Thursday, May 17, 2012

Cecilia Makiwane Hospital - an example of unhealthy public healthcare


I live in Buffalo City in the Eastern Cape. In Buffalo City we have two large public hospitals. Frere Hospital and  Cecilia Makiwane Hospital. Recently a couple of friends and co-workers have had to use Cecilia Makiwane Hospital and I would like to write about their experiences and use these experiences as examples of how badly the ANC manages public health care in the Eastern Cape.

Before you think I am some right wing crusader, I would like to make it crystal clear that I am a bleeding heart liberal and I am certainly not against public health care. I am actually a huge proponent of it. However, I am a realist and I understand that public health care is very difficult to manage and if not managed correctly it leads to disaster. Like in the case of Cecilia Makiwane Hospital.

The Administration and Management of Cecilia Makiwane Hospital

The first thing you will notice when you walk into Cecilia Makiwane Hospital is that there is very little organization. It appears that the last thing on the minds of upper management at Cecilia Makiwane Hospital is the idea of having a competent and functional administration.

As you walk in you notice giant plasma screens everywhere (that in the 5 times I have been to Cecilia Makiwane Hospital... have never been switched on. Guess someone scored in a useless tender there). The next thing you notice are the hundreds of people aimlessly milling around and waiting for service.

There is no order in this waiting. No lines, no cues, no one managing all the sick people coming in. You basically have to work your way to the front of the cue and hope that you are at the right cubicle. If you are lucky enough to have chosen the right cubicle you then have to pray to your creator that the person on the other side of the glass is willing to help you. From my personal experience, about three quarters of the time you are ignored as the administration clerk behind the window finds some excuse as to why he or she does not need to work.

When you finally do find someone to assist you it is almost always with an attitude and the perception you get is that you should be grateful that the clerk even bothered to acknowledge you exist.

Its really frustrating standing there. Waiting for several hours, only to watch lazy administration clerks idly chatting to each other while drinking coffee and ignoring all the people that are in urgent need of assistance.

The Dermatologist

The dermatologist working at Cecilia Makiwane Hospital is perhaps one of the least qualified humans to be working in health care that I have EVER come across. A female friend of mine was worried about a mole on her back and went to visit the dermatologist (there are very few dermatologists in Buffalo City). The dermatologist at Cecilia Makiwane Hospital is an elderly lady by the name of Dr Le Grange.

Anyways, my friend goes and asks her about her mole, and to ask  Dr Le Grange the best method of dealing with it.  It is alleged that Dr Le Grange looked at my friend as though she is crazy and tells her there is nothing about moles she needs to worry about, and that the best thing she could do for herself was to go lie in the sun without sunblock.

My friend has a fair complexion and was a little worried about this advice as she was always told that going out into the sun without protection was actually bad for your skin. After voicing this to the dermatologist she was met with a rather surprising response from  Dr Le Grange is alleged to have instantly responded with, "Don’t believe that. You do not need sunblock. Sunblock is a scam run by the sunblock people to make more money, the sun does not cause skin cancer" and, "skin cancer is not that bad, all your ancestors had it".

Another story involves a family member that went to see  Dr Le Grange. My sister (due to the lack of dermatologists in Buffalo City) went to see  Dr Le Grange. She got some shocking advice. She was told that moisturizers and facial cleaners were useless and then she was prescribed some medication. When she went to the pharmacy to get the medication that  Dr Le Grange has prescribed she was told that the medication was out of stock as  Dr Le Grange had been prescribing the same medication to everyone of her patients that day!

The last story I want to share about the infamous  Dr Le Grange involves another doctor who works at Cecilia Makiwane Hospital with her. It is alleged that this doctor got an infection underneath one of her nails and went to see  Dr Le Grange. She was then allegedly informed by  Dr Le Grange that she refuses to treat the infection as the patient that came to see her had long nails with nail polish on.  Dr Le Grange refused to treat her claiming, "I do not treat dolled up patients".

This is probably the first doctor that I have met that believed in big pharma conspiracy theories while punting an anti-science and anti-medicine world view.

If our public health care was run like the most successful western public health care systems, Dr Le Grange would have been fired and sued a long time ago for malpractice. It is only the incompetence of the administration Cecilia Makiwane Hospital and the lack of quality oversight that allows Dr Le Grange to continue peddling her unscientific quackery.

The Pharmacy

The pharmacy at Cecilia Makiwane Hospital I have heard many stories about. Just today I heard a story about a pharmacy assistant in the pharmacy that is so careless... she regularly almost kills patients. The examples I heard of today were pretty hair raising. Both the incidents I am about to describe happened on the same day. Both incidents happened because of the same incompetent pharmacy assistant and the lack of competent oversight of the pharmacy assistant by the pharmacy management.

In the one case, a young child came in for some medication to treat his ADHD. The child was instead given very powerful anti-psychotic medication designed to be given to fully grown adults with intense paranoid schizophrenia. Needless to say, there were some undesired side-effects and the distraught parent brought her “zombiefied”child back a few days later for the correct medication. In the other case, a patient looking to get their prescription of muscle relaxants was given strong anti-diabetic pills!

The last thing I want to speak about with the pharmacy at Cecilia Makiwane Hospital is the high levels of theft. It is an open secret that the expensive medication there is being robbed blind. That medication is designated for the poorest and weakest of our society, yet some criminal elements within Cecilia Makiwane Hospital, feel that it is their right to steal from the weak and poor. Apparently the medication that has gone missing there amounts to "millions of rands worth".

Many years ago an elderly gentleman tried to address the theft and took the issue to his superiors and complained. That night he was visited by six men in the middle of the night at his home. All six men had giant knives known as "pangas".The poor old man had one of these blades placed against his throat and was warned that if he continued to investigate the matter he would be killed. Needless to say, to protect his own life, he stopped.

The staff transport

While on one of my long waits at Cecilia Makiwane Hospital I sat there chatting to a staff member who was telling me about their staff transport woes. Most of the staff who work at Cecilia Makiwane Hospital live in Buffalo City. Since Cecilia Makiwane Hospital is a little out of town, there is a transport system to assist them getting from Frere Hospital to Cecilia Makiwane Hospital.

The staff are meant to be fetched at 7:15AM to be at Cecilia Makiwane Hospital by 7:45AM. In reality this translates to the staff being fetched closer to 8:15AM and only arriving at Cecilia Makiwane Hospital at 8:45AM.

The transport for the staff often comes in the form of an unroadworthy minivan. So unroadworthy that on several occasions, the staff transport has been pulled over by local law enforcement authorities and impounded. Leaving the staff to have to walk 15KMs to work.

When the staff vehicle is not being impounded the staff have to put up with reckless drivers that often hit speeds of "180 km's per hour". You can imagine how terrifying this must be, doing those types of illegal speeds in an unroadworthy vehicle with an incompetent, careless driver


The underlying problem here is the complete lack of competent administration staff and a complete lack of oversight. Bad staff can basically get away with anything as it’s near impossible to fire someone in the government health system, and the unqualified ANC cadre deployed administration means that you have a hospital administration that lacks both the compassion and skills to be running a complex entity such as a public health care centre.

Complete reform of the Cecilia Makiwane Hospital administration needs to happen. Someone needs to go into Cecilia Makiwane Hospital with a big stick and remove all the rotten and corrupt apples. The remaining administration needs to go for management training lessons. Until they do, Cecilia Makiwane Hospital will always be known as the "baby killer hospital".

1 comment:

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