"We are doing battleground medicine," says minister
A massive increase in gun violence in the Western Cape is putting critical health services under pressure. This emerged at a press conference in Cape Town on Thursday.
Professor Andy Nicol, head of the Groote Schuur Hospital trauma centre, said the centre attended to 37 gunshot victims per month on average in 2012. This number has increased to 73. About a quarter of gunshot victims which are seen at the hospital are return patients.
Nicol showed a video of how they stabilise patients to save lives. They put in plastic shunts, staples and tubes to stop massive bleeding, cover the wounds up with "plastic" and admit patients to the intensive care unit for 24 hours. Thereafter they are taken to theatre for surgery to repair injuries.
Some patients are admitted with multiple gunshot wounds. "All this trauma does damage to interns, nursing staff and even doctors who have been here for years ... They are exposed to massive levels of trauma," he said.
According to the Western Cape Department of Health the average number of gunshot victims per month at Tygerberg Hospital is 107.
In the 2018/19 financial year, 81% of violence-related deaths occurred in the Metro Health District, with Tygerberg Hospital receiving 318 cases from Khayelitsha, 242 from Parow and 239 from Delft.
The ripple effect of this is that people booked for other surgery - such as a hip replacement, tumour removal or eye surgery - are bumped off the operating theatre list and their surgery gets repeatedly postponed.
Dr Beth Engelbrecht, Head of Department of Health in the Western Cape, said 65% of homicides in the province occur between 5pm on Fridays and 4am on Mondays. Some 80% of the gunshot victims are male, according to the department.
Engelbrecht said the high caseload due to violence forces the department to shift funds away from other areas. She said violence therefore affects all sectors of society.
The Forensic Pathology Services (FPS) are also under pressure. They can't "save time on cases, because they have to testify in court. This leads to other bodies not being released and families have to wait longer."
In 2018 the FPS recorded 11,930 bodies of which 4,170 were unnatural deaths; of these, 2,029 died from gunshot wounds. Since January this year there were 5,840 bodies admitted and 1,100 were deaths due to gunshots and 893 to stabbings.
Engelbrecht added that due to the violence in some areas the response time of the Emergency Medical Services has dropped from being at a scene within 15 minutes 60% of the time to 12%. This is because ambulance crews first have to wait for a police escort before they enter high risk areas.
Dr Nomafrench Mbombo, Western Cape Minister of Health, said: "Our budget now goes to crime. We are doing battleground medicine." The province's health budget was cut three years in succession and she said it looks worse ahead.
She said people complain that they have "to sleep on the floor as they wait for a bed" but "they will wait longer, because of this [high incidence of gun violence] ... We run out of beds and have to put patients in the passage, that is how it is."
Mary Bruce, from Hanover Park, spoke about how she was shot on the 7 July while she was hanging washing in her backyard. "I heard the first shot. The second bullet hit me while I was running away. He just kept shooting ... I don't know who he is."
Bruce was shot in the knee. "I lay there for 10 minutes, hiding, before anyone found me. I thank the Lord. I could have been dead. I could have lost my leg if it was not for the people from Groote Schuur."
Bruce works with about 50 children to help them escape gang life. "I tell them, you have to get out, because either you die or you go to prison."
"I am scared every day of my life. The bullets are like rain there [on the Cape Flats]," she said.