Pilani Clinic is often the first point of care for patients from Cradock, Eastern Cape but it is often not their last as systemic shortages fuel a referral system that is costing patient lives and money.
“Phone an ambulance? My dear, phoning an ambulance doesn’t even cross my mind. In my seven years at Pilani Clinic, I have never seen an ambulance at this clinic,” says Sister Sylvia Horner.
Horner and a nursing assistant, Selena Arends, run the rural clinic that sees up to 1 800 patients a month. Yet it has no electricity, only one outside tap and frequent medicine shortages.
Patients who need to be transferred to Canzibe Hospital, the closest district hospital in the Nqileni district, have to find their own way there.
Recently, there was no antiretroviral medicine for three months, while vaccines for children and common medicines for treating conditions such as diabetes, high blood pressure and pain are often out of stock.
Horner has persuaded the local shop owner to keep temperature-sensitive medicine in his fridge, and walks to the (ARV depot) herself to fetch medicine.
Patients referred to Canzibe Hospital don’t fare that much better. Two Dutch doctors are trying to keep services going. But the hospital serves 11 clinics, and 80-100 patients can be found in the outpatients department alone every day. This is aside from the 80 inpatients. The doctors can thus only manage to see the sickest of these.
Pregnant women who need Caesarean deliveries have to be referred to St Barnabus Hospital, an hour’s drive away. Yet there is seldom transport to take them there.
There is no pharmacist and a serious shortage of nurses. The X-ray machine doesn’t work because management failed to have it serviced, the hospital often runs out of oxygen.
Taken from “Death and Dying in the Eastern Cape: An investigation into the collapse of a health system,” a production by the Treatment Action Campaign and Section27.
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Article source: http://allafrica.com/stories/201309111212.html