Settling for less

For many students, Settlers Hospital is the only option when it comes to emergency treatment. But how efficient and professional is the hospital? Candace Whitehead, Kim van Beeck and Rodain Joubert take a look.

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It was a typical evening for Victoria Moore. That is until she cut her head open.

A fun-filled jaunt at Friar Tuck’s last year was cut short after Moore stepped into the nightclub’s bathroom.  She slipped and landed on her head, leaving her with a severely bleeding wound and no immediate medical assistance. Still conscious, she was able to ask for a lift back to her residence and promptly knocked on the door of her friend, Katy Nottingham. When she saw the injury, Nottingham immediately opted to drive her to Settlers hospital. It was 4am, but they felt sure that emergency staff would be on call there.

Upon arriving, however, the two girls were unable to find any of the staff on duty and spent several minutes frantically searching through the hospital in their vain attempt to find a doctor. “It was really scary,” said Moore, “I was desperate, my head was bleeding and there was no one around to help.” When it became clear that help was not forthcoming, they drove back to town to seek help from the Rhodes Sanatorium.

“It was ridiculous,” Nottingham said, “If Vic had been more badly hurt I don’t know what would have happened.” Moore eventually received treatment, but she and Nottingham were left unimpressed with the service at Grahamstown’s only hospital.

Unlike the private establishments that many students may be used to, Settlers is a state hospital. Being funded by the government, it has a somewhat limited capital and has consequently received a lot of flak about the apparent quality of its service and the lack of emergency staff members or specialists.

In an interview with Dr DM Berenisco, the Chief Medical Officer of Settlers Hospital, the concern surrounding lack of staff was raised. However, he says that he believes that staffing is not necessarily a problem. A distinct lack of health care professionals has been noticed in South Africa, including doctors, nurses and pharmacists, and Dr Berenisco feels that Settlers is “standard” in this issue. At all times, Dr Berenisco explained, there should be two professional nurses with primary health care training and a nursing assistant staffing the casualty, with the assistance of a doctor on call overseeing the entire hospital. However, many students arriving after hours find this is not the case at all.

Steven* was admitted to Settlers, unconscious and unresponsive, after an intentional overdose at the end of last year. Because of the lack of staff present, two of his friends had to carry him from the reception area to casualty, without assistance, and place him in a wheelchair. Only after his admission form had been filled out was he wheeled through to casualty, where his friends again had to lift him onto the bed unassisted.

When Steven was eventually seen by a doctor, it was immediately assumed that he was merely a victim of alcohol poisoning and had passed out. When his friends tried to explain that Steven had intentionally overdosed, the doctor ignored them and began instead berating them, saying he was “tired of always treating drunk students”. Although Dr Berenisco does not endorse this attitude, he does understand it. Over the weekends, he estimates that 70% of people (both students and the general population) who are admitted are admitted because of alcohol abuse – either victims of drunken assault or other medical effects of alcohol. He does not endorse the berating of students, however, “Obviously patients are human beings and should be treated with human dignity. To just berate somebody offhand and write them off, and essentially refuse to treat them is completely unacceptable,” he says.

As a means of trying to minimise the waiting period for urgent patients, a triage system has been recently implemented at Settlers. Patients are assessed according to certain physiological parameters – blood pressure, pulse rate, temperature, mobility and level of consciousness – and certain discriminating factors – chest pains, seizures and age – and are then assigned a level, ranging from green to red. Red patients are to be treated immediately, orange patients within 10 minutes, yellow-scored patients within 60 minutes, and green-rated patients within four hours. This waiting period, says Dr Berenisco, is internationally approved. “It may not be patient acceptable”, he says, “but it is medically acceptable.” If the patient cannot be treated by the state doctors, or a specialist is required, the patient is then transferred to Port Elizabeth as soon as is possible.

Settlers Hospital is not the only place in Grahamstown for students to receive medical treatment. The Rhodes University Sanatorium should normally be your first port of call when you have a cough or a cold and are in need of a leave of absence form. Although the San is available 24 hours a day, Sister Jeanne Shaw, recently appointed Head Nurse of the San, says that more serious cases should be taken immediately to Settlers, “If you are critical, for example you are bleeding, it’s pointless to come to the San. For your own medical health you should go to the place where you can be given the best treatment, in the quickest time.” When asked whether she had had any complaints by students about Settler’s medical treatment she commented that she hadn’t received any so far, and regularly refers patients to Settlers.

According to Sister Shaw the care a student will receive will depend on whether he/she has medical aid or not, “If a student needs a doctor and has medical aid, a GP [General Practitioner] will come to the San, if the student doesn’t have medical aid he or she will go directly to Settlers.” Sister Mildred Mwrebi, who has worked in public hospitals before and now works in the Sanatorium, says that other public hospitals in the area do not measure up to Settlers standards. “I am very impressed by the level of cleanliness in Settlers,” she says. Sister Shaw reinforced this point by explaining that Settlers covered a huge district and that many other local hospitals often transferred patients to Settlers. The San is open from 8:30am to 5:30pm and there is a nursing sister on call after hours, Sister Shaw added, “We will see anybody who comes in”.

Regardless of good experiences or bad, Settlers is the only option most Grahamstown residents have when in need of emergency hospitalisation. Despite the horror stories, the fact remains that people are treated successfully and do recover. So don’t write off Settlers just yet – it’s a long way to drive to Port Elizabeth with a head wound.

*not his real name


3 Responses to Settling for less

  1. Your blog is on the very high level and includes a lot of very interesting information and was very useful for me.

  2. lesedi says:

    can i please have the email adress of settlers hospital

  3. Candace says:

    I can’t seem to track down an e-mail address for them, but their number (also applies for after-hours) is 046 622 2215, and their fax is 046 622 5366. Hope that helps!

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