East London hospitals: Horrific findings after surprise inspection

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Following unannounced inspections at the Cecilia Makiwane Hospital’s Mental Health Unit and Frere Hospital’s Nerina House Nurses Home in August 2019, the Public Service Commission (PSC) released its report on Tuesday 3 December 2019, which contained recommendations and horrific findings.

Prior to the PSC inspection of the two East London hospitals, there were media reports alleging that the Cecilia Makiwane Hospital’s Mental Health Unit, in particular, was in disrepair, with broken windows, abandoned medical equipment, and exposed electrical wiring which posed a danger to the patients and staff.

The media reports also suggest that the Hospital did not have a psychiatrist since December 2018 and security was virtually non-existent, which left both staff and patients at risk.

Furthermore, the media report mentioned that there was a dire shortage of staff and that patients did not have recreational facilities. Similarly, the patients and staff were also traumatised.

Key findings at Cecilia Makiwane Hospital (Mental Health Unit)

The PSC found:

  • The conditions of the old structure of the Mental Health Unit were indeed in a position of total disrepair as they have not been maintained for years.
  • The windows were broken, the walls peeling off and electrical wires in the passages were exposed which posed a serious threat to staff, patients and the citizens.
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  • Some patients in the male psychiatric ward were lying on the concrete/cemented floor and the PSC found this to be an unacceptable way of treating patients.
  • There were no beds allocated to the restraint/seclusion rooms. Floors in the secluded areas were just cement with no carpets and mattresses.
  • Cameras were not in working conditions.
  • Secluded areas were not environmentally friendly and were designed like apartheid secluded prison cells.
  • Some members of staff generally appeared professional, well conversant with their work, friendly and helpful.

Key recommendations for the Cecilia Makiwane hospital (Mental Health Unit)

The PSC recommended the following:

  • The Cecilia Makiwane Hospital should demolish the Seclusion Wards and replace them with environmentally-friendly rooms that are provided with the necessary equipment for the utilization of patients.
  • The Cecilia Makiwane Hospital should set funds aside to fix the dysfunctional camera in the restraint or seclusion room.
  • Whilst waiting for the long term fixing of the seclusion rooms, matrasses/beds, and other safety equipment should be installed in these rooms.
  • The existing building requires a major facelift as the conditions outside the old building reflects the high degree or standard of uncleanliness and lack of years of maintenance.
  • The resting areas (courtyards) for both male and female patients must be provided with the necessary equipment to avoid patients resting and lying on the cement floor.

Key findings at the Frere Hospital (Nerina Nurses Home)

  • The hostel is inhabitable and generally a physical and health hazard to both student nurses and their visitors.
  • Heaps of uncollected waste piled alongside the entrance of the hospital.
  • Pungent smell in the first and second floors of the hostel accompanied by buzzing flies and maggots.
  • The PSC noted that waste was last collected in January 2019 by the municipality.
  • The state of the hostel posed a serious health threat to students and workers alike.
  • The infrastructure of the building is dire.
  • The window seals were broken, doors vandalized and the roof is dilapidated. In other rooms, the wooden floors were falling apart.
  • The PSC noted that there were numerous burglaries that took place in the hostel before due to a lack of visible security.
  • A security guard was dispatched by the hospital on the day of the inspection upon learning of the PSC’s inspection.
  • The lounge areas were infested with old and unused beds and mattresses.

Key recommendations for Frere Hospital (Nerina Nurses Home)

  • The Eastern Cape Department of Health (ECDoH) should, as a matter of urgency, consider closing down Nerina House Nurses’ Home, whilst alternative accommodation for students is sought by the Lilitha Nursing College (a plan of action to relocate to be effected within 30 days).
  • The ECDoH should set aside emergency funds to cater for the refurbishment of Nerina House Nurses’ Home’s deteriorating infrastructure. An action plan in this regard should be developed in conjunction with the Department of Public Works to renovate the building.
  • The ECDoH, should develop an aggressive approach in improving the safety of students by means of employing security guards on the premises. The PSC has submitted the Reports to the ECDoH and some of the recommendations are being implemented for both East London Hospitals.