Healthcare workers struggle to cope in Mpumalanga, where a spike in Covid-19 infections and a shortage of beds in public and private hospitals have put clinic and hospital staff under immense pressure. Like those in other provinces trying to manage the second wave of the pandemic, healthcare workers are battling fatigue, a death of staff; many have died of the virus or are in quarantine, inadequate personal protective equipment (PPE) and financial woes brought on by a freeze on salary increases in 2019 and a lack of danger pay.
According to nursing unions and healthcare personnel, the workers hardest hit by Covid-19 are nurses and other essential support staff in the frontline healthcare sector, especially in clinics.
“They say I must wear an apron and a mask, but I don’t know if the patients I am attending are positive or negative. When you transfer them to the hospital, they test positive. As the first contact person, was I protected?” said one of the nurses at Beatty Clinic in Emalahleni.
Unlike workers in hospitals who are somewhat resourced with protective gear, most nurses and support staff in clinics do not have proper PPE, despite attending patients with unknown Covid-19 results. At Beatty Clinic, the nurse explains that they see between 150 and 200 patients a day. There are seven nurses at the clinic. Two are on leave and one is dedicated to attending patients with Covid-19 symptoms. The nurse said they attend to around 15 people with Covid-19 symptoms a day.
Three auxiliary nurses are responsible for checking vital signs such as blood pressure and temperature. Currently, one of them is on leave. Auxiliary nurses are often only given non-medical masks and sometimes disposable aprons and face shields.
“[Recently], there were 11 patients presenting with Covid-19 signs, and last week, it was more than nine. We are not safe in Mpumalanga, and people are dying. What makes us a hotspot are the mines. People come from different parts of the country and most of them are working in the mines,” said the nurse.
The nurse also added that Covid-19 infections are rampant among cleaners and administrators, who are also essential staff in the healthcare sector but are often forgotten.
“In a clinic set-up, cleaners are only given masks, yet in hospitals they receive full PPE. We need PPE that [is] worn at the hospital to be given to cleaners, admin staff and auxiliary and professional nurses, as we are highly exposed,” explains the nurse.
About 3km from Beatty Clinic is the Witbank Provincial Hospital, which admits patients from at least 14 hospitals around Mpumalanga, mainly from the Gert Sibande and Nkangala districts. At one of the hospital’s wards, a senior staff member concurs with the nurse at Beatty Clinic that healthcare personnel and support staff in clinics face precarious working conditions.
“We deal with the same patients, but the standards are not the same. Especially at primary care they lack a lot of PPE. Cleaners are the most affected people. Even from the president you can hear he says doctors and nurses, but frontline workers are more than this. We don’t think of the food service staff, the porters and more … Many porters and cleaners … have died,” said the staff member.
“I have lost count of the workers who have either been infected by the virus or have died from it. So many, many, many, many and some of them are in quarantine. These people have children, and they are our mothers and fathers,” she added.
Staff at the Witbank Provincial Hospital are relatively well equipped with personal protective gear compared to clinics, but they are still battling to manage the influx of patients.
“[The] Covid-19 wards are full. We are scared but we are used to it. It is like [being] a soldier who is at war,” explains the senior staff member. “[Recently], we had a meeting as workers to explain why our government does not take care [of] us. They keep saying we are heroes, but there is nothing to show for it. The government has failed us.”
“Clinics are no longer referring patients to the hospital. Instead, patients just come presenting with the symptoms … This thing of staff [shortages] is killing us. More than 10 staff [members] a week go to quarantine. There was a time around January when doctors were in quarantine and we had to ask just any doctor to assist. We are really experiencing the second wave,” said the staff member.
The Mpumalanga secretary of the Democratic Nursing Organisation of South Africa (Denosa), Mzwandile Shongwe, says they are losing many colleagues to Covid-19 and need somehow to fill the vacant positions.
“We want the government to absorb nurses and doctors. We have a lot of healthcare workers [who] are not employed and the government must ensure that those people come back. This issue with [the Treasury] that there is no money, that is not our baby,” said Shongwe.