DM168

OPEN LETTER

A wake-up call for Health Department heads: Children are dying because of horrendous state of our public hospitals

Dr Tim De Maayer is a paediatric gastroenterologist at Rahima Moosa Mother and Child Hospital. (Photo: Supplied)

Paediatrician Dr Tim De Maayer’s open letter to Health Department heads: ‘How do you manage to come to work every day, fail at your job of ensuring basic healthcare for the people you serve and still sleep at night?’

Dear administrators,

Last week I attended the funeral of a 13-year-old patient of mine who I have looked after for years at Rahima Moosa Mother and Child Hospital.

Today I counselled two mothers, informing them that our resuscitation measures had been in vain.

I wish you could be there to see the pain and grief that these parents and their families go through.

Children are dying and the horrendous conditions in our public hospitals are contributing to their deaths.

I wish you could come to our unit and see doctors trying to intubate children and administer cardiopulmonary resuscitation by their mobile phone’s torch, as the power has failed … again… Or the cold neonate whose incubator went off with the loss of power (from load shedding) and did not keep him warm.

How about excluding a mother-and-child hospital from your load shedding schedule? Our generators are unfortunately inadequately sized to supply the hospital.

I wish you could come and explain to parents that their child needs an urgent computerised tomography scan of the brain but he’s going to have to wait, since our scanner has been broken for nearly three months, Chris Hani Baragwanath is overflowing, and Charlotte Maxeke has had crucial parts of its scanner stolen.

He ended up waiting for 48 hours, when the Nelson Mandela Children’s Hospital managed to assist.

I wish you would come and look at the toilets when the water has been off because the local water reservoir was running low.

Or, even better, come and see how hospital-acquired infections spread like wildfire through the neonatal ward because the taps are dry, and washing your hands while lifting a five-litre water container after examining each child is just not feasible.

No, scrap that. Please come out of your ivory towers and come and use our lidless toilets. (There is one for fathers on the ground floor; the rest are off limits to men.)

Perhaps you could come and try to manage a critically ill little patient without the benefit of blood test results, as the National Health Laboratory Service’s turnaround time is frequently more than 24 hours at our hospital.

Or see doctors drive around to different hospitals trying to acquire essential supplies that are not available at our hospital.

I could go on, but want to pose some questions to you:

Would you admit your child to this hospital?

Would you trust the overburdened and burnt-out healthcare staff to look after your little one in their hour of greatest need?

And if you wouldn’t, how do you manage to come to work every day, fail at your job of ensuring basic healthcare for the people you serve and still sleep at night?

Having worked in the public sector for 21 years, I can tell you frankly: things are falling apart.

If your healthcare workers are the centre of providing care, we cannot hold. Things are going backwards, fast. The care that is being provided in your less than glittering hospitals is getting worse every day.

Are you worried about the greedy lawyers who are waiting in the wings, suing your department for millions because a premature infant went blind because there was no functional meter (which costs less than R1,000) monitoring her oxygen delivery?

You should be, because money is being wasted on paying negligence lawsuit compensations rather than preventing the problem in the first place.

And before you ask, yes, these issues have been raised with management repeatedly, including two reports on the critical state of the neonatal wards and obstetric services in 2016 and 2021, and a more recent letter on 11 April 2022 detailing the disastrous state of the hospital.

The “correct procedures” have been followed, with no visible response. Have you read the reports?

I can predict your response: “Illegal foreigners are clogging the system.”

Well, if you don’t control the borders or have a functional Department of Home Affairs to deal with refugees, you cannot blame desperate and indigent people for trying to improve their lives and seek care when they or their children are ill. The truth, though, based on Statistics South Africa data, is that at least half of the one million immigrants into Gauteng between 2016 and 2021 were from Limpopo, KwaZulu-Natal, Mpumalanga, and so on. Yes, South Africans.

Despite the ever-expanding demand for health services, the Gauteng Department of Health budget is decreasing in real terms.

And when the Covid-19 budget gets allocated, it goes to hospitals that are struggling to function, such as the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), and cuts out hospitals managing the redistributed workload such as Rahima Moosa Mother and Child Hospital.

Yes, I know you claim the CMJAH Emergency Department is “open”, but since it only accepts patients stabilised at other hospitals, and the Gauteng emergency medical services are unable to provide ambulance transport within a reasonable time, it remains nonfunctional.

I’m sure district hospitals in Gauteng are feeling the same pain.

I’m fully aware we are not alone or special, and that other hospitals and different disciplines across them are facing equally atrocious conditions.

I do, however, have a calling; a calling to be a paediatrician and to provide the best care I can to our little patients, and a calling to advocate for those without a voice.

