A team from Gift of the Givers will today start refurbishing wards in Settlers Hospital’s former Netcare private section to accommodate the rapidly increasing number of local Covid-19 patients needing care. This comes just three days after Dr Imtiaz Sooliman visited the district facility this week..
The Gift of the Givers founder visited Settlers Hospital with his co-ordinating team on Monday 30 November to assess what’s needed to equip the former private intensive care unit and other sections to care for Covid patients. Accompanying the Gift of the Givers team was Makana Mayor Mzukisi Mpahlwa. They met with Chief Medical Officer Dr Ziefred McConney and acting CEO St Yvonne Ngesi. The senior managers took them on a tour of disused units in the former Netcare private section of the hospital, including maternity and ICU.
Netcare withdrew from the public-private partnership, and the hospital, at the end of last year, taking with them some key equipment owned by them. Grocott’s Mail understands that the Department of Health must undertake a full audit of the former private section before it can allocate replacement resources, and that this will only be undertaken at the start of the new financial year, in April.
On the day Grocott’s Mail visited Settlers Hospital, the casualty section was overflowing with emergency admissions – most suspected Covid cases. With the examination cubicles full, a number of people waited on chairs to be attended to. Grocott’s Mail can confirm that at least two patients in severe respiratory distress were forced to return home, as embattled staff struggled to cope with the desperate tide.
Sources later told Grocott’s Mail that currently, five doctors at the hospital are out of action and those covering for them have worked for days without a break. Five additional beds had been moved into the main 23-bed ward in the former private section to accommodate more Covid patients there. One doctor was tasked with attending to close on 30 patients there.
Not only are there gaps in medical staffing. Grocott’s Mail recently reported on claims that three weekends ago, there had been no oxygen for Covid patients. We’ve since had it confirmed that there was oxygen; however, the hospital’s technical services are outsourced and a technician was required to switch over the supply at a critical time. Sources said medical personnel had regularly driven to fetch the technician from his home in the middle of the night to perform the switch-over.
The far end of the hospital grounds is seeing a steady stream of funeral home vehicles arriving to remove bodies. On Monday morning alone, undertakers fetched eight bodies from the hospital mortuary and another three directly from the wards. Sources confirmed these were all Covid deaths.
60 new Covid cases were reported in Makana on one day last weekend (all in Makhanda) bringing the active reported total to 234.
Settlers key to three-part strategy
It is against this background, along with strain on Eastern Cape health personnel and facilities in general as they struggle to cope with the rapidly rising number of cases, that the Gift of the Givers is implementing a three-part strategy in the Province. As a District Hospital, Settlers is an important part of it.
First, support the hospital staff; second, take the pressure off the central (epicentre) hospitals by keeping patients in their own towns and treating them there. To do that, though, the public needs to have confidence in their local health care facilities – which need to be correctly equipped to look after them.
In an interview ahead of this week’s visit to Settlers, Sooliman said, “The Covid-19 strategy for the Eastern Cape needs to look at different modalities.
“First, it needs to focus on the epicentre and that right now is the Nelson Mandela Bay Metro, including several hospitals and clinics within the system. You have a limited number of facilities, and exhausted doctors who can’t cope anymore and so they make mistakes.
“Since March, the mental and emotional stress has been unbelievable as they’ve watched family and colleagues die as they themselves strain under a shortage of manpower.”
Stop the burnout
Dr Sooliman’s strategy to stop burnout among medical professionals is a combination of psychological, and very practical, support.
“Simple creature comforts make a world of difference,” Sooliman said, drawing from his first-hand experience working in disaster zones across the world. “Tea, coffee, biscuits – as simple as that.”
Also learnt from disaster zone experience is that there’s safety in numbers.
“If you’re in a disaster zone and you’ve only got 3 or 4 people working there, they’re going to break. If you have 15, you know we’re all there for each other. It’s exactly the same in hospitals,” Sooliman said.
A plan to bring in unemployed paramedics could turn around what currently is a lonely and overwhelming load for doctors.
“You don’t need highly qualified medical personnel to care for Covid patients; you need monitoring and management,” said Sooliman.
“You need to check oxygen levels – things which paramedics can do very easily. Paramedics are also very skilled in intubating – better than most private doctors, because it’s not something doctors routinely do in private practice.
“Paramedics can take a lot of the pressure off medical professionals. They are also go-getters. They can put up drips and do intubation, depending on their level of training.”
Care for patients in their own town
“Then you must ensure good facilities in your own town so people can see they will be well looked after. At the moment when someone gets sick, they’re saying, ‘No I don’t want to go to that facility – I’d rather go to the epicentre.’
The two go together
“You could put the best world-class facilities here in Makhanda – but it would not help if you don’t have personnel. You can have a top class private hospital – like a hotel – but there’s nobody to look after the patients,” Sooliman said.
“Without staff, and without oxygen, a building is useless.”
“All of the hospitals in the Eastern Cape are full of Covid,” Dr Sooliman said. “And the demands on us are huge, but we must help wherever we can.
“This is a beautiful hospital. This is going to be easy,” was his assessment of the task ahead at Settlers.
Refurbishment work that will begin today includes replacing missing plumbing in the former private section specialised units; and putting in piping and control and delivery systems for oxygen throughout the former private section.
“The aim is to convert these unused units into high-oxygen facilities for Covid patients,” Sooliman clarified.
This is not the same as equipping an intensive care unit. In other words, while the former private ICU will be used, it will be to administer oxygen to Covid patients and won’t be equipped as an ICU.
“We will put in the oxygen infrastructure,” Sooliman said. Once the basics are there, it will be possible for the Department to later buy the equipment required to run an ICU.”