Mom says hospital staff used duct tape on her wound

For 10 days after giving birth, Anke Young, 28, could not hold or care for her newborn daughter due to excruciating pain from her C-section wound.

When she went to the clinic to have her dressing changed, nurses were horrified to find the wound gauze had been stuck in place with duct tape and the incision had become infected.

Young, from Kariega in the Eastern Cape, gave birth at Uitenhage Provincial Hospital on July 5. The hospital, which serves a population of about 500,000 people from the Nelson Mandela Bay area, is under scrutiny for what some claim is systemic neglect.

“As a first-time mother, I was both excited and nervous and I could not wait to hold my baby,” Young told the Sunday Times.

“I was admitted on June 29 but only gave birth on July 5. Everything seemed fine when I was discharged and told to return to the clinic on July 10 for wound cleaning,” she said.

When I went to the clinic, the nurses were shocked, my wound was covered with duct tape

—  Anke Young

Shortly after returning home, she began experiencing persistent pain. “I thought it would go away, but it didn’t. What upset me most was that I couldn’t even care for my baby. When I went to the clinic, the nurses were shocked, my wound was covered with duct tape,” she said.

The clinic referred her back to the hospital, where she claims she was made to sit upright in a chair for four hours before receiving antibiotics.

“No surgical inspection or further care was offered on that day,” she said.

Following mounting public pressure and calls from activists, Young was admitted for remedial treatment last week. She had a wound  debridement, in which dead or infected tissue was removed.

“They also restitched the operation site, and the wound was cleaned again the following day,” Young said.

She has to visit the clinic twice a week for wound care, and in a fortnight she will return to hospital to have her stitches removed. She said she is looking forward to bonding with her baby.

Her case is not unique. A 16-year-old who gave birth at about the same time at the same hospital said her baby’s umbilical stump was tied off with a thread, rather than the standard medical clamp.

General health standards require the stump to be kept clean with gauze and water, and it typically falls off within two weeks.

“My baby was constantly showing signs of distress and her stomach became swollen. When I went back to the hospital, they gave me antibiotics and told me her file was missing,” the young mother said.

She said she complained to nurses at the hospital but was not given proper guidance. “I didn’t know which procedure to follow. I showed the nurses that my baby’s stomach was swollen. One of them said it was nothing to worry about and gave me antibiotics,” she said.

She added that the baby’s stomach remains swollen around the umbilical cord. “That’s why I decided to turn to community activists for help,” she said.

Both Young and the teen are seeking legal advice with a view to taking action against the provincial health department.

The Uitenhage Provincial Hospital and the Eastern Cape health department did not respond to requests for comment.

Kayzel Forbes, an advocate for better health-care services in the area, said Young’s case was a small victory but many other patients had not been as fortunate. She said she was deeply concerned by the treatment of the two mothers. “After giving birth, women need proper medical attention, but this hospital failed them.”

There was a clear shortage of staff at the hospital, Forbes said. “Some staff members have a terrible attitude, and the service is really poor.”

She said hospital infrastructure had not kept up with rapid population growth in surrounding areas. “The hospital simply hasn’t kept up with demand. Nothing has been done to expand or improve it.”

Of the nine provinces the Eastern Cape has the highest rate of medical negligence claims, many of which relate to childbirth complications.

In a response to a parliamentary question from the DA earlier this year, health minister Aaron Motsoaledi said hundreds of medico-legal claims are filed in the province every year, placing increasing pressure on its health budget.

Dr Haseena Majid, public health programme director at the NGO Usawa for Learning and Healing, said the ballooning cost of medico-legal claims, now amounting to billions of rand, often arose due to maladministration, poor governance and a collapse in leadership.

“Funds lost to legal claims divert critical resources away from essential service delivery,” said Majid, a fellow of the Atlantic Institute in Oxford, Britain. 

“Beyond the money, these cases are devastating for families and often drag on indefinitely. The public health system is already in a dire financial position. Prioritising a national medico-legal strategy is urgent if we are to prevent further degradation of the system.” 

Majid said inappropriate care was no longer the exception but increasingly the norm in some parts of the public health system.

“It’s deeply concerning that such acts of inappropriate care ... have become more common. This has eroded public trust in the system. You can see this in the growing fear and negative perceptions people hold about state health-care services,” she said.

At the core of the health system’s failures, Majid said, were long-standing structural issues such as staff shortages, procurement and supply chain breakdowns, inadequate infrastructure and weak clinical governance and oversight.

“Maternal and child health is a national priority. South Africa is fortunate to have some of the best medical minds and highly committed clinical teams. What we urgently need is to improve the capacity and quality of supervisory functions, especially at the district health management level, so that frontline staff are better supported and accountability is restored,” she said.

The Eastern Cape health department has faced multiple court cases related to medical negligence. Last month, the Bhisho high court awarded damages of more than R11m to a woman who sued the health MEC after a botched delivery at Holy Cross Hospital in Mthatha left her newborn baby with cerebral palsy.

National health spokesperson Foster Mohale told the Sunday Times that medical professionals most frequently targeted in litigation were obstetricians and gynaecologists, neurosurgeons, spinal surgeons and orthopaedic surgeons.

He said the department was considering greater use of mediation in an effort to reduce the number of cases that go to court.

Motsoaledi said in November last year that just 23 health officials had been trained in mediation across the country. Only Gauteng and Mpumalanga had implemented mediation so far.