Patients pay price of hospital crisis

Despite a public outcry, conditions remain more that of hopelessness than healing in Swaziland's largest state-run hospital.

Underfunded and understaffed, the burgeoning numbers of patients with AIDS-related illnesses over the past decade has left Mbabane Government Hospital (MGH) even less able to provide basic care. Over 40 percent of Swazi adults are estimated to be HIV positive.

A visit to the hospital found that ward 12 - the male patients' ward - was the hospital's most overcrowded. The main women's ward was not much better, with patients sleeping on floor mats and beneath beds. Other patients appeared to have collapsed in the corridors.

"Health care is expensive - medicines, equipment, beds, and all the rest. No one expects a five-star hotel, but it is dispiriting to patients and staff to endure conditions that do not improve. HIV/AIDS has made things worse," a nurse, who asked not to give her name, told IRIN.

Midsummer worsens conditions, and despite the hospital's hilltop location overlooking downtown Mbabane, the capital, little air seems to circulate in the patients' wards. Summer storms that might bring relief only aggravate the misery when leaking roofs soak patients lying on the floors.

Orderlies and other hospital workers spoke freely about their discouragement. "Rich people don't come here, and maybe that is why we are neglected," one orderly said.

In a string of disparaging reports on government hospitals in the Swazi press, staff and equipment shortages, unhealthy food and unhygienic conditions are recurring themes.

Accusations of negligence continue to generate front-page headlines and this week The Times of Swaziland ran 'Horror at Mbabane Government Hospital', a story detailing scenes of human feces found in a sink used for dish washing.

Supreme Audit Institution of Swaziland (SAI), an environmental auditing firm, recently concluded its investigation of MGH and reported that the hospital was in violation of environmental laws by failing to manage clinical waste, which is supposed to be incinerated.

Mixing clinical waste with general rubbish exposes patients and others to contagious diseases, and poses a health hazard, SAI said, adding, "it was noted that there were no guidelines or operating manuals on waste management to ensure compliance with environmental legislation and regulation."

IRIN was unable to contact the hospital administration for comment. Hospital manager Thobo Maseko was absent at a retreat, and Senior Medical Officer Dr Austin Ezegu was on leave. The Ministry of Health postponed commenting until new health minister Mfomfo Nkambule, appointed by King Mswati last week, acquainted himself with the hospital's situation and formulated a plan of rehabilitation.

One hospital official speaking to IRIN off the record shrugged off the negative press reports about the facility. "We are used to bad publicity," the official said.

Appealing as they may be, due to the low cost of treatment, the countries other government subsidised hospitals, located in the capitals of Manzini region, Lubombo region, and Shiselweni region, are reportedly in a similar state of crisis. The problems are the same: a shortage of nurses caused by low salaries, which prompt workers to find employment in better paying South Africa, and under funding by government.

Meanwhile, Finance Minister Majozi Sithole announced an increase in the government's health and social welfare ministry budget from US $57 million last year to $63 million for 2006/2007. The 6.8 percent increase matches the expected rate of inflation. By comparison, the nation's security forces will receive $87 million.

To give Mbabane's patients alternatives to the government hospital, private groups are beginning to offer free or low-cost medical care.

The US pharmaceutical company Bristol Myers-Squibb Foundation and the Baylor College of Medicine financed and staffed a new hospital for children living with HIV/AIDS and other ills. The $2 million Children Clinical Centre of Excellence located two kilometers from Mbabane Government Hospital, was opened this week by King Mswati.