Port Elizabeth patients in limbo

Some admitted to Livingstone lie in bed for weeks waiting for operations as urgent cases overwhelm hospital

Livingstone Hospital
Livingstone Hospital
Image: Google Maps

You may have to lie in a Livingstone Hospital bed for an entire month before a surgeon operates on your broken ankle.

That is the grim reality at the state facility where hundreds of trauma, violence-related and accident cases every month are stretching the orthopaedic surgery department to its limit.

It means simple surgeries such as a broken arm are put on the back-burner because there are just too many more pressing emergencies.

The hospital has come under fire for its policy of admitting patients for simple surgery and then keeping them waiting for weeks.

The patients say their absenteeism from work puts their jobs and livelihood at risk and disrupts their family life.

But Livingstone, in response, has listed its reasons for keeping the patients waiting in hospital, primarily because it ensures they are available immediately and because the enormous casualty and emergency workload makes a fine-tuned schedule impossible.

The hospital has also admitted it can take months for scans and MRI scans to be conducted.

What has emerged is that: There are up to 100 orthopaedic patients awaiting surgery at any point;

Patients who would normally, in a “First World hospital”, get surgery, are not receiving it at Livingstone due to time constraints, but are receiving more conservative treatments;

One patient had to wait 36 days from her date of admission for surgery to be performed; and

About 75% of Livingstone’s orthopaedic patients require surgery for trauma-related reasons.

A group of Port Elizabeth women started an online fundraiser recently to assist women who have been waiting for up to a month for surgery at Livingstone, as many are at risk of losing their jobs due to the long wait.

Nicky Hartel, who started a petition to change the policy of admitting patients for an endless wait, said she did so to help a friend in this position.

She said she hoped it would motivate someone to change the system.

“This is for the ladies in Room 20 of Livingstone Hospital who are waiting for operations,” Hartel said.

“They have to stay in hospital to keep their place on the waiting list.

“These women and countless others across the country are unable to go home, to be moms to their kids, to work and earn an income.

“This is one policy that really should change.”

Patients were wary of being identified as they still had to access the hospital for treatment.

One of the women for whom the petition was started and who needed ankle surgery, said she was worried she might lose her job.

She did not get breakfast for nine days in a row as she was prepared each day for her surgery, but never actually went to theatre.

She eventually had the operation 36 days after first being admitted.

Another woman, who also needed ankle surgery, had to wait in hospital for a month despite having a seven-year-old child at home.

A third woman, who was in an accident in which the father of her child was killed, said she could not go home and had to tell her son about his father’s death while she was still waiting in hospital.

She needed surgery to an arm.

Hospital CEO Thulane Madonsela said the hospital was admitting between 120 and 140 orthopaedic patients a week, of whom 90 to 110 required surgery – the vast majority of cases being trauma-related. Of these, many cases involved multiple injuries that threatened lives and limbs or people who developed severe infections following trauma and needed surgery right away.

Each surgeon could operate on only four to five orthopaedic patients a day – but their operation lists were often filled entirely with urgent trauma cases.

Madonsela said six specialist surgeons were assigned each day to do trauma cases, one for emergencies and minor cases, and a dedicated hand specialist to operate on hands.

A surgeon specialising in spines does only spinal surgery.

“At any point, there are between 150 to 200 orthopaedic patients in Livingstone, of which 50 to 100 are awaiting surgery,” Madonsela said.

In the past three weeks, the fundraising group has raised close to R20,000 to pay for private care for the mother whose finances have become strained due to her long wait.

Madonsela said there were good reasons for the policy, which included:

● As 90% of the work done by the orthopaedic surgeons is trauma-related, the surgeons do not know how busy they will be and therefore patients need to be available if there is time to do their surgery;

● Admissions from the casualty unit are unpredictable, making it impossible to schedule surgeries;

● If patients are sent home, they often have transport problems and fail to make it back on time for their appointment;

● If patients are at risk of developing complications, it is better to keep them in hospital; and

● Once patients are discharged and need to return for surgery, there might not be a bed available for them.

He said surgeries were sometimes cancelled to accommodate more urgent cases, when lists ran past 4pm, or where everything required in theatre was not available, equipment was broken or there were staff shortages.