I guess your inaction and disregard for the health of children does not matter, since children cannot vote and so why should you bother to meet their needs?

While Nelson Mandela, Chris Hani, Charlotte Maxeke and Rahima Moosa are turning in their graves, disturbed by the dismal conditions at hospitals bearing their names, I want to reassure them that we, the frontline healthcare workers, will keep fighting to maintain the health and wellbeing of our vulnerable children.

But it would be nice if you did something too. DM168

Dr Tim De Maayer is a paediatrician at Rahima Moosa Mother and Child Hospital, where he has worked since 2009. Before that, he worked in other public hospitals in rural Limpopo and trained at the University of the Witwatersrand. He is passionate about children’s rights, health and wellbeing.

Note from Mark Heywood, the editor of Maverick Citizen

This article is a cry from the heart.

It arises from moral injury occasioned by silence, from a doctor’s Hippocratic oath and after years of unsuccessful efforts by healthcare workers at Rahima Moosa Mother and Child Hospital to have the problems it describes attended to.

Knowing the risk of victimisation for speaking out, careful consideration and discussion with peers accompanied the decision to publish.

The best response of the Gauteng Department of Health and the hospital CEO to the article would be to admit and urgently fix the problems it raises, not shoot the messenger.

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R25.

Gallery

Comments - share your knowledge and experience

Please note you must be a Maverick Insider to comment. Sign up here or sign in if you are already an Insider.

Everybody has an opinion but not everyone has the knowledge and the experience to contribute meaningfully to a discussion. That’s what we want from our members. Help us learn with your expertise and insights on articles that we publish. We encourage different, respectful viewpoints to further our understanding of the world. View our comments policy here.

All Comments 36

  • A very sad cri de coeur and a warning of what we face if the NHI proposal is invoked – PUBLIC HEALTH WILL DISASTEROUSLY DETERIORATE ACCROSS ALL SECTORS!

  • Politicians should have to use public hospitals not private health care. Politicians do not care – simple as that. Have the unions been a help or hindrance? Another can of worms as people suffer and die. The Jubilee Hospital in North Westwas in very bad shape 25 years ago – gas anything changed?

  • No problem our government is going to fix it with NHI which means bringing the private sector down to their level, there, problem solved. Unbelievable stupidity.

    • Absolutely! Forget improving their (the ANC and voters) standards. They will drag us down to their level and beat us with experience!

  • And citizens – i advise you to peruse your municipal budget. I bet it includes office refurbishment, new aircons, updating fleets of sedans – while potholes, unfinished housing projects, lack of necessary service delivery of basics remain. There is no accountability. It seems the government sticks to doing whats its good at – raising flags, renaming things and going on tv to tell us that they assure the public that they are doing all they can.

  • They. Don’t. Care. End of story. And it is amazing that NHI will be positioned as the Saviour. If you are poor in South Africa you are fucked. If you are not, you will be dragged down to the same level, eventually.
    The pigs are walking on two legs now.

  • And all ministers use private health care! The ANC does not care about anything or anyone! The only thing they care about is how to make them selves rich at any cost! The most absurd thing is that there are voters that keep this crooked and incompetent bunch in a job. The NHI will necessarily make things even worse! Preventing this ideology must be severely fought against!!!

  • Government ministers and officials should be forbidden from using private hospitals or overseas facilities (Cuba, etc.) Maybe then they will do something about the state hospitals.

  • Thank u Tim de Maayer for this heart touching article. We need more people like you defending the vulnerable. Anything touched by this current government is for self gain/self destruction. Oh let the wickedness of the wicked come to an end, but establish the just for the righteous God trieth the hearts and reins. Absolutely NO to the NHI its just another cash cow for greed.
    I pray that this article will bear immeasurable fruit…….we need more Tims thank you for standing up for your patients.

    • Agree Elmarie and yes an enormous thank you to Tim and other HCWs who are stoically bearing this impossible load. “Things fall apart; the center cannot hold…” (The Second Coming, W Yeats) Vote and hope.

  • Heartbreaking and infuriating. Thank you Doctor, for giving voice to what has been happening for far too long. It should be mandatory for all “Comrades” to only attend state hospitals (and state schools), perhaps then attention will be paid to the conditions there. “All animals are equal, but some animals are more equal than others” – too true.

  • All I can say is “hats off”to the wonderful doctors and nurses that have to battle daily in these most appalling conditions, but comes a time when they will just say “we’ve had enough” – that’s scary!
    All the while the ANC cadres will just sit on their fat backsides and do bugger all.

  • Perhaps all members of parliament, as well as all managerial government and municipal staff should be compelled to make use of public or government hospitals. I think that swift and significant attention would be given to the hygiene and security standards at those establishments!

