In 2017 an assessment commissioned by Tambo Memorial Hospital in Boksburg in Gauteng reportedly found that the hospital building was "unfit for human habitation" and was considered to be "an occupational hazard".
Five years later, patients and healthcare workers at the hospital are continuing to receive and provide health services under unusually difficult conditions. According to Democratic Alliance (DA) MP Haseena Ismail she found during an oversight visit earlier this year found that conditions had not improved.
A bad smell hangs over parts of the facility and much of the infrastructure remains substandard. Some healthcare workers have now resorted to wearing masks because the stench from leaking sewer pipes has become unbearable.
The Gauteng Department of Health is aware of the problems at the hospital and some maintenance work has been done, but, among others, it says the money isn't currently there to build a new hospital.
'Decaying infrastructure'
When Spotlight visited the hospital last week, the stench was noticeable from the corridor that leads from the reception counters to the dispensary. Paint was peeling from the hospital's walls, cracks and damp were clearly visible, and some windows were broken. There were workmen on the premises working on plumbing in some of the toilets.
A nurse told Spotlight the conditions at the hospital are bad and that there is nothing they can do as healthcare workers but wait on the department to fix or build a new hospital. "This hospital is very old. I understand why it has all these issues. It's because the building needs to be maintained or replaced," the nurse said.
"We work under stressful conditions. The sewer is another problem. As you can see, I'm wearing my mask to protect myself from the smell of the sewer." She said healthcare workers work in fear because of the decaying infrastructure.
Opened in 1905, the hospital is said to be among the oldest in the country. It initially started as a joint hospital of the government and the East Rand Property Mine until 1984 when the government took full ownership.
One healthcare user said she arrived at the hospital at 6am and was still waiting for her mother's medication at 14h15 amid the stench hanging over the dispensary, the casualty unit, and the main entrance at the admission block.
She says when the emergency door opens at the dispensary on a hot day the smell that comes from the sewer is unbearable. "That dispensary is always full. You queue for a long time while bearing the smell of that sewer. It is horrible."
The waiting area was filled with patients during Spotlight's visit - many looking visibly frustrated. Due to renovations in the toilets, the floors were covered in dust and some patients had to make their way through dimly lit corridors.
We work under stressful conditions. The sewer is another problem. As you can see, I'm wearing my mask to protect myself from the smell of the sewer - nurse
An ongoing struggle
According to Monwabisi Mbasa, Gauteng chairperson of the Treatment Action Campaign (TAC), they have been advocating for the building of a new hospital in Ekurhuleni for years, but "it's an ongoing struggle". "Ekurhuleni residents, particularly those who are residing in places like Boksburg, Benoni, Kempton Park, and Germiston are being grossly undermined and their lives continue to be subjected to hazardous conditions," he said.
Mbasa said the hospital is "grossly unsafe and unfit to render healthcare services". "It does not comply with safe building standards and needs to be replaced. It's an old building and people who are using that hospital and the employees' lives are in perpetual danger."
He acknowledged that there has been periodic maintenance, but says it doesn't change the fact that the hospital is unsafe. "As TAC we reject with contempt the patch-up jobs, trivial renovations, and alterations. The hospital," he says, [remains] a threat to human beings and it's a violation of human rights."
Several parties concerned
According to the DA's health spokesperson in Gauteng, Jack Bloom, the sad reality is that there is no budget to build any new hospitals in Gauteng in the near future.
"Staff have valid concerns about occupational safety at Tambo Memorial but only patch-up jobs are likely to try and mitigate the risk." The whole East Rand area is under stress with inadequate health facilities for the growing population," he said.
Meanwhile, the South African Medical Association (SAMA) also raised concerns.
SAMA Chairperson Dr Mvuyisi Mzukwa told Spotlight that the organisation is concerned about infrastructure at Tambo Memorial and other public health facilities. He says poor infrastructure poses a great danger to the safety of healthcare workers and patients.
"The quality of infrastructure at the OR Tambo Memorial Hospital and all other hospitals in the country is important to us. The Gauteng Department of Health has promised to fix the problem at these facilities, however, this process has been extremely slow. This creates an ethical and moral dilemma for the doctors and other healthcare professionals who eventually have to self-sacrifice by working in sub-optimal conditions in order to save lives," Mzukwa said.
Following complaints, the Office of Health Standards Compliance (OHSC) inspected the facility at the beginning of February this year. According to OHSC spokesperson Ricardo Mahlakanya, however, the final report on this inspection is still undergoing internal processes, which involve the health establishment. "Therefore, the OHSC is not in a position to disclose the status of the health establishment prior to issuing and finalising the report with the health establishment."
The Office of Health Standards Compliance (OHSC) inspected the facility at the beginning of February this year.
Department: Work is underway
Following the oversight visit, Ismail in July this year asked South Africa's health minister Dr Joe Phaahla why the building is still being used given that the hospital had been deemed unfit and what the plans are to replace the hospital.
The department is aware of the bad infrastructural condition at the Tambo Memorial Hospital - Health minister Dr Joe Phaahla
In response, Phaahla said that the province "is aware of the bad infrastructural condition at the Tambo Memorial Hospital". "The province had embarked on a feasibility study with the intention of revitalising the entire facility. Initially, the Gauteng Provincial Department of Health wanted to construct two new facilities - a 350-bed district hospital and an 800-bed tertiary hospital respectively on different sites. However, the Gauteng Department of Infrastructure Development (GDID) currently has no land (site) allocated for both facilities," he said. Then, "following the peer review meetings of July 2016, it was decided that the Tambo Memorial will now be a single 600-bed Regional Hospital, but no site was available."
According to Motaletale Modiba, Gauteng health spokesperson communities of Boksburg and the surrounding areas showed resistance to moving the hospital during the previous public participation engagements. "There is therefore a need to continue using the facility whilst working out alternatives. The continued use of the hospital building is managed with due consideration to compliance with legislative requirements," he said. "Maintenance and refurbishments continue to keep the facility usable in the meantime until an alternative hospital is commissioned in consultation with the community and interested parties like local government."
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The continued use of the hospital building is managed with due consideration to compliance with legislative requirements - Motaletale Modiba
Modiba said that the facility's refurbishment and occupational health and safety programme is meant to address concerns over unsafe infrastructure. He said there are plans underway to build a new orthopaedic section since parts of the hospital built with asbestos are being decommissioned.
Modiba also confirmed that the maintenance projects at Tambo Memorial include renovations to the Kangaroo mother care ward 1, the children's ward 12, the accident and emergency department, and creating a new parking area. He said upgrading of the kitchen area is ongoing, vinyl flooring in the corridors is ongoing, as well as the replacement of vandalised toilet taps and seats. The department is also installing CCTV cameras and installing burglar bars on doors and windows.
According to him, the current cost estimate to build a new hospital is over R5 billion, for which there is currently no budget. "The department is seeking alternate funding to address the budget challenges," he said. He could not provide timelines for this.
Phaahla in his response in Parliament said the new hospital building project was eventually put on ice until the department's financial position improved. R40 million has been allocated under the Provincial Equitable Share funding for some major refurbishments at the facility and there are maintenance and repair projects underway. In this financial year (2022/23), R13 million has been allocated for maintenance at the facility, said Phaahla.
NOTE: A representative of the Treatment Action Campaign is quoted in this article. Spotlight is published by SECTION27 and the TAC, but is editorially independent - an independence that the editors guard jealously. Spotlight is a member of the South African Press Council.
