The RK Khan Hospital board has hit back at what it described as a “surprise, overnight decision” by KwaZulu-Natal Health to redeploy the institution’s CEO, reports The Mercury. The department said that the decision to move RK Khan CEO Dr Prakash Subban was not only because of an incident in which maggots were found in a patient’s mouth, but also because he had allegedly ignored the department’s directives.
The report says Subban is being moved to St Aidan’s Hospital while Nqobile Mkhwanazi, CEO of Queen Nandi Memorial Hospital at Empangeni, will move to RK Khan Hospital. The department said Mkhwanazi would lead a multidisciplinary team that would determine the challenges facing the hospital and develop a turnaround plan within six months.
But, according to the report, the hospital’s board said the decision would not solve the issues the hospital faced which included lack of staff and funding. The RK Khan Hospital board chair, Reverend Cyril Pillay, has since called on the department to rescind its decision on Subban. Pillay said RK Khan Hospital was losing a “stalwart” medical superintendent and “thousands of local and regional patients and staff will testify to the smooth running of the hospital under Dr Subban”.
KwaZulu-Natal Health MEC Nomagugu Simelane-Zulu is quoted in the report as saying a number of interventions the department had tried to implement were ignored by management. “This follows a protracted investigation and directives which were in the past given to hospital management to remedy the challenges but were not acted upon. So, we took a decision that Dr Subban be moved so we can bring in a new CEO with fresh eyes who will be able to actually turn around the institution,” Simelane-Zulu said.
The report says last week the hospital made headlines when a video of a patient, Sadek Ebrahim, with maggots in his mouth, went viral. Ebrahim, who had gangrene, died last week of natural causes. But speaking off the record, a hospital official said Ebrahim was in a “very poor state” when he arrived at the hospital and nurses and doctors “tried their very best with him”. “He also was not in hospital for two weeks as the patient’s family claimed,” the official said.
The report says Ebrahim’s family could not be reached for comment.
Simelane-Zulu said that Mkhwanazi would remain at RK Khan hospital until it was back on a sound footing and then return to Queen Nandi hospital.
The report says the hospital’s board defended Subban, saying that he had been instrumental in maintaining RK Khan as “a leading teaching, training and referral hospital” in Chatsworth for more than 30 years. “Dr Subban led the hospital through the apartheid era and a countless number of patients, nurses, doctors and auxiliary staff will hail his strong leadership skills through difficult and challenging years,” Pillay said. He added that as with all state hospitals, if the correct budget and staff compliment were allocated, “there would have been no negative vibes”. “Dr Subban is the son of the soil at RK Khan Hospital and we ask the MEC of Health to rescind the premature redeployment decision,” Pillay said.
When contacted for comment, Subban said he was unable to comment on the situation or his removal as he was still employed by the department.
The report says after the video of the patient went viral, community activist Visvin Reddy formed the RK Khan action committee, which is demanding that the department provide details of the interventions that were allegedly ignored by hospital management. Reddy said the committee also wanted the hospital board to be dissolved. “We want the MEC to give us an undertaking that most, if not all, vacant posts will be filled at the hospital. All the department is doing right now is changing the driver of a broken bus. The bus needs to be fixed,” Reddy said.
Speaking on the turnaround strategy for RK Khan Hospital, Simelane-Zulu said in the report that the new project team headed by Mkhwanazi had been organised into five work streams including: General hospital administration; clinical services; supply chain management; patient flows and work process in outpatient departments; infrastructure maintenance; and quality assurance, infection prevention and control.
“Despite financial constraints, the department remains committed to improving the quality of care at RKKhan Hospital as well as all other health facilities across the province,” Simelane- Zulu said.
Medics, staff and others aligned to RK Khan Hospital believe Subban is the casualty, says a Sunday Tribune report. Subban’s supporters claimed he was pivotal in ensuring health care became a reality at the hospital, in spite of not receiving adequate support and resources from the Health Department. In spite of the challenges, the hospital achieved various service excellence awards during his more than 20 years as head of the hospital.
Yet, Subban had to shoulder the blame when patient Sadek Ebrahim was found with maggots wriggling under his upper lip, his backers claimed.
The report says since Ebrahim’s death, the SA Nursing Council, the Health Department’s Special Investigations Unit and the SA Human Rights Commission have all conducted investigations.
A source at the hospital, who asked not to be named, said: “Removing Dr Subban from the hospital is just a ruse. It has been done deliberately to take the attention away from the Health Department.” The source said the only intervention that was required in recent times was the vervet monkey problem at the hospital. “Sonic deterrents were installed, which significantly reduced the monkey problem, but the hospital had to pay R270 000 for the relief from its own annual budget.”
According to the informant, constant water leaks, faulty air conditioning systems in wards and theatres and the shortage of staff and resources are the challenges that Subban and his team had to contend with on a daily basis. And their call largely ignored.
“Often nurses and the medical staff would be overwhelmed by the high volume of patients that required treatment at the hospital, but Dr Subban was able to motivate them to keep going for the sake of the patients.”
The report says when Subban made a brief appearance at the hospital on Thursday of last week, a long line of staff queued for the opportunity to commiserate. Former long-standing hospital board member Marlan Padayachee, who was present, said he was there on a fact-finding mission after the recent maggots debacle. “The decision to redeploy Dr Subban smacks of unfairness and injustice. “He was made a political scapegoat. “The turnaround strategy will not work if the hospital continues to battle low staff morale, crumbling infrastructure and forever shrinking budgets,” he said.
Padayachee said in the report that under Subban’s watch the hospital received numerous accolades. They include the Premier’s Service Excellence Award, a gold award from the Centre for Public Service Innovation in December for the audiology work done at the hospital. The African Ministers of Public Service Gold Award the hospital received in 2013 for its Centralised Chronic Medicine Dispensing and Distribution programme was its highest honour, according to Padayachee.
“That programme services 28,000 patients with chronic medication every month and it has since been rolled out by the Department of Health throughout the country and in some southern African countries,” he said is quoted in the report as saying.
The Mercury report Sunday Tribune report (subscription needed)