  • Absolutely heartbreaking .
    Stop this cadre deployment bullshit. Employ only on merit. Take the unions out of the play by calling this an essential service which it is!
    Help keep our medical professionals in the country as I see them streaming out of here because of the crap administration, wicked hours, shocking treatment by uneducated bureaucrats.

    Imagine this useless lot trying to run a NHS ? They cannot run a primary care clinic !!

  • As a retired public health care doctor myself, I wholeheartedly support Dr De Maayer’s plea FOR SANITY AND COMPASSION TO PREVAIL IN THE CORRIDORS OF ADMINISTRATORS. And this includes everyone from the top down: ministers, deputies, director-generals, MEC’s, and hospital managers. It is time for medical doctors to make their voices more loudly heard. The status quo should not be allowed to continue. We should form a united front against injustice and suffering. Mark Heywood could be our “leader”. How about a petition handed over to parliament?

    • A great post and observation…. Thanks Helga. And now they choose to suspend Dr De Maayer?! It is typical of SA health department to want revenge on someone for trying to escalate a serious problem instead of trying to do what they can to improve things. They see it as disloyal when in fact it was not at all, it was a desperate plea which touched the hearts of many. The ANC seems determined to be stupid cowardly and inefficient at any cost. I hope you are voted out and die poor and homeless.

  • It continues to boggle the mind that the very people most affected by this massive corruption/ineptitude are the ones voting for the people who are the cause of it.

    • We all frame our thinking around the informatuon we are exposed to, whether in propoganda, fake news or inside information. That those voters are fed fake news should be highlighted in society. It should be a thing.

  • This open letter from Dr Tim de Maayer is a tragic assessment of how low we have sunk as a country. The lack of competence of local government as well as hospital management is definitely the issue. In contrast, the Government hospital in George is very well run, spotless and ahead of many private hospitals in the standard of care provided to patients…food for thought 🤔

  • This was said regarding Coronation (Rahima Moosa) Johannesburg General and Pretoria Academic name changes at the the time

    The Provincial minister of Health Brian Hlongwa said a lengthy and exhaustive process had been followed since August 2007 to enable the name changes. He spoke of changes allowing a clean break with a past that ”no right-minded person can be proud of”.

    Dr Tim de Maayer’s article re the conditions at Rahima Moosa Hospital is heart breaking as is the treatment of all patients at our State Hospitals – and Department of Health wants to administer and run a National Health System???? The current state of affairs “no right-minded person can be proud of”
    Shame on you!

  • It’s shameful. A proper generator would have kept that incubator working, provided light for that vital intubation and resuscitation. I invite you to sit beside those bereaved parents, Minister Pandor, and explain again why it’s more important to give taxpayers’ money to Cuba, whose child mortality rate is probably much lower than ours. And if they don’t understand, keep telling them the millions would not have been enough to save their child. It will ease their pain.

  • Thank you, Tim De Maayer, for speaking out so courageously about the disastrous situation at the Rahima Moosa Mother and Child Hospital. As a (retired) public sector paediatrician myself, I’m very aware of the enormous responsibility we carry when society entrusts us with the care of its most vulnerable members. It’s unthinkable that you and your fellow staff members find it impossible to provide the excellent care you are committed to delivering.

    That your years of following “the right channels” to persuade the health department to put things right have not had meaningful results is a disgrace. So may your letter, which I fully support, shame them into taking constructive, positive action, not only for the children at Rahima Moosa but also for other dysfunctional hospitals.

  • Quote “Note from Mark Heywood, the editor of Maverick Citizen”

    So Mark, who will YOU vote for in the coming elections? No! Do not tell me, that is private, but will it be a truly democratic party? Yes/No?

  • Nothing will change until a law is passed, which of course it never will be, that all ANC MPs may only have their children treated at a public hospital.

  • What a sad state of affairs… cry our beloved country.
    Hospitals
    Eskom
    Prasa
    SAA
    Home Affairs
    Joburg decay
    Infrastructure decay
    I’m an optimist but it’s becoming harder and harder to have any kind of faith in things getting better.
    Thank god for the private sector and millions of hard working second economy entrepreneurs. The unions should be ashamed of themselves and their demands while millions don’t have jobs.
    Cyril must go… I had faith in him but he has proved to be spineless. And the ANC is running around like a chicken without a head. It’s such a sad state of affairs.
    Cry the beloved country… crying out aloud.

  • “The best response of the Gauteng Department of Health and the hospital CEO to the article would be to admit and urgently fix the problems it raises, not shoot the messenger”.

    Any bets, it will shoot the messenger….

  • Please peer review 3 community comments before your comment can be posted