Baragwanath Hospital, Soweto

Abstract

In the weeks leading up to the national elections of 7 May 2014, discussion of health care policies and infrastructure occupied a far more central place than has yet been the case in South African electioneering. While all parties agreed that the country's public health system is still failing to meet citizens' Constitutionally-affirmed right of access to health care, the forcing of this recognition into the political arena has in part had to come 'from the ground up', from those who work at state hospitals and clinics, including at South Africa's 'legendary' Chris Hani Baragwanath Hospital in Soweto. With just under 3,000 beds, the hospital is amongst the largest in the world, and has a far higher ratio of patients than WHO recommended standards. In October 2013, in a well-publicised media protest, eight Baragwanath doctors were photographed holding aloft posters stating, for example, 'Patient in need of simple operation discharged (theatre lists too long). He died a few weeks later', and 'Tired Doctors (Shifts Longer than 16 Hours) = Compromise of Patient Care And Doctors Safety'. One young doctor was quoted as saying, '"I really love my job. I love working here, but it's just extremely difficult to look my patients in the eye and feel that I've done my best for them… We just feel like we let them [our patients] down"'. Ominously, the report added: 'She's scared about speaking out-if she's caught, the consequences could change the course of her career' (Green 2014). As Simone Horwitz's book, Baragwanath Hospital, Soweto: a history of medical care 1941-1990, powerfully illustrates, unfortunately, South African medics have long had to struggle against the governments that fund them and the broader economic and political terrain in which they work in order

Kidney Transplantation and South African Medical Hierarchies: Nursing Innovations and Inequities, 1960s–1990s

“…However, the nature of large academic hospitals within South Africa's complex overlapping health care bureaucracy meant that, very often, individual nurses had a great deal of autonomy. 83 A hospital such as the Johannesburg Hospital was governed by the state, provincial and, in some aspect, municipal legislation and pronouncements. Being a teaching hospital it was also reliant on Wits University for administration and staffing.…”

“…Rather than leading to tighter controls, this structure led to uncertainties and ambiguities that provided space for the institution and individuals within it to assert greater levels of independence. 84 Such autonomy also allowed nurses to be more involved with their patients's care. For example, Sr Maloi again went against doctors's orders to save a patient's life.…”