At Dora Nginza Hospital in Gqeberha, South Africa, 38 doctors from the obstetrics and gynecology department signed a letter describing working conditions as an unacceptable risk to mothers and newborns, Daily Maverick reports. Ten days before the letter was signed, a 28-year-old woman suffered a hemorrhage after giving birth, went into cardiac arrest, was resuscitated, but died later that evening.
The doctors said infrastructure failures complicated the resuscitation of the critically ill patient because necessary equipment could not be used due to the lack of functioning electrical outlets. In their view, this led to the maternal death. The Eastern Cape Department of Health disagreed with this assessment and said an internal investigation found no causal link between the woman’s death and power supply disruptions.
Faulty equipment and cancelled operations
The doctors reported regular cancellations of scheduled caesarean sections and gynecological operations, including oncology and urology procedures. According to them, patients with gynecological cancers returned with inoperable forms of the disease after their operations had been postponed repeatedly.
The medical staff also reported malfunctions in operating theatres and the maternity unit that made infusion pumps, cardiotocographs, incubators, ventilators and resuscitation equipment unreliable or unusable. An internal case review seen by the publication states that a manual resuscitator did not work during the resuscitation, while an ambulance crew provided a defibrillator, a resuscitator and electrocardiogram pads.
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The following day, a clinician recorded faulty outlets and a defibrillator, an empty oxygen cylinder, and the absence of working monitors, a ventilator and other resuscitation equipment. According to the doctors, for about six weeks an extension cord had been run from a common area to one of the maternity wards to enable the resuscitation and warming of newborns.
Health department’s position
The department said the hospital had already been designated for special intervention, and a task force was established for the Nelson Mandela Bay district in June. The agency reported replacing 122 standard and 116 red outlets in neonatal and maternity units, as well as completing repairs to medical gas systems on July 27.
The department also reported appointing healthcare workers and plans to convert Empilweni Hospital into a district hospital to reduce pressure on Dora Nginza and Livingstone hospitals. At the same time, the doctors consider the staffing reinforcements insufficient. They noted that because of a shortage of nurses, three of four operating theatres can usually function, while on some days only two can operate.
The Health Ombud’s Office registered a complaint on July 15 under number 70385 and is determining the scope of a possible investigation. According to the office, depending on the complexity, the review may take up to 24 months.
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