Volume10, No.2 - March 2001

We're part of the union

Life in hospital

A day in the life of Victoria Hospital

By Althea MacQueen, Today is the 8th of January and I am still is hospital, one of the patients that have been here the longest. In this ward I have seen patients come and go. Some come in with two legs and then leave with one. It is traumatic to loose a limb, but the patients are consoled that the intense pain of the bad leg is gone.

Other patients are elderly women in their 80s or 90s who have fallen and broken their bones. They, like me, need surgery to be repaired. I am the youngest patient in this ward but the most immobile. Both my legs have been operated on. I have been bedridden for four weeks. Fortunately, my hospital bill will be less than R100 because I'm unemployed, like many other patients.

I am in Victorian Hospital in Wynberg, Cape Town. Compared to what I have heard on television about the state of public health care, this hospital is not bad. Doctors do their daily rounds to patients every morning. The hospital is kept spotlessly clean. There are porters to assist patients who are immobile. The bed sheets are changed regularly.

Breakfast, lunch, and a light supper are served everyday and next to your bed you have your bottle of drinking water.

The nurses are friendly but curt. They are stressed out because of the workload. They complain about the abnormal 12-hour working day and low pay. Most of them are permanent nurses but fear that with further budget cuts, some might loose jobs.

The hospital also uses agency nurses (casual) at times. The agency nurses complain about the work insecurity, the commission they are obliged to pay the employment agencies and lack of pension/provident fund or medical aid. One nurse has plans to emigrate to England to explore greener pastures.

There is a feeling of insecurity amongst the hospital staff about the future of their workplace and conditions of work. This affects the morale of the staff and their attitude towards patients.

Convalescing

I have been to another public hospital to convalesce. This means another four weeks in bed - but three days in this ward is enough for me. I want to convalesce at home. Why? The other patients in this ward are psychiatric patients.

ll of them are on pink tablets three times a day and half of them are on nappies. Can it be that I have been "committed" - institutionalised? Will I be staying here for the rest of my life?

The food is not edible, the television is on full volume the whole day and there is no communications among patients. The old woman next to me grabs my pillow and sheets. When I try to reason with her, she swears at me. Opposite, another women cry bitterly for her family. The nurse on duty tells her to be quiet but this only makes her louder. The staff at this hospital is more stressed out and overworked than those at Victoria Hospital. Patients do not pay hospital fees at this hospital - the service is provided for free.

Other Stakeholders: NGOs and the Private Sector

After three days I move into another convalescent home run by a non- governmental organization. Here the cost is R100 per day per room with three meals and two teas. Although my family can afford it, it is still far beyond reach for others. Nurses who are skilled in home care work take a good care of me. Some are students attending the Home Care Training course offered by the NGOs.

Public hospitals can no longer afford to take care of patients who are terminally ill or need to convalesce for longer periods. Many are sent home to their families who do not have the training, time and patience to take good care of their sick relatives.

There are non-governmental organizations (NGO) trying to address this by training people to become home care workers. This is good, but it is not the same as being taken care of in a public hospital by trained professional nurses that still believe in the ideals of Florence Nightingale.

There is of course, the option of convalescing in one of the popular private hospitals. But this is only possible if you are on medical aid or if you can afford to pay R700 to R1000 cash a day. You still have to pay separately for the services of a medical doctor. Although many people are on medical aid, many are complaining about the escalating costs. The focus of private medical care is more on being a profitable investment than of taking care of the sick. Will this profiteering will continue for ever?

The health sector is becoming more and more deregulated, flexible and diverse. What effect does this have on health sector workers' conditions and on the training courses that are offered? Is this not affecting the quality of services?

Taking care of the sick is still the focus of the public hospitals. It is an essential service delivered by the state. The poor, unemployed and particularly the aged benefit greatly from the service. More pressure should be put on public hospitals as more people become ill from Aids-related diseases.

Ensuring that our country has a good public health system that delivers a quality service is obviously not only a necessity but an investment that can only give good returns.