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Attacks on doctors highlight security dangers in state hospitals

UFSFree State University has resumed training at a Bloemfontein hospital, briefly suspended over security concerns following an incident where a doctor prevented a rape attempt only by virtually biting off her assailant's tongue.

UFS briefly withdrew interns over security fears at Pelonomi HospitalThe SA Medical Association said it was "greatly concerned and dismayed" at the frequency of assaults on health-care practitioners at public institutions.

Undergraduate medical students of the University of the Free State (UFS) have resumed their training at the Pelonomi Hospital after it was suspended due to security concerns. News24 reports that the suspension followed two separate incidents involving female doctors – attempted rape and armed robbery. The attempted rape occurred at night on Monday, 3 June, and the armed robbery on Saturday 8 June.

Undergraduate students of the university’s Schools of Clinical Medicine, Nursing and Allied Health Professions are trained at various clinical platforms in Bloemfontein. They train at the Pelonomi Hospital, Universitas Hospital, National Hospital, Mangaung University Community Partnership Programme (MUCPP) and the Free State Psychiatric Complex.

The report quotes Professor Francis Petersen, UFS rector and vice-chancellor, as saying the decision to resume training followed after discussions over security concerns with different stakeholders. This involved the university management, the head of the Free State Health Department, the executive committee of the Pelonomi Hospital and the police.

“Free State Health provided the university with a security plan comprising immediate and medium-term interventions, and a commitment to execute the plan as a matter of urgency. The main concern for the executive management of the university is the safety of its students and staff. We are satisfied with the security plan and the overall interventions committed to by the Department of Health,” said Peter¬sen.

He said the UFS executive committee will monitor the implementation of security interventions with the ma¬nagement of the Pelonomi Hospital and the department. Petersen said the department has furthermore extended its bus service between the clinical platforms in Bloemfontein to students in need of transport at the School of Clinical Medicine from the beginning of the second semester. The transport service will ultimately be extended to undergraduate students in the Schools of Nursing and Allied Health Professions. “We will also look into further transport solutions in the longer term for our students,” said Petersen.

He said in the report that the university’s executive committee also met with undergraduate students in the Schools of Clinical Medicine, Nursing and Allied Health Professions to discuss the situation at the hospital. “Trauma counselling is provided to students and staff and those in need at the Pelonomi Hospital,” he said.

 

The Citizen reports that the university sent out the notice to its students on Saturday, following a week in which a medical intern survived a rape attempt by biting off her assailant’s tongue, and another was robbed at gunpoint on the hospital premises.

On Monday, discussions involving the university management, the head of the Department of Health in the province, the executive committee of the Pelonomi hospital, and Saps took place regarding the security situation at the hospital.

The health department provided the university with a security project plan comprising immediate and medium-term interventions, and a commitment to execute the plan as a matter of urgency, UFS said in a statement.

Interventions in the security project plan include:

the installation of high-mast lights in the precinct of the hospital,
reparation of the perimeter fence, security locks, and limiting access to the hospital and the hospital grounds between 8pm and 6am. A "venue operation centre" made up of Saps officers, institutional security management, and the community policing forum will also be established at the hospital.

“We are satisfied with the security plan and the overall interventions committed to by the department of health and will monitor the implementation of these interventions,” said UFS vice-chancellor professor Francis Petersen.

Prof Petersen also met with undergraduate students in the schools of clinical medicine, nursing, and allied health professions on Monday to discuss the situation at the hospital.

"Trauma counselling is provided to undergraduate students and staff and those in need of counselling at the Pelonomi hospital," said the university.

In addition to the security measures at the hospital, the department will extend its bus service between medical facilities in Bloemfontein to students in need of transport of the school of clinical medicine. This service will later be extended to undergraduate students in the schools of nursing and allied health professions.

Pelonomi is the province’s biggest hospital and is highly dependent on the services of students from the medical school and school of nursing, as well as interns completing their training at the facility.

Spokesperson for Free State Health Mondli Mvambi was earlier quoted as saying they were surprised at the UFS decision to suspend their students’ service to Pelonomi without consulting with the department, as this withdrawal could lead to “panic and crisis”.

The hospital is no stranger to controversy, as a female doctor was raped and assaulted with a brick in 2010 while walking down a dark hallway between sections of the hospital.
Mvambi is quoted in the report as saying that security measures had undergone a massive overhaul since then, but unfortunately “criminals become sophisticated and manage to find loopholes in the security system”.

