In 2017, an assessment commissioned by the Tambo Memorial Hospital in Boksburg, Gauteng, reportedly found the building was “unfit for human habitation” and “an occupational hazard”, and yet, five years later, patients and healthcare workers at the hospital are continuing to receive and provide health services under unusually difficult conditions, writes Thabo Molelekwa for Spotlight.
DA MP Haseena Ismail said during an oversight visit this year she found that conditions had not improved since the initial assessment report – which has not yet been published.
A putrid 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 says there is no money 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 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 that conditions are bad but there is nothing they can do except wait for the Health Department to fix or build a new hospital. “This hospital is very old… the building needs to be maintained or replaced,” the nurse said.
“We work under stressful conditions. The sewage is another problem. As you can see, I’m wearing my mask because of the smell.” She said healthcare workers work in fear because of the decaying infrastructure.
Opened in 1905, the hospital is 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 outpatient said she had arrived at the hospital at 6am and was still waiting for her mother’s medication at 2.15pm amid the stench hanging over the dispensary, the casualty unit, and the main entrance at the admission block.
She said when the emergency door opens at the dispensary on a hot day the sewage smell is unbearable. “That dispensary is always full. You queue for a long time while with that smell. It is horrible.”
The waiting area was filled with patients during Spotlight’s visit – many looking visibly frustrated. Due to renovations in one area, the floors were covered in dust and some patients had to negotiate dimly-lit corridors.
An ongoing struggle
Monwabisi Mbasa, Gauteng chairperson of the Treatment Action Campaign (TAC), said 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 living in Boksburg, Benoni, Kempton Park, and Germiston, are being grossly undermined and their lives are subjected to hazardous conditions,” he said.
Mbasa said the hospital was “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 patients’ and the employees’ lives are in perpetual danger.”
He acknowledged there had been periodic maintenance, but said it doesn’t change the fact that the hospital is unsafe. “TAC rejects with contempt the patch-up jobs, trivial renovations, and alterations. The hospital,” he said, “remains a threat to human beings and it’s a violation of human rights.”
Several parties concerned
DA health spokesperson in Gauteng Jack Bloom said the sad reality was that there was 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 attempt to 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) has also raised concerns.
SAMA chairperson Dr Mvuyisi Mzukwa told Spotlight the organisation was worried about infrastructure at Tambo Memorial and other public health facilities. He said poor infrastructure posed a great danger to the safety of staff and patients.
“The quality of infrastructure at the Tambo Memorial Hospital and all other hospitals in the country is important. 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 doctors and other healthcare professionals who eventually have to self-sacrifice by working in sub-optimal conditions to save lives,” Mzukwa said.
After complaints, the Office of Health Standards Compliance (OHSC) inspected the facility in 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 before issuing and finalising the report.”
Department: Work is under way
After the oversight visit, in July Ismail asked Health Minister Dr Joe Phaahla why the building was still being used, given that it had been deemed unfit, and what the plans were to replace it. In response, he said the province “is aware of the bad infrastructural conditions …”
“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, after the peer review meetings of July 2016, it was decided the Tambo Memorial Hospital would now be a single 600-bed regional hospital, but no site was available.”
According to Motaletale Modiba, Gauteng Health spokesperson, the communities of Boksburg and the surrounding areas were resistant to moving the hospital during the previous public participation engagements. “There is therefore a need to continue using it while working out alternatives. The continued use of the 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 local government.”
Modiba said that the facility’s refurbishment and occupational health and safety programme was meant to address concerns over unsafe infrastructure. He said there are plans to build a new orthopaedic section, as parts of the hospital built with asbestos were being decommissioned.
Modiba also confirmed that the maintenance projects included 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 was ongoing, as was fitting vinyl flooring in the corridors, and the replacement of vandalised toilet taps and seats. The department was also installing CCTV cameras and putting burglar guards on doors and windows.
He said the current cost estimate to build a new hospital is more than R5bn, for but there is no budget. “The department is seeking alternate funding,” he said, but 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. He said R40m has been allocated under the Provincial Equitable Share funding for some major refurbishments at the facility and maintenance and repair projects are under way. In this financial year (2022/23), R13m has been allocated for maintenance at the hospital, Phaahla added.
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