Hi everyone from the clinical manager at a tense and tired Madwaleni.
Its a complex issue, this strike, I’m told. Maybe so, but I confess
– I choose to dull my understanding, to label the whole mess complex and difficult, to de-think the rationale and reasoning of both government and strikers that brought us to this point. Is that normal for me? I would hope not. Understanding the bigger picture has always been important to me. But thats for another time. For a time when i can sit and reflect. In the here and now, there is a job to be done which is not complex at all. Patients are ill and its our job to make them well.
So at this deep rural EC district hospital, a small team of doctors, and four/five brave managers including our new hospital manager (one month in the job) are cleaning, feeding, nursing, doctoring, washing laundry and fixing the water supply. We can only refer out a limited number of those who are acutely ill. I sit here now trying to find ways of keeping team morale up, but the strain is taking its toll.
Its often in the details. A junior doctor nearly breaks down when she asks an elderly, breathless man in casualty the whereabouts of his relatives, so as to corroborate the history of his complaints – only for him to point out the window at the gate where his daughter, a nursing sister, is toyi-toying. And the frustration felt at a striking nurse who leaves the gate, enters OPD and strides to the front of the queue, requesting his chronic meds repeat as if he has that right.
We are in near total shutdown, and intimidation comes in all shapes and sizes, with smiling efficiency. Security guards can now not be porters, board members are not welcome on the property, and neither stipended counsellors nor NGO-funded pharmacy assistants may work to assist us. But unlike at other hospitals, we doctors are being left alone.
Tensions are not helped by the fact that the majority of the strikers live on the property. The army has moved in yesterday to provide more security, but to see the huge “Hippo” armoured vehicle stationed next to OPD – a place of healing and comfort – is very sad.
With those that die, I find myself erring on the side of “perhaps they would have anyway”. Not good. The time for that analysis is not right now. A positive is that we have not had one neonatal death during the strike. Yet. Our labour ward and theater are operational, but running on effort and determination alone, both of which are a limited resource.
This needs to end now. But then I remember, “unthinking” it is the way to go, just doing is the answer, being busy is protective. I really hope we will not be prevented from doing.
Wishing all the very best to all our colleagues out there.