Mvambi said the victims were both “in good spirits”. “The first doctor wanted to return to work on Friday, but we told her to take it easy and complete her trauma counselling,” he said. “The second one was joking with colleagues yesterday, and said she didn’t think it could happen to her, and that she should have asked for an escort.”

 

Following the armed robbery, the department said it was considering bringing armed guards at all hospitals. “The criminals had guns which now makes us to consider deploying armed tactical response units to our hospitals,” Mvambi is quoted in City Press as saying.

He said because this move has broader security and financial implications, the department would hold consultations with the justice and crime prevention cluster.

The department said in its statement: “We have asked our health workers to ask for security escort into areas of work and the parking areas. We have asked our doctors and health workers not to walk alone but be accompanied all the time.”

During his visit to the hospital last week national Health Minister Zweli Mkhize said the hospital “should be reasonably higher maximum security”.

A 32-year-old man from Bronville has, meanwhile, appeared briefly in the Bloemfontein Magistrate's Court on a charge of attempted rape, Free State police said. According to an IoL report, the case was postponed to 14 Jun for further investigation.

During the incident, the doctor managed to overpower the suspect and bit off a part of his tongue in the process. The suspect then ran away. He was traced and arrested at another local hospital where he went to seek medical treatment and was arrested. He was remanded in custody pending his next court appearance, SAPS said.

The report says earlier, the Health and Other Services Personnel Trade Union of South Africa (Hospersa) and the South African Medical Association (SAMA) condemned the attempted rape of a doctor. Hospersa called for strong action against the alleged perpetrator and for the new Health Minister to urgently address the poor state of safety and security management at public health institutions in the country.

 

At the time of the incident, the doctor was attending to the 32-year-old suspect who was posing as a patient at the hospital, reports News24. Police spokesperson Colonel Thandi Mbambo said: "The suspect fled the scene after the doctor bit his tongue off."

Nearby health institutions were immediately notified to be on the lookout for the suspect in case he visited them seeking medical attention. The report says the police eventually tracked him to the National District Hospital, where he had sought treatment.

It has not yet been established how he had managed to gain entry to the hospital at around midnight. Mvambi said the suspect had first visited the hospital on Saturday posing as a patient. "He pretended to be sick, but the hospital quickly established that he was not. The suspect then showed up at the hospital again on Sunday and security guards noticed that he was behaving strangely." The suspect was then told to return to the hospital on Monday to see social work services, but he didn't show up," said Mvambi.

"Immediate security measures were put in place to make sure that any breaches are swiftly attended to," said Mvambi in the report. "It is by the grace of God that the doctor had the strength to fight back and bite the suspect's tongue off…"

Sama said it was "discouraging" that the safety and security of health-care practitioners in public institutions is an issue which has still not been prioritised by the department of health, especially at this hospital where a similar incident has occurred before."

Dr Angelique Coetzee, chair of Sama is quoted in The Times as saying that Sama was greatly concerned and dismayed at the shocking frequency of assaults on health-care practitioners at public institutions. These assaults threatened the lives and wellbeing of health practitioners and patients. "The safety of all health-care practitioners in our public institutions is of paramount importance and, as such, Sama calls on the minister of health, together with the minister of police, to urgently assess the safety and security at these institutions."

The report says Dr Rhulani Edward Ngwenya, convener of A SAMA task team, requested doctors to e-mail security concerns at their institutions to labour@samedical.org to assist in identifying all institutions which experienced security risks.

 

In 2011, Dr Senzosenkosi Mkhize, a newly qualified doctor, was stabbed to death by a patient in Middelburg Hospital in Mpumalanga. The Times reports that doctors staged marches and a memorial lecture, and the Sama asked the Health Department to improve hospital security to protect staff. But nine years later, a lack of hospital security remains an issue, says Sama member Dr Akhtar Hassain. He said that in 2011, after that incident, the doctors’ organisation asked the government for metal detectors and CCTV cameras at hospitals. It is still waiting.

And in the wake of the attacks at Pelonomi Hospital, Sama asked doctors to e-mail concerns about safety. According to the report, one email said that Pelonomi Hospital’s main gate is often open, security guards don’t watch the gate, and doctors do not feel safe. There had been calls for students and doctors to stop working at night.

