Now they have sheets on the beds, but no money
December 06, 2004
Kerry Cullinan
Some years ago, pregnant women were expected to bring newspapers along with them when they came to the Alexandra Clinic to deliver their babies as there were no sheets.
After 75 years of existence, the clinic can offer sheets in its wards - but it is still struggling financially.
Foreign donor funding has dried up and the R20-million grant the clinic received from the Gauteng Health Department this year is not enough to cover basic operating expenses.
Mike Maile, the clinic's chairperson, says it is in "dire financial straits".
"Currently, we owe many of our suppliers money. The council's water and electricity departments are continuously cutting our services because of outstanding debts," says Maile in the clinic's annual report.
The brightly painted clinic, officially called the Alexandra Health Centre and University Clinic, is a local landmark and has offered high-quality primary healthcare to the township since 1929.
The only 24-hour clinic in Alexandra, it inspired the TV series, Soul City which is still filmed there from time to time.
Demand for healthcare is huge in the overcrowded township designed to accommodate 70 000 people but offering a home to around half-a-million people today.
Around 700 to 800 patients pass through the clinic every day, with the women's ward being the busiest. It also has an outreach programme.
Although financial constraints make it impossible for the clinic to offer its staff benefits including medical aid, director Catherine Mvelase says there is a relatively low staff turnover.
"The money is not good but personal happiness is important. I have stayed because I have peace of mind," says Sister Patricia Jass, the deputy head of the maternity unit, who has worked at the clinic for 30 years.
Sister Tiny Sehlapelo, who has 25 years' service at the clinic, says only one of the clinic's nurses was tempted to go and work overseas.
"She came back quickly and said that the Alex clinic is the best place to work," says Sehlapelo.
Dr Sharon Patz has been working at the clinic for the past 25 years. "I think the clinic delivers an excellent service to the Alexandra community," she says. "People look after their children beautifully under difficult circumstances and they are appreciative of what we do. That's what keeps me working here."
Another doctor who did not want to be named but said she had 40 years' experience described the clinic nurses as "the best I have ever worked with".
Much of Alexandra's history is contained within the clinic's tranquil tree-filled courtyards and mural-adorned walls.
Students who had clashed with police during the 1976 schools uprising were treated here. During the 1980s when police and the army were constantly in Alexandra, clinic staff would attend the wounded.
"The clinic was bombed twice. In 1986, people were sleeping in the hall for safety. We would hear gunshots. It was very scary," recalls Jass.
One of its busiest and most traumatic times was during the 1990s, when war erupted between the Inkatha-supporting hostel dwellers and ANC-supporting township residents.
Although the clinic was seen as an ANC stronghold, it never turned anyone away and wounded hostel dwellers were also cared for there.
"At one time, Inkatha people came into the clinic searching for ANC people. People were hiding under cupboards and beds and tables. One of the nurses was too big and she was half sticking out of a cupboard," says Jass.
Today, one of the clinic's major roles is as midwife for the new generation.
An average of 400 babies are born in the clinic every month. During a recent visit to the maternity ward, six women were in the early stages of labour, moving about slowly and moaning.
Precious Funani, standing outside the labour ward with her partner, Mziwonke, was in the early stages of labour. "This is my first baby," she explained, her eyes big with apprehension.
Another two women were behind yellow curtains, writhing in the throes of labour, while two others were recovering after giving birth.
A tiny bright pink baby was being warmed under an ultraviolet light, her umbilical cord still a glistening silver-grey.
Jass describes how Alex was one of the first places to recognise the value of women having someone to support them during labour.
"In the 1980s when Dr Tim Wilson was in charge, we introduced a labour companion," says Jass. "This person is not a nurse because we don't have enough nurses. But it is someone who has some training and can support and comfort women during the first and second stages of labour. It made a big difference to the women."
Although the clinic also encourages fathers to attend their baby's births and has a special family room, the male response has been very disappointing.
"Since we started this in 1988, I can only remember about two guys who came along. Most women come with their mothers," says Jass.
Sehlapelo is deputy manager of the outpatients department, which sees a lot of patients with chronic illnesses.
"Chest problems are the main complaint. There are a lot of hypertension cases, diabetes, asthma and epilepsy," she says.
HIV has taken its toll on the patients too, and the disease profile of the clinic has changed as a result.
Of the 8 890 people who were tested for HIV last year, almost half were positive. In the past year, a hospice has been set up in Alexandra and that has helped ease the clinic's burden a lot.
The casualty ward is busiest over the weekends. "Gunshot cases have decreased a bit but we are still seeing a lot of
stabbings. In a week we see about 20 to 25 injuries. Rapes have decreased dramatically. There used to be over 15 cases a week and we would sit all day dealing with rape cases. But now we see one or two cases," says Sehlapelo.
But she adds that while community programmes and stiffer prison sentences have helped, the decrease is partly due to the fact that the local police station has its own rape centre and doctor and it deals with all child rapes.
Crime has changed the clinic's ability to help the people of Alexandra, and nurses are no longer able to do house visits. Ambulances have been hijacked and nurses in the mobile clinics have been robbed of money and cellphones.
Although the clinic is only supposed to keep patients for a maximum of 12 hours, transferring them to nearby hospitals if they need more care, in some cases the rules are bent. "We deal with the abandoned, homeless and the very sick. Sometimes we have to keep them for a week or two until the social workers find a place for them." - Health-e News Service
