Renovations and shortage of specialists hobble SANDF’S flagship medical facility

It is a sad state of affairs*1 when the military has to rely on civilian service providers

NELSON Mandela could not be admitted to 1 Military Hospital in Pretoria because the facility’s two intensive-care units and theatre for VIPs have been closed for renovations since 2010.

Instead, the former president was rushed to the Mediclinic Heart Hospital, where he is now spending his 37th day for treatment of a recurring lung infection. His condition has been described as critical but stable.

The military hospital is supposed to cater for the country’s president and deputy president, their predecessors, foreign dignitaries and members of the South African National Defence Force and their families.

But 1 Military, meant to be the SANDF’s flagship hospital, has been forced to transfer patients to private hospitals, including Mediclinic Heart Hospital, Unitas, Zuid-Afrikaans and Louis Pasteur, for treatment because of the shortage of medical specialists and specialised operating theatres and ICU beds.

The Sunday Times has established that the hospital refers cardiac patients to Mediclinic Heart Hospital, and doctors use operating theatres at the Zuid-Afrikaans Hospital for orthopaedic surgery.

Documents reveal that between March 2009 and April 2012, therewere 77 045 approved requests for referrals to government and private hospitals and health facilities by the South African Military Health Services (SAMHS) at a cost of almost R449-million. At least R295.7-million of this was paid to facilities that rendered services to 1 Military Hospital.

Most of the hospital’s first floor, which previously housed the intensive-care units and theatre for VIPs, as well as a further 11 theatres, intensive-care and high-care wards and a trauma emergency unit, remain shut because of renovations that have been at a standstill for years.

Three theatres and an emergency theatre are now housed in the former gynaecology and obstetrics unit on the third floor.

Instead of having individual compartments, the casualty section is now separated by curtains.

Defence Minister Nosiviwe Mapisa-Nqakula admitted in parliament last month that “optimal health services are also hampered due to facilities which are not properly supported by the Department of Public Works, for example, the repair and maintenance programme at 1 Military Hospital”.

In its 2011-12 annual report, her department also admitted that the repair and maintenance programme at its three military hospitals was impacting on healthcare service delivery.

Mapisa-Nqakula said outsourcing was done for certain diagnostic services because of unforeseen equipment failure, or for highly specialised services and certain specialised treatment.

According to staff, Mandela would have required a full-time ICU specialist, which the hospital does not have. A medical officer oversees the ICU ward at 1 Military Hospital.

The facility does not have a specialist cardiologist and neurosurgeon, or heads of ancillary health and gynaecology.

The staff shortage is so dire that if a patient needs to be transferred to ICU, the staff have to first call the ward to see whether a nurse is available to manage the bed.

“It is a gross waste of funds and a sad state of affairs when the military has to rely on civilian service providers,” said a source close to the military.

A staff member said the current and former presidents were reluctant to use the facility because it was poorly resourced.

“Mandela would not have received the best treatment here because of dwindling standards,” said the staffer.

More than nine months ago, the Department of Defence promised in a statement to the Sunday Times that “all efforts are being made to expedite the finalisation of the refurbishment” at 1 Military Hospital.

It said that military health services had embarked on a renovation, maintenance and refurbishment programme of military hospitals in 2009.

“This resulted in the availability of some capabilities like operating theatres, intensive care and high-care facilities, diagnostic radiology services and clinical laboratory services being less than normal,” it said.

This week, the department declined to comment on the issue of 1 Military failing to meet the needs of VIPs, including the current and former presidents and deputy presidents.

Defence spokesman Brigadier-General Xolani Mabanga said it was standing policy not to discuss the operational capabilities of its facilities in public.

But he acknowledged that military health services were “tasked to provide a multidisciplinary military health service to all military deployments and members of the armed forces, their families and others, including heads of state”.

With acknowledgement to Prega Govender and Sunday Times.

*1       It is a sad state of affairs.

It is a sad state of affairs, caused by :

• the SANDF running budget being gobbled up by the knock-on effects of the Arms Deal;

• gigantic ineptitude from all spheres of "government"; and

• little time nor inclination by Zuma and his cohorts to do anything other than feather their nests.