"The situation at Eastern Cape hospitals is depressing."

That is how Deputy Public Protector Advocate Kholeka Gcaleka has said, describing conditions in the province's overwhelmed public hospitals following a two-day visit.

Gcaleka, her team of investigators and chief operations officer Charles Mohlaba, were in the province to investigate disturbing reports of shocking conditions at the public health facilities.

Following the last leg of her visit, Gcaleka told News24 that Mthatha General Hospital, which functions as a district and regional facility, was underresourced.

She said management complained that the provincial health department gave more support to the neighbouring Nelson Mandela Academic Hospital.

Gcaleka said there was leadership instability at the hospital, with many senior positions left vacant. "A lot of people in senior positions are acting, there are no permanent appointments."

She described how patients went for days, sleeping on beds with stained linen or without it as the laundry facility was overwhelmed.

"Their laundry facility has a critical shortage of workers, so they don't return the clean laundry back on time. The nurses told me that they believed the unhygienic linen was part of the reasons why they saw a spike in cross infection amongst nurses. The bedding has fluids. Some beds don't have linen."

She said there were no community-based health programmes done by the hospital because the facility did not have a vehicle. "There is a serious shortage of fleet."

Nessie Knight district hospital in Qumbu, outside Mthatha, was built in 1923 and was also "not conducive".

"That place is not conducive to offer health care services," said Gcaleka.

She said there was only one bed for the isolation of Covid-19 patients. The hospital serves large parts of Qumbu, but can only admit 80 patients. She said this created a burden for neighbouring hospitals.

"The staff are doing their best despite critical shortage of personnel," noted Gcaleka.

"The hospital transfers too many patients to neighbouring hospitals which is in Tsolo, 60km away, and Mqanduli which is like 100km."

She said the hospital's laundry was also taken to the neighbouring hospitals, because its machine had broken down as it was too old.

'Safety hazard'

There were also no X-rays done at the hospital and patients with broken bones had to be driven for 60km to 100km to the nearest hospital. 

Gcaleka also expressed satisfaction with a construction of new wards taking place at the hospital. "There is construction work done. The project is expected to be completed in two months. A previous contractor had abandoned the hospital in 2018 and left it in a mess, with exposed wiring which posed a safety hazard."

Advocate Gcaleka expressed satisfaction with newly-built state-of-the-art residences for clinical staff. She said this project was meant to be finished earlier this year, but was delayed by lockdown.

"The hospital management and workers were very forthcoming with their problems and they told me the challenges of resources at the hospital was partly because the government gives more focus on the Nelson Mandela Academic Hospital.

Dysfunctional laundry services

"Human resources and financial resources are very limited at Mthatha General which makes it difficult for them to perform well or render quality service. The Covid-19 pandemic has magnified their challenges, but they commended the military health workers for their support," said Gcaleka.

Gcaleka said the management believed that military health workers had dealt with the novel coronavirus due to skill and an excellent work ethic.

"They informed me that the soldiers can work for five to six hours without taking a break and were excellent in their jobs which really gave the hospital a huge relief."

Gcaleka started her tour of the Eastern Cape hospitals on Tuesday in Uitenhage and Port Elizabeth, before concluding it at Mthatha General and Nessie Knight.

She said the common problem at the hospitals was a high vacancy rate, small wards, leadership instability and dysfunctional laundry services.

Eastern Cape Department of Health spokesperson Siyanda Manana promised to respond at a later stage. His comment will be added once received.