The maze that is the government health system….

See previous post about Priv and her bun in the oven.

Priv goes down to her local clinic, which is in Milnerton.

She goes on Wednesday last week, and leaves our house just before 08h00 to get to the clinic.  We know she is pregnant, she has had a fetal assessment centre scan – so she is going for them to check her blood pressure, her weight and have a measure and a feel around.

Seems reasonable.

I had a busy day, and got home with the kids around 17h30 – I thought she was in her room, and I carried on with the evening.  I sent her an SMS, and at about 19h00, I went to knock on her bedroom door to check she was okay and see what the clinic said.  No answer, and I think “shame, she is exhausted I will let her sleep…

At 19h30, I start to wonder why I have not seen her, and now I start to worry, and go back and knock on her door with a bit more force.

I picked up my phone to call her, thinking she must be fast asleep, and saw that she had sent me a message at 18h40.  She was still in the queue, her phone battery had died and she had used the phone of the person sitting next to her.

It is not about 20h00 and no sign of Priv.  I start trying to reach people I think she might have walked to.

I tried to call her just in case.  I then called the number on my phone and spoke to the person who sat next to Priv at the clinic.  She had left the clinic at 19h45, and she is already home, she does not know where Priv is.

Now I was really worried.

It is dark – it is really late.  I know the taxi’s that run no longer run to our area.  How the hell is Priv going to get home?  How the hell am I going to figure out where she is?

Now I am panicked.  I am tried to work out if I should wake the kids and put them in the car and start driving around aimlessly screaming “Priv!!!  Where are you?” out the window like a crazy person.  I am weighing this up, and trying to work out whether I should go in my jammies or not, when I hear out front door unlock, and Priv walks in – it is 20h30!

{long story about how she walked and caught a taxi, and eventually went into a block of flats, someone took pity on her, and packed up his family into his car and gave her a lift to our house}

The clinic had kept her there the entire day.  After hours of waiting, she was told she needs to wait for the pre-natal nurse who arrives at 15h00.  Each patient takes 45 minutes, and that is where the time went, she did not want to leave as she knew that she would have to repeat the exercise and tomorrow might be worse.

She is exhausted, she looked a bit traumatised – I think sitting in a government clinic all day might put you in a position to see too many things you pray you do not ever have to witness.

And for the cherry – she had to return in the morning to have her blood taken, as the nurse who takes blood had gone home.

So we headed back to the clinic on Thursday morning, another three hours later she had her blood drawn.

10 minutes to draw blood, 2 hours 50 minutes to find the files that had been misfiled on top of a filing cabinet by the night nurse who had left the night before.  Of course she had to wait for them to find the file for them to draw blood — makes sense.

Priv will need to remain at this clinic, until she is past 32 weeks, then they will refer her records to the clinics which are closer to our (and her) home – they say they are not willing to refer her before that.

I asked her which hospital she will deliver at, she says she does not know.

I get the sense from her, that she has to continue going to the day clinic.  She goes there and if she thinks she is in labour, at that point they refer her to a day hospital to deliver.

Do bear in mind she needs to get to the day hospital by herself while a baby is threatening to appear out of her vee-jay-jay.

She said that they told her not to call an ambulance if she goes in to labour, they will not come fetch her.  Right well, now we know – I am off to buy a Golden Arrow bus card for her, because clearly even head out of vee-jay-jay is not a reason to call an ambulance.

If the birth has complications the day hospital then will then refer her to a hospital like Karl Bremer (which is close by) or Groote Schuur (or the day hospital will close and send her to the hospital or home…) – the hospitals deal with complications.

And here I was thinking a hospital was there to help someone say when they are giving birth or have cut off their leg with a salad fork.

I cannot imagine anything more long winded with gaps to where a baby can be delivered in a taxi or on a street corner, or in my kitchen with the aid of my Carