The doctor and nurse to patient ratio is becoming “more and more ridiculous” as Covid-19 cases mount.
By Amanda Maliba and Tshepiso Tshabalala
THE COUNTRY’S hospitals are bursting at the seams as the third wave of Covid-19 infections takes hold. In addition to the shortage of beds and medical supplies, there is also the age-old chronic scarcity of health care workers.
Just last week, 288 eligible medical graduates from across the country were said to have been in need of placements to undergo training as part of their academic programme. Only 133 interns of those were placed this past Thursday, leaving 155 graduates still waiting for placement.
According to the South African Medical Association’s board chairperson, Dr Angelique Coetzee, even with the 288 placements, there is still a huge gap that needs to be filled.
“There is definitely a skills shortage in South Africa. If you look at the World Health Organization’s doctor per patient ratio, we are so far behind, which is the first problem.
“The second problem is that, we need these intern doctors to run our clinics to ensure that people visit the clinics and are treated at the clinic level where there is a huge shortage, leaving the more experienced professionals to treat Covid-19 patients in ICU,” said Coetzee.
She noted that with the many challenges faced on home soil, now compounded by the pandemic, long working hours and the lack of PPE, more and more health care professionals are prompted to seek greener pastures elsewhere in the world.
Like Dr Freddy Nkosi from George Mukhari Academic Hospital, who says the last couple of years of being a doctor in South Africa has been nothing short of passion draining.
The 37-year-old doctor, who has been practising medicine for nine years, said the pandemic has not only exposed what has been stewing for many years, but it has left him demotivated, scared and physically depleted.
“I honestly didn’t expect my career to be so daunting. When I chose to be a doctor, I knew that I was going into a profession where I had a job waiting for me, an assurance that many people don’t have. During my studies, various professionals would come to talk to us, and that intensified the excitement until I started working. We are overworked and underpaid, with the job eating away into my weekends. The sacrifices that my body takes versus what I’m earning does not justify it,” said Nkosi.
The doctor, who said he would soon be leaving the country, explained that the situation is so dire at the hospital that nurses would be stretched to see three times more than their required patients, and if a nurse falls ill those that remain must further divide themselves to cover the patients.
“The one awful memory I can think of is a situation where one of the Covid wards was so full of patients, and the number of nurses to patients was smaller. The issue of lack of PPE is another thing that we are struggling with. Before Covid-19 even hit South Africa, we were already struggling with personal protective gear. When you look at China’s PPE distribution, health care professionals there are supplied with layers upon layers.
“Here, you get an N95 mask that was at some point disapproved by the FDA or are given a scrub top as PPE,” he said, adding that because of the influx of patients caused by the pandemic, when one health professional tests positive for Covid-19 or dies there is no replacement for them, and that leaves a gaping hole in the system.
Tumelo Ndou (not her real name) from Helen Joseph said being a nurse is strenuous and has started affecting her health.
“Patient nurse ratio is ridiculous as there are more patients, even more so because of Covid-19, and there are fewer nurses. This is definitely an age-old problem because there have been people who are resigning and others dying, and they are not replaced because we are told there are no funded posts. So there was that gap.
“Then Covid came and made the situation worse, and the gap has gone bigger. There were people who were employed, but those appointments didn’t do much to the continuously growing gap.
“Staff members are getting sick from Covid-19 and some are dying, leaving maybe four staff members in a unit where there are supposed to be nine staff members. It is a mess,” said the visibly exhausted nurse.
The 30-year-old nurse said she chose the profession out of the love of serving people.
“Now, I just don’t know. As we speak, in my unit I work with two other nurses and we must see 32 patients and that hinders quality nursing care.
“There used to be a course dubbed D4, which offered general nursing, midwifery, psychiatry and community nursing training – that course used to allow for the training of more nurses, but that has been phased out, which creates a decrease in the induction of new nurses,” she added.
Coetzee reckons that the shortage of health care workers should be prioritised, adding that the issue should have been addressed many moons ago.
“We need to stop corruption and all these tenderpreneurs. We need to question the millions of rand spent on Cuban doctors, the dodgy PPE tenders, and many more.
“Surely, after we redress these issues, there should be more than enough money available to pay these people’s salaries and get doctors employed to come to serve in the hospitals,” she said.
National Department of Health spokesperson Popo Maja said there were many layers to the placement of graduates.
“This will not entirely address the shortage of health care workers. The shortage of healthcare professionals is not new, and there are many contributing factors including shrinking budgets to fund additional posts, on the other hand,some professionals leave the country for better salary packages abroad.”