HEALTH workers at one of the Western Cape’s busiest hospitals have to manually pump oxygen for ICU patients when load shedding strikes.
This is but one of the challenges raised by public hospital managers and staff who cautioned that not being exempt from Eskom’s crippling power cuts could mean the difference between life and death.
The CEO of Khayelitsha Hospital, David Binza, said even though the hospital had a generator on site, the lag time before it switched on meant staff had to scramble to assist critical patients.
“Patients who are on ventilators and anaesthesia need to be treated manually,” he said, adding that they now need to get their ventilation from an ambu bag that a nurse or doctor will have to pump by hand.
“At present, (the generator) covers critical areas like the nursery, patient wards, theatre and some offices … once the electricity goes out, it takes between one and three minutes for the generator to kick in, halting (electricity) for that duration.
Binza noted that those few minutes were life-threatening.
“Thankfully, we have had no lives lost due to the manual interventions. However, it causes unnecessary panic.”
The hospital’s 14 000-litre generator burns through 2 000 litres of diesel during two-and-a-half hours of load shedding.
Should the hospital endure two such cycles a day, it costs roughly R104 000.
Cape Town-based emergency medical officer David Goldsack, who used to rotate between three public health facilities in Gugulethu, Delft and Mitchells Plain, said at times procedures had to be halted to wait for generators.
“We have to stop what we’re doing and wait for the generator to kick in. There have been times we’ve run out of diesel, which makes it even more disruptive,” he said.
“Sometimes you are standing with a needle halfway through someone’s skin or incubating someone and the next second, absolute darkness.
“We are always under pressure and it affects morale.”
A staff member at the Mitchells Plain District, who asked to not be named, said it was worrying that a facility that caters to crime-riddled and poor communities was not spared from power cuts.
“Before load shedding, there is a broadcast to switch off all computers and because our hospital works on diesel, you have to wait up to 30 minutes at times for everything to be fully operational,” she said.
“Load shedding caused our heating system to break. There is no hot water so patients cannot be bathed.”
The acting provincial secretary for the Democratic Nursing Organisation of SA (Denosa), Jaco van Heerden, said the safety of nurses was also a concern.
He said there was fear among the nurses who work 12 hours and often had to travel to and from work in pitch darkness.
“We have seen patients argue with staff, which has turned violent on certain occasions. Load shedding has inflamed this.
“Those moments (waiting for a generator) pose a big risk but I believe that contingencies are in place to alleviate this.
“Additionally, the water supply gets interrupted which has no generators,” he added.
Western Cape Health MEC Nomafrench Mbombo said the province had spent roughly R53.2 million since April on fuel, oil and medical gas to keep healthcare facilities running during load shedding.
On Friday, Health Minister Joe Phaala called on provinces to provide a list of hospitals that they wanted exempt from load shedding.
Mbombo listed 19 hospitals in the province that required the exemption. These included Khayelitsha, Mitchells Plain, Mowbray Maternity, George and Beaufort West.
“Most energy-consuming equipment, like X-ray, nuclear medicine, radio therapy equipment, and clinical equipment used in theatres ICUs and emergency centres are affected by load shedding,” said Mbombo.
Provincial health spokesperson Mark van der Heever said load shedding placed equipment at risk of damage and it exacerbated the existing backlog in elective surgeries.
The head of Internal Medicine at Charlotte Maxeke Hospital in Johannesburg, Professor Adam Mohamed, launched a petition calling on the government to exempt hospitals from load shedding.
Mohamed said load shedding had put a strain on hospital equipment andpatients’ lives, while Cabinet ministers were not affected. The petition has so far garnered close to 40 000 signatures.
“Streets with ministerial homes do not get load shed for security purposes, but hospitals that are used to save lives do. Does that mean that the lives of healthy politicians are more important than those of the sick public?” asked Mohamed in the petition.
“UPS batteries in neonatal care wards and other ICUs do not have enough time to recharge between power cuts during load shedding, which is fatal for infants and the most vulnerable of patients.
“Even where hospitals do have generators, they cannot power the entire hospital, so out-patients for example, who sit in an area that is not considered an emergency area, will sit in total darkness requiring healthcare professionals to use their cellphone torches to examine them,” Mohamed said.
The head of the Solidarity Doctors’ Forum advisory board, Dr Angelique Coetzee, said power outages had a major impact on public health facilities.
“It impedes critical operations. Yes, some hospitals are fully equipped with battery packs and generators, but is it sustainable?
“Diesel prices surge all the time. It has a huge emotional impact on our doctors and nurses. The stress is just too much.”
While private hospitals are not affected by load shedding, a private doctor in Oudtshoorn, Dr Wessel Vermeulen, said power cuts affected the healthcare in both sectors.
"When we get load shedding, we put acute problems aside and day-to-day clinics are badly affected,” said Vermeulen.
“Normal functions of providing initial diagnosis get taken away. Usually, you need to start treatment as soon as possible to prevent problems in future,” he added.
“The cost of load shedding is severe but I think the cost of losing effective medicine and treatment with diagnosis would amount to millions of rand in future.
“People wait months for an appointment and now, because of load shedding, they have to be turned away. Some people are travelling 70km for an appointment and now we have to refuse treatment.”
An EMS crew member also spoke to the Weekend Argus about the pitfalls of working during load shedding.
“For instance, a call-out to Parkwood or Lavender Hill when there is load shedding, we contact the dispatch to reach out to the caller to come out (of their residence).
“If the person does not answer his or her phone after the third try we cancel the call, so you drive away thinking did that person make it or not? It plays on your conscience.
“When it’s pitch black and you don’t know the area, you can easily become a target, so it’s a 50/50 chance of survival for both the patient and personnel,” he said.
Economist Ulrich Joubert said load shedding results in taxpayers having to fork out large amounts of money to compensate for the financial vacuum caused by rolling blackouts.
“It’s a catastrophe and the fiscal impact is austere. Cold rooms, for example, use a vast amount of power. Sometimes cold rooms can’t be added to a generator and the items in these cold rooms go to complete waste,” he added.