Language barriers and overworked staff in Barkly West
In a candid interview, Aletta and James Wilscott of Barkly West in the Northern Cape lay bare the everyday challenges they face at the town’s Professor ZK Matthews Hospital.
The couple are seated on a sofa in their lounge. James (61) is a retired bricklayer and Aletta (59) a retired domestic worker. They met in Kuruman; fell in love and got married after two years. They have seven children and have lived in Barkly West, thirty kilometres from Kimberley, for the past 25 years.
At their feet, a tin brims with cigarette butts. James has suffered from asthma all his life; the onus falling on Aletta to help him get medical care at the Professor ZK Matthews Hospital, half a kilometre away.
Our conversation is in Afrikaans.
The couple say there are language barriers between Afrikaans patients and foreign doctors at the hospital; that nurses have been attacked by knife-wielding men, and that ambulances are slow to arrive in emergencies. Sometimes they don’t arrive at all.
“The problem is that James suffers from asthma,” says Aletta. “Sometimes the ambulance takes really long to arrive. Sometimes they never arrive. When you eventually get to the hospital, then there is no doctor available. Meanwhile, I can see the doctor walking around there, but he is not paying any attention to us. The other doctor is just sitting there, busy on his phone. I mean, my husband is sick, he can’t sit and wait all day. He needs to lie down. One day he sat there from 9am until 6pm without any attention from the doctors. He was sitting straight up in a chair in the waiting room. At least the nurses gave him oxygen and something to eat. So, I went to the doctor and said: “Must I take my husband home, or will you help him?”
“Another thing,” says Aletta. “So, then they discharge him. But he’s weak. How do we get home? They don’t offer an ambulance. So, we walk home, sit-sit, sitting down next to the road every few metres for him to recover. It’s half a kilometre, but still, when you’re weak it takes a long time.”
James coughs, adding: “There are several doctors, all of them from Nigeria, or those other foreign countries. They speak English. Let’s say they speak ‘kitchen English’ – it’s not quite pure English, it’s a bit mixed. Sometimes they switch to their own language, then I don’t understand a thing. Mostly we do understand though, when we don’t understand the nurses might help out.”
James coughs again. “See, I usually speak kindly to them,” he says. “But in these moments when the service is bad, I lose it.”
Aletta pats James’ arm. Outside their corrugated iron home, a rooster crows and dogs barks in the morning heat.
Revisiting old concerns
Spotlight first decided to visit Professor ZK Matthews Hospital in Barkly West as it made headlines last year. In August, community newspaper, the Diamond Fields Advertiser, reported that the hospital’s staff were on strike. It quoted National Education, Health and Allied Workers’ Union (NEHAWU) shop steward Kgalalelo Maketlo: “There are no curtains at the hospital and patients have no privacy,” said Maketlo. “The windows are taped down because they are not working. General workers double up as kitchen staff to cook food for the patients, while nurses are expected to clean, on top of caring for patients, once the cleaners have finished their shifts.” Spotlight tried to get comment from Nehawu this week but calls to NEHAWU’s four Northern Cape offices went unanswered.
When DA-MP Delmaine Christians who served on Parliament’s National Council of Provinces’ Select Committee for Health and Social Services, visited the hospital in November, she found similar concerns raised by the Wilscotts.
“The hospital is falling apart,” she told Spotlight. “Things are rough there. I spoke to one of the members of staff, who did not want to be named. People are scared to talk. The staff member said there are way too few doctors and nurses on duty. When I was there, there were very few patients too. Most of the patients are transported to Kimberley. There were just two ambulances, but the one was broken. Administration and planning is a big problem. Infrastructure isn’t maintained; basic yearly maintenance is not done.”
Christians says hospital security was flagged as a problem during her last visit. Moreover, following more concerns recently raised by a Barkly West councillor, Christians adds that she has scheduled another visit to the facility this month.
Aletta agrees that security is a problem at the hospital. “They are chased around with knives in the hospital,” she says. “The one nurse was crying bitterly the other day, men from outside got in and pulled a knife on her.”
Built at a cost of R68 million, when the Professor ZK Matthews Hospital opened in 2008, it had a bed capacity of 45 and was supposed to receive patients from five clinics and two mobile clinics in the area. According to a Statistics South Africa survey in 2011, Barkley West has a population of 46 800 people.
At the hospital Spotlight found that the bathroom next to the waiting room has no soap. This, despite an information leaflet stuck over the washing basin describing how hands ought to be washed with soap.
The waiting room was empty, except for two security guards behind a glass panel. They said entry to the rest of the hospital was not allowed.
At the hospital’s main doorway, two men were speaking, one with a stethoscope slung around his neck. When politely approached by Spotlight, the man with the stethoscope said: “I am busy, can’t you see? Go and wait there.” He pointed toward the waiting room. Minutes later he stride over, his demeanour softening when the Spotlight journalist introduced herself.
The man went on to introduce himself as one of four doctors presently employed at the hospital. Originally from the Democratic Republic of Congo, he cautioned that he does not want to be named. He added that the hospital faces severe doctor and nurse shortages, especially at month-end when people in the local community receive their social grants and casualties increase.
Asked about his shift – eyes blood-shot, he said he started work the previous morning at 7:30am, and will leave the hospital at 12am that coming evening – but that he did take breaks in between. The man by his side was a visiting physician, also from the Democratic Republic of Congo.
In a recent interview with Spotlight, Northern Cape MEC for Health Mase Manopole acknowledged the province’s human resource challenges and said that some of the gaps are being filled by foreign doctors, notably from the Democratic Republic of Congo. “In many peripheral areas of the province we have foreign doctors,” she said . “They were already in South Africa, where they applied for the positions. I mean, anyone can apply to stay here in our province. Some of them have said they love the Northern Cape, and they won’t move to any other place in South Africa.”
Manopole also claimed that only minimal language barriers exist between foreign doctors and patients.
But back in his shack when Spotlight asked James and Aletta what their over-arching opinion is of service at the hospital – James just nodded, saying: “The service is oraait,” and again complained about the doctors.
The Northern Cape Department of Health did not provide comment by the time of publication. This article will be updated once the department responds.