South African Hospital Faces Overcrowding, Staffing Shortage with ‘Flood’ of AIDS Patients
Officials at Chris Hani Baragwanath Hospital in Soweto, South Africa -- the largest hospital in Africa with 3,300 beds -- say the facility is "overwhelmed" with a "flood" of AIDS patients and lacks the beds and staff to accomodate the numbers admitted each day, the Wall Street Journal reports. The institution is the main teaching hospital for the University of the Witwatersrand, the "Harvard of South Africa," is staffed with "highly trained and fiercely committed" physicians and "pride[s] itself on never turning away a patient." But admissions have increased nearly 40% in the past five years without subsequent increases in beds or staff, leading to a higher rate of inpatient mortality. Hospital statistics show that when 43 patients are admitted per day, an average of 8% die during their stays, but when 120 patients are admitted more than 10% die. In 2001, the hospital has averaged 108 admissions per weekday. Nurses, working at more than 35% below allocated staff levels, can no longer provide daily basic services for each patient and their "morale has sagged." In addition, exhaustion and overwork has led to a "shocking" rate of needlestick injuries -- 69% among interns.
Prof. Ken Huddle, head of the department of medicine at the hospital, said that with such a high admission rate and overworked staff, "We can no longer go on like this." He said the current crisis "cries out for a national plan," adding that he would like a plan that would allow the hospital to reroute patients to other hospitals when the facility reaches its capacity. Hospital staff say that the problem is as much the result of "poor government policy toward AIDS as it is by the disease itself," criticizing the government for stalling on providing antiretroviral drugs to patients as other African nations construct plans to distribute the medicines. Following a "desperate" letter sent by Huddle to the hospital's CEO last month, the heads of Johannesburg's three major hospitals met to plan a strategy in response to the "swelling avalanche" of AIDS patients at their sites and this week met with Laetitia Rispel, head of the health department of Gauteng Province. Rispel said that Baragwanath "bears some responsibility for its crisis," noting that senior physicians have conceded that not all patients require hospitalization and recommending "better use of the existing referral network" (Schoofs, Wall Street Journal, 8/16).