A nationwide strike of government employees started last week here in South Africa and looks to have serious repercussions for the health care sector. I am a semi-retired general practitioner but have sessions looking after three of the psychogeriatric wards at our local psychiatric hospital. The patients are mostly very vulnerable elderly patients on long term medication.
On arrival at the hospital gates this morning there was a large mob of striking staff singing and toyi toying in front of the gates and preventing staff from entering. It is said that the custom of toyi toyi, which is a rhythmic stomping dance was used in the old days in Africa when the people had a grievance. They would collect outside the chief’s compound and would dance and make a noise to get the chief’s attention.
As it was early in the morning and I must have been the first doctor to arrive they allowed me to enter in my pickup truck. They know me as a daft elderly white man so I think they judged me to be fairly harmless. It was quite eerie inside as there were no cars in the ward car parks and the curtains were all drawn and the wards were locked down. I managed to get a staff nurse in one of the two assessment wards to let me in as she had been threatened by the strikers not to answer the phones. She and another helper had managed to feed the patients and give them their medications. They were both afraid that the strikers would find them and label them as igundane, which is an isiZulu word for a “rat” and is the equivalent of a scab in English. Some of the nursing staff in other hospitals have been sjambokked (a sjambok is a leather or plastic whip stick) by the strikers for going to work.
The situation was worse in my long term female ward, which is in an isolated part of the grounds of the hospital. I found the patients milling around outside the ward as the night nurse had been threatened and had left the hospital and there was no staff at all in the ward. They had managed to find food but had had no medication for two days and one elderly patient was lying in front of the door having had a fit. She was now conscious and had a haematoma on her forehead but otherwise was unscathed so two of the other patients helped me get her into bed.
It is a challenging situation to be in a hospital psychiatric ward with no staff and no medications and no keys to open the medication cupboard so I decided to go down to the gate and talk to the union officials to try and persuade them, at least, to let one of the nurses, who knew the ward, to come in to help me give out the medicines. The union officials refused adamantly to let any more staff in so I returned to find some of the other doctors had been let in and were helping feed and wash the patients and give out medicines.
We then heard that a mob of strikers had entered the hospital grounds through the gate and were looking for igundanes. We have advised the staff who are in the wards to lock themselves in and await developments. I really appreciate the courage of these few women who are continuing their work in very difficult circumstances.
Chris Ellis is a semi-retired general practitioner from Pietermaritzburg, KwaZulu-Natal, South Africa.