The Eastern Cape Department of Health is to investigate allegations that several deaths occurred when nurses and porters abandoned their posts for an illegal four-day protest at Dora Nginza Hospital in Nelson Mandela Bay last week, reports The Herald.
Video footage circulating online showed a patient lying – apparently dead – on the floor of a ward, while another video showed protesters singing and dancing outside the building.
The nurses, who simply abandoned their posts citing exhaustion and overwork, left a trail of chaos and panic in their wake, with surgeries in limbo and patients unattended.
The strike was roundly condemned by a furious Eastern Cape Department of Health, which implemented a no-work, no-pay policy.
At the hospital on Friday, dirty, bloodstained linen that News24 was told had been used to mop up water from an overflowing, filthy bathroom, was piled on the floor. Bins overflowed, and rubbish littered the passages.
The only ward where at least one nurse was visible and on duty was in the high care unit.
One patient said the staff hadn’t been seen “for days”. “I’m diabetic, but I haven’t received any medication all day.”
Another woman, who had undergone surgery on Wednesday, said the drain inserted during her surgery had not been emptied or replaced for two days.
An elderly woman in the surgical ward said she’d had to change her own dressing, but had received no meds.
Back to work
Staff had returned to work on Monday after a Labour Court ruling on Friday barred them from continuing their strike, granting an interim interdict in favour of Eastern Cape Health MEC Ntandokazi Capa, and pending a full hearing on 19 May.
At a media briefing, HoD Rolene Wagner said the department had filed several criminal charges and launched investigations into the allegations.
The decision to strike was reportedly triggered in part by discontent over patients being diverted to the hospital from the Motherwell Community Health Centre (CHC) because of repeated burglaries at the clinic.
According to Wagner, there had been six break-ins at the Motherwell facility, with the most recent one in March. Criminals stole several computers and other equipment, causing damage to infrastructure and traumatising staff.
Subsequently, some employees had said they needed counselling support before returning to night duty, while others reported sick for the day shift.
This led to patients being diverted to Dora Nginza Hospital and other clinics.
Wagner told The Herald the strike was related to a demand for additional overtime, blanket overtime across the entire facility, as well as pressure from the added patient overload from Motherwell CHC.
“Motherwell was closed … and we recognised that Dora and the surrounding facilities had to absorb the patients being referred,” she said, but added that it was not true no staff were taking care of patients during the strike. She said management “were often the only people available in the ward”.
“All doctors were on duty… the nurse managers were sometimes left alone looking after all of the patients, so it was not ideal.”
Rescue plan
But during the emergency measures rolled out during the strike to ensure continued nursing care for pregnant women and their babies, long-standing systemic failures were exposed, including decade-long staffing gaps – and concern over a rescue plan that was developed without sufficient clinical input.
Daily Maverick reports that less than a month ago, Health Minister Dr Aaron Motsoaledi had told EFF MP Sixolisa Gcilishe, in a written response, that there was no need to place the department under administration to address the hospital’s challenges.
“We went to the Eastern Cape … to meet the Premier, the MECs for Finance and for Health, and the provincial Director-General. We discussed all of the shortcomings and problems within the health department and at Dora Nginza.
“A plan was developed and is being followed to correct some of the shortcomings …one is the issue of pregnant women sleeping on benches and chairs at the hospital. The problem was identified as being caused by a shortage of district hospitals in the area, not by Dora Nginza Hospital itself.
“This shortage … causes every pregnant woman to be sent to Dora Nginza, and leads to overcrowding, and to some sleeping on benches,” the Minister said.
He suggested that the solution was not to put the Eastern Cape under Section 100 administration, “but rather to put up facilities within the district… to relieve Dora Nginza Hospital (of overcrowding)”.
But last week’s strike has again highlighted the dire, long-unaddressed conditions under which staff work, driven largely by severe staffing shortages and systemic failures that have been addressed at a snail’s pace.
