 1, Children’s Ward 12, Accident and Emergency Ward and the creation of a new parking lot. He said kitchen upgrades were underway, vinyl flooring in hallways was underway, as well as replacement of vandalized faucets and toilet seats. The department also installs CCTV cameras and burglar bars on doors and windows.
According to him, the current estimate of construction costs for a new hospital is over R5 billion, for which there is currently no budget. “The department is seeking alternative funding to address budgetary challenges,” he said. He couldn’t provide a timeline for that.
Phaahla, in her response to parliament, said the plan to build a new hospital had finally been put on hold until the department’s financial situation improved. R40 million has been allocated as part of the provincial fair share funding for some major renovations to the facility and maintenance and repair projects are underway. In this financial year (2022/23), R13 million has been allocated for the maintenance of the facility, Phaahla said.
*This article was published by Projector – public interest health journalism.