I remember clearly my first impression
of a hospital I went to as a ten-year old
child perched in the middle of an open
shrubby veld, with citrus farms that yielded
juicy oranges almost every winter on the
north western side. The nearest village
to the hospital must have been a good
20 km away. With public transport still
not affected by the explosion of the current
gun-infested taxi-industry of the 90s, it
must have been a pressing need that
would make people visit the hospital.
No wonder the queues of patients waiting
to be attended to were relatively short
within the hospital premises.
Compared to my granny&rsquos cow-dung
polished mud-hut back at home, the
hospital was the closest to my imagined
heaven. The walls, freshly painted in orange
(as if to match the nearby citrus fields)
caught as much of my attention as the
white clothed nurses who matched the
neat surroundings. The fluorescent lighting
at night seemed to bring out something
angelic from this ever-smiling platoon
of health workers as the dark night of
the open lands hovered around. When I
recovered my consciousness (after a minor
surgical procedure), half a dozen of them
stood around my beautifully spread bed
in the virtually empty ward with all the
caring smiles that even the best spring
morning would have struggled to match.
I spent a full week in that ward doing
nothing except to enjoy the easing of
my excruciating pain down under. [I have
since learnt that nowadays, it takes no
more than a few hours for one to undergo
a similar surgical procedure and be
discharged on the same day.]
The nurses seemed to relish the challenge
of waking ahead of the dawn chorus of
birds and returning to their homes at dusk
in order to complete a 12 hour long working
shift at the hospital. The superintendent
of the hospital instilled an orderliness
that seemed to reverberate from his white
coat every time he walked down the
corridors of the hospital - normally, with
the revered Chief Matron behind.
Twenty years later (about four years from
today!), I was back at this once famous
hospital, this time, not because of anything
to do with my personal state of health.
The changes that had occurred since my
first visit greeted me before I even entered
the hospital premises. Persistent drought
had ravaged the citrus fields. The once
open veld was now covered by numerous
shacks of mushrooming informal
settlements and villages within a 2 km
radius of the hospital. It seemed as if
the villages and the settlements had finally
caught up with the hospital once shielded
by the empty open veld around it. The
once shining walls looked dirty as decaying
old dark brown paint sheaths peeled off
uncontrollably due to many years of neglect.
Many patients stood in long queues outside
the hospital gates with those too weary
to stand huddled under tree shades as
the African summer sun blazed relentlessly.
The nurses seemed to be dragging
themselves as the mutter of their sighs
was drowned by the heat wave steaming
down the littered hospital corridors.
As I left later in the afternoon, I could
not ignore the feeling relief that this time,
I had not come to lose any of my body
parts. I kept on wondering how many
people in the long queues identified with
my experience of twenty years ago. An
experience, that I now realise, was not a
real one. This hospital, like many, had
been removed from the real problems
of communities because its location made
it inaccessible probably due to some grand
ideological plan of the past.
As reality finally confronts the hospital,
it is found wanting. Many hospitals are
faced by similar situations compounded
by dwindling resources and rising demands
of communities for better health care.
This issue of Update gives a synthesis
of these challenges and possible suggestions
for the effective management of the
restructuring process. |
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