Dr Jeremy O'Kennedy, chair of the Registrars Representative Council at the UFS, said the security was so lax, “it was just a matter of time before something happened”. For instance, the keypad at the security gate, where the intern was sleeping when the attempted rape happened, had been broken for seven months. “I can say, a hundred percent for the past two years, I have continuously raised security concerns with officials and the health department.”

He said the main concern was that improvements to the security are maintained.

The report says Free State Health spokesperson Mondli Mvambi confirmed that the security gate leading to where doctors slept was broken and that CCTV cameras were not manned properly. “We are aware that where the attempted rape incident happened, the padlock of the security gate leading to hallway … didn’t work,” he said. “Sometimes security matters fall through the cracks. It is not reluctance on behalf of the health department. It has never been department’s policy not to replace locks.”

He said doctors walking at night and in dark parking lots were supposed to call security guards to accompany them. “Everybody must feel safe. Doctors, nurses, porters, patients – and visitors to the hospital.”

Hassain is quoted in the report as saying the lack of adequate security at hospitals was a widespread problem. “We have been going hospital to hospital and collecting information. So far, each hospital’s safety and security measure is inadequate.”

A Sama task team would visit Pelonomi Hospital to find out what happened.

Intern doctors are vulnerable, said Cassim Lekhoathi, general secretary of the Denosa nursing union. When he worked as the KwaZulu-Natal union’s provincial secretary he frequently heard stories about drunk youngsters threatening nurses if they did not treat their friends before other patients. He said that usually interns were tasked with walking long distances to take blood samples from casualty wards to the laboratory to request matching blood for a transfusion.

Denosa had been complaining for years about the lack of security at clinics and hospitals. “It is broken record,” the report quotes Lekhoathi as saying. Two years ago he had asked the KwaZulu-Natal Health MEC to stop using female security guards at night because they were assaulted by people who jumped over hospital and clinic fences.

Other recent safety breaches at hospitals include: a baby was kidnapped last week at Chris Hani Baragwanath Hospital in Johannesburg, but later found; there was an attempted rape of a social worker at Johannesburg Rahima Moosa Mother and Child Hospital in 2018; a video of a patient abusing a nurse and holding her hostage went viral in December; a child was raped at Port Elizabeth’s Dora Nzinga Hospital in 2017; in April, a community health worker was raped while walking to the community she was going to help; and three doctors were shot when heavily armed men burst into their residence at Letaba Hospital in Limpopo during a 2018 robbery.

The report says Lekhoathi praised the UFS for withdrawing student doctors from training at the hospital. “That is a serious action on the part of the university. Maybe we nurses should think of withdrawing services when incidents happen.” “It is the health department’s duty and responsibility to protect health workers.”

Lekhoathi said they wanted security guards in parking lots, wards and strategic places. “Patients are not safe either. We cannot carry on like that. Nurses go to a workplace with the sole intention to provide a service and we must now look over our shoulders to see who will stab and rape us and all these things.”

According to the report, national health spokesperson Popo Maja said the matter of safety at hospitals remained a priority. “The issue of security at our facilities remains the priority of the ministry of health. The ministry is working closely with the ministry of police to ensure that our staff, patients and members of the public are and feel safe at our facilities,” Maja is quoted in the report as saying.

[link url="https://www.news24.com/SouthAfrica/Local/Express-News/pelonomi-training-resumes-20190611"]News24 report[/link]
[link url="https://citizen.co.za/news/south-africa/health/2141083/ufs-advises-intern-doctors-not-to-report-for-duty-at-dangerous-pelonomi-hospital/"]The Citizen report[/link]
[link url="https://city-press.news24.com/News/doctor-robbed-on-hospital-premises-just-days-after-colleague-was-nearly-raped-20190608"]City Press report[/link]
[link url="https://www.iol.co.za/news/south-africa/free-state/rape-suspect-who-had-his-tongue-bitten-off-by-free-state-doctor-appears-in-court-25550152"]IoL report[/link]
[link url="https://www.news24.com/SouthAfrica/News/doctor-bites-off-tongue-of-patient-who-allegedly-tried-to-rape-her-20190605"]News24 report[/link]
[link url="https://www.dailysun.co.za/News/National/dr-bites-off-would-be-rapists-tongue-20190605"]See also Daily Sun report (picture)[/link]
[link url="https://www.dispatchlive.co.za/news/2019-06-10-its-chaos-doctors-nurses-work-in-fear-of-their-lives/"]The Times report[/link]

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