Some critical shortages, particularly of midwives, date back nearly a decade
Thousands of deliveries
The Obstetrics Unit at Dora Nginza, which has a high-care unit for critical cases, is operating under extreme pressure. Specialists perform 20 to 25 Caesarean sections per 24 hours, while midwives deliver around 600 babies a month, with the unit recording more than 11 000 deliveries in some years.
When services at community health centres are disrupted, all pregnant patients are referred to Dora Nginza. The same applies to all critical maternity cases from the western part of the Eastern Cape.
In 2025, Wagner told the South African Human Rights Commission that a special plan was needed to improve conditions in the Nelson Mandela Bay Health District, specifically at Dora Nginza.
She said the department would provide Humansdorp Hospital with theatre staff to perform C-sections, allowing patients from the neighbouring Sarah Baartman district to be treated there.
She also said that Uitenhage Provincial Hospital would be provided with theatre staff to do the same. It is understood from hospital sources that, after the strike, agency theatre nurses were brought in to Uitenhage Hospital to help with operations.
Another key part of the plan was that Empilweni TB Hospital would be converted into a district hospital, where mothers could be referred for post-delivery care.
Lofty plan
Communications director Siyanda Manana conceded that the department was facing some “challenges”, but that all emergency and high-risk cases were being prioritised.
“These include critical maternity cases requiring urgent surgical intervention, as well as specialised neonatal and paediatric care. Patients are receiving appropriate care within available capacity, supported by established escalation protocols.”
Emergency cases were transferred by helicopter to other facilities, including Empilweni Hospital, Settlers Hospital, Uitenhage Provincial Hospital, Port Elizabeth Provincial Hospital, Livingstone Hospital, Andries Vosloo Hospital in Somerset East and Midland Hospital in Graaff-Reinet.
These facilities had been placed on standby to receive patients where clinically appropriate.
Additional capacity options across the district were also being explored to relieve pressure on Dora Nginza, including the possibility of making additional beds available at Empilweni.
“The Department has further moved to contract additional nursing personnel to reinforce capacity,” Manana said.
Clinical flaws
However, obstetricians have criticised the plan, saying it appeared to have been formulated with limited clinical input, and that it was highly risky to refer critically ill pregnant patients to district hospitals for Caesarean sections performed by community service doctors with limited experience.
Doctors have also raised concerns about inadequate provision for complications, including access to specialist paediatric and neonatal care, and experienced anaesthetists.
The latest available official figures for nursing staff at Dora Nginza Hospital are from 2025 and were provided by Motsoaledi. At the time, the hospital had 83 professional nurses, including midwives, 32 operational managers and advanced midwives, and 187 nursing assistants.
There were 50 nursing vacancies, including in maternity services. The Public Protector has previously pointed out that shortages – particularly of midwives – have persisted since 2017, pushing staff to breaking point.
Discouraged doctors said they had stopped even talking about the shortages of doctors in the unit.
“The hospital was not able to fill these posts due to budgetary constraints,” Motsoaledi said, adding that recruitment for 42 professional nurses, staff nurses and assistants had begun in the second half of 2025.
Oversight findings
The findings against the department on conditions at Dora Nginza Hospital have been piling up for years, including the Public Protector findings in 2021 and 2025.
There have also been numerous oversight visits by Ministers and the Parliamentary Health Committee, while the South African Human Rights Commission continues to monitor conditions at the hospital.
Despite this, implementation of the plan has lagged for more than a year – and the situation remains at breaking point.
Daily Maverick article – Dora Nginza ‘rescue plan’ fears as Eastern Cape health department hits crisis mode (Open access)
News24 article – Silent hallways, unattended patients: Dora Nginza strike causes chaos An illegal strike at Dora Nginza (Restricted access)
See more from MedicalBrief archives:
Power outage adds to Dora Nginza Hospital woes
Dora Nginza staff down tools over unpaid overtime – again
Nurses strike over unpaid overtime
Maternity unit strike at Dora Nginza Hospital, Eastern Cape, ends
Doctors urge crisis management as Eastern Cape Hospitals collapse