Baby death hospital was doomed from the start


Baby death hospital was doomed from the start

Report seen by Times Select shows architectural design flaws exposing newly built hospital to infection control problems


The Thelle Mogoerane hospital in Vosloorus, east of Johannesburg, where six babies recently died of the drug-resistant bacteria Klebsiella, had architectural design flaws that could cause poor infection control, according to a report seen by Times Select.
A report, titled “Thelle Mogoerane Hospital Post-occupancy Evaluation” and compiled by the Council for Scientific and Industrial Research (CSIR) shows the construction of the hospital not only almost cost double the budgeted amount, but also had fewer beds than the old Natalspruit hospital it was set to replace.
The new Thelle Mogoerane hospital had overcrowded wards from the very beginning, forcing it to accommodate babies and patients in the passage – still a problem to this day.
The report was commissioned by the Gauteng health department and published in 2016, but has not been made public. 
It said the project to build the new hospital faced several delays and was completed in 2014, six years after its target. It was budgeted to cost just under R900m, but ended up costing R1.7bn.
In one delay, when the national health department asked for plans to be changed, it took 22 months for approval. In that time, the contractor, who could not do any construction, was paid R6.7m while waiting for the approval.
Yet there were still design flaws that included an overly small neonatal ward for babies (there was space for 10 babies, compared to 50 in the old hospital), a labour ward that was too small and inadequate space to store cleaning equipment.
The six baby deaths between May and September at the hospital were due to Klebsiella being a highly drug-resistant bacteria, but also: overcrowding makes it easy for the Klebsiella to spread.
Gauteng health spokesperson Lesemang Matuka told Times Select the province’s population had doubled since 2006, but the capacity of its state health facilities remained the same. 
“This leads to overcrowding in hospitals, and the overcrowding in wards and ICUs makes it easy for germs to spread,” Matuka said.
The report said the old Natalspruit hospital had 870 beds, compared to Thelle Mogoerane’s 760 beds.
“One would expect the new hospital to be the same or better, but this does not appear to be the case in all areas,” the report reads.
From inception, some wards were 100% occupied.
“In many wards, such as the labour ward and medical admission wards, there are patient beds in the passages or beds are doubled up, such as in the private delivery ward,” the report says.
Then there was another problem – some wards were understaffed.
The intensive care unit had 22 beds but could only accommodate 11 patients because there were not enough nurses to serve a full ICU.
Other problems included insufficient storage space in general. In the wards, there is not enough storage space for stock, and clean and dirty line.  As a result, the assisted bathroom in the maternity ward was used as a dirty linen store.
The nurses’ station in the neonatal ward for newborn babies was used to store unused equipment, which also posed a health and safety risk.
“Storage for old, broken and unused equipment is inadequate.”
Treatment Action Campaign chairperson Anele Yawa in November described the situation at Thelle Mogoerane as “deplorable”, saying there were serious staff shortages, dirty facilities, overcrowding problems and long waiting times.
Acting CEO of the hospital Dr Jatin Ganda told Times Select some of the problems that were identified by the CSIR had since been fixed.
This included no wash basin being at the entrance to the neonatal baby ICU, where doctors and nurses needed to wash their hands; and no isolation ward for babies with infectious diseases.
Ganda confirmed the hospital now had a wash basin and an isolation ward for babies, and said adequate storage space had been created for cleaning equipment.
But the hospital remains overcrowded. Ganda said “due to population growth” the number of babies in the hospital exceeded the number of baby beds available.

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