The hospital in chaos, with rubbish piling up. Picture: Supplied
The hospital in chaos, with rubbish piling up. Picture: Supplied

From Wuhan to New York, hospitals across the world have resembled warzones as they’ve been overwhelmed by an influx of Covid-19 patients. But as cases begin to spike in the Eastern Cape, the province’s state-run Livingstone Hospital has instead become the site of a trade union-led laundry war.

The academic hospital in Port Elizabeth has 26 Covid-19 patients and, as the primary site where people who contract the coronavirus are due to be treated, it’s bracing for many more. But in recent days, the hospital has been a mess, with litter strewn in the corridors. Worse: the casualty ward had to be closed in the middle of last week, as blood remained uncleaned on the floor.

This was all because the National Education, Health and Allied Workers’ Union (Nehawu), which represents hospital cleaners, kitchen staff and porters, have been protesting about the nonpayment of overtime allowances. They refused to wash laundry this month and on Saturday, tensions ratcheted up when strikers blocked the entrance to the hospital.

It led to a farcical situation where doctors tried to smuggle laundry out of the hospital so they could wash it at home, while surgeons took to washing their own surgical gowns.

To make it worse, the Igazi Foundation, an NGO that supports blood cancer patients, was prevented by union members from taking the hospital laundry, like bed sheets, to private laundromats.

Effectively, this amounts to shutting down the hospital, since patients cannot be operated on or treated without clean sheets or surgical gowns – vital at the best of times, but doubly so during a contagious virus outbreak.

Insiders say this is not the first time the “linen bank” has been used as a tool in labour disputes.

Igazi CEO Cole Cameron says that as epidemiologists predict a surge in cases in the Eastern Cape, “our main Livingstone hospital is on the brink of collapse – it was before Covid-19, but it has been exacerbated”.

It means, says Cameron, that the province is “is desperately unready for [the] challenges ahead”.

Last week, Igazi volunteered to make food in the hospital kitchens as staff were on strike, but porters refused to take the meals to patients. One doctor tell the FM this left patients in a state of “acute starvation”.

On June 8, Cameron wrote to health department of deputy director-general Anban Pillay, describing the “grave situation” and asking for a meeting with health authorities.

The letter states: “The ongoing labour problems making the hospital ungovernable have most alarmingly resulted in personal protective equipment (PPE) funding being diverted to buying disposable sheets. Labour has refused to do ‘Covid-19’ laundry. This has wasted precious state funds and will put lives at risk.”

However, he received no response. Doctors who spoke to the FM remain concerned at the lack of intervention by provincial and national authorities to address this dispute, especially given its designation as a locus for provincial Covid-19 patients.

However, Nehawu provincial secretary Miki Jaceni tells the FM that on Saturday the provincial authorities had promised, in writing, to pay the overtime allowances. As a result, says Jaceni, the union members began to clean up blood and litter, which allowed for the casualty ward to reopen.

Jaceni provided the FM with before-and-after photos depicting how the filthy hospital had been cleaned up.

The hospital in chaos. Picture: Supplied
The hospital in chaos. Picture: Supplied

On Sunday night, the union put out a statement saying its office bearers visited the hospital the day before and found the condition of the hospital to be “appalling”, with medical waste “strewn all over the place”.

“The entire hospital was in disarray after general assistants … decided to down tools because of unpaid overtime,” it said.

Nehawu said 84 hospital staff had contracted Covid-19, two of whom had died. Morale was also low, with more than 100 vacant doctors and nurses posts. It means each medical professional was doing the work of three people.

Yesterday, Cameron confirmed to the FM that the hospital appeared “calm” as the union members went back to work.

‘Unions risking lives’

One doctor at Livingstone, who would only speak to the FM on condition of anonymity as he said doctors had been “grossly intimidated” and warned against speaking to journalists, said the union members were putting lives at risk.

He said doctors took it upon themselves to buy disposable linen for the hospital. “There is a history of labour being politically powerful in the Eastern Cape. Sadly, at the drop of a hat they down tools,” he said.

The hospital in chaos, with rubbish piling up. Picture: Supplied
The hospital in chaos, with rubbish piling up. Picture: Supplied

Yet administrative staff from the provincial head office hadn’t bothered to intervene, he said.

The Livingstone hospital also has no full-time CEO, while the acting CEO, Dr Khanyisa Makamba, a specialist urologist, was asked to stay on in his management position once Covid-19 hit SA. But doctors say he is not skilled in “warfare” with the unions, who “outmanoeuvre” him.

“Unions are just gunning for him,” said the doctor. “He is not there to play mind games. Doctors are not chess players”.

Eastern Cape provincial government spokesman Sizwe Kupelo said that last week Makamba was even called in to work in the casualty ward due to the shortage of medical staff. Kupelo downplayed the strike, saying there are “sporadic” labour disputes like this, and the “linen issues” are being addressed.

However, Jaceni tells the FM that hospital workers went on strike for more than just unpaid overtime: there was also a shortage of PPE and the union also wants a guarantee that all wards with Covid-19 patients will be regularly sanitised.

In Nehawu’s statement, it said: “Seven managers including the former CEO, who has since tendered his resignation, have been on protracted suspensions which has left a huge void in the management structure of the hospital.” It called for a “speedy finalisation” of the disciplinary hearings so staff could be reinstated or replaced.

But Kupelo denies there is a shortage of equipment. “There has never been a shortage of PPE at any of the health facilities in the Eastern Cape. We have explained this several times and visited some of the facilities to audit the availability of PPE,” he says.

Cleaners and staff back at work at the hospital. Picture: Supplied
Cleaners and staff back at work at the hospital. Picture: Supplied

He says health minister Zweli Mkhize had sent a procurement specialist to the province to “accelerate procurement of PPE [and] we are currently spending R281m on PPE”.

But the doctors dispute this too. One doctor tells the FM that PPE is not fairly distributed within the Eastern Cape. Livingstone Hospital, for example, apparently ran out of ordinary gloves, and instead began unnecessarily using highly expensive sterile gloves.

Kupelo says many hospitals in the province are doing “extremely well” in managing Covid-19. “St Barnabas and Zithulele Hospital in the OR Tambo District [have admitted] over 50 positive patients with 98% and 100% recoveries respectively.”

On Sunday, Livingstone’s casualty ward was open, but unusually empty.

While this is promising, there’s no guarantee the labour dispute won’t happen again. Ominously, Jaceni tells the FM that the current state of calm was dependent on whether “management would keep its promises” about the overtime pay.