State patients in the province have fewer and fewer facilities available near to where they live and must travel hundreds of kilometres for treatment because of the nursing shortage.
Another rural hospital in the Northern Cape has shut its doors at night because of the province's shortage of nursing staff. The Connie Vorster Memorial Hospital in Hartswater, 120km north of Kimberley, is a health facility with 50 beds for patients who can be admitted overnight. It's supposed to be open 24 hours a day, seven days a week. However, it has become little more than a day clinic operating between 7am and 7pm after the Northern Cape Department of Health failed to employ enough nurses to staff the night shift.
This has a knock-on effect on ambulance services in the region. A patient arriving at 6pm cannot be admitted and an ambulance must be found to transfer them to the Robert Mangaliso Sobukwe Hospital in Kimberley, or the Professor ZK Mathews Hospital in Barkly West, which is 100km away.
The Connie Vorster hospital became infamous in 2018 when its mortuary fridge broke down for five months, prompting questions in Parliament for the minister of health.
The Dr Van Niekerk Hospital in Springbok, another 24/7 facility, is still open at night but it has taken 50% of its beds out of operation because of a shortage of nurses and other health professionals. The hospital now only has 20 beds available for half of the vast 126 836km² Namakwa region. The only other Namakwa hospital is in Calvinia, 380km away.
The Democratic Nursing Organisation of South Africa (Denosa) held an emergency provincial executive committee meeting on 1 June after not receiving a response from Northern Cape Premier Zamani Saul to its demands in May that the situation be addressed. It is now demanding that Saul and the provincial health department attend conciliation meetings with the union. If these meetings fail to find a solution to the health crisis, Denosa has vowed to lead "a total shutdown of health services in the province".
The union's provincial secretary, Anthony Vassen, also announced a picketing campaign outside Saul's office. Saul is accused of having a disregard for the residents of the Northern Cape to the point of negligence. Vassen said apart from the night and bed closures at hospitals, every health clinic in the province is now so starved of funding and staff that they are no longer able to offer any meaningful health service to patients.
"In all other health facilities in the province, the services that communities receive are similar to those when purchasing groceries at a supermarket. Patients are only scanned and let go, because of the sheer numbers [of them] that a short-staffed nursing fraternity need to deal with," he added.
Nurses are living in fear that the "substandard" care will cause serious harm to their patients and are distressed at being forced to work like this, Vassen added. Denosa will also ask the South African Human Rights Commission and the Office of Health Standards Compliance to "investigate the human rights violations on access to quality healthcare currently faced by the people of the Northern Cape".
Dwindling options
New Frame reported in May that two other 24/7 Northern Cape health facilities in Pampierstad and Warrenton were recently forced to close their doors at night and on weekends because of the lack of nurses. Sick patients in these impoverished communities must now find their own way to other hospitals up to 200km away during these times.
The Northern Cape is vast and rural. Remote areas such as Kamiesberg do not have a single doctor or dentist in their public health facilities, and staff from the Dr Van Niekerk Hospital have to travel 100km to work at the local clinics in Kamiesberg. Nurses in the area circulate through 10 satellite clinics that have no nurses of their own.
During the first Covid-19 lockdown, 56 children under the age of five died in Northern Cape hospitals, mainly from "prematurity, infection and birth asphyxia" in the case of newborns, and "diarrhoea, pneumonia and septicaemia with HIV infection and malnutrition as important underlying conditions" in the case of those aged from one to five, according to a parliamentary reply from the then minister of health, Zweli Mkhize.
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Saul's spokesperson, Bronwyn Thomas-Abrahams, said Saul had been in Spain and Germany since receiving Denosa's demands on 12 May and was not ignoring the union.
"The commitment was made by the premier that he wishes to meet with Denosa to engage in discussions with them. The office of the premier has in the meantime been working with the Department of Health to develop amicable solutions to the challenges raised. The office-bearers of Denosa have also been contacted to provide a suitable date for the meeting and they have proposed a date for next week to engage with both the office of the premier and the Department of Health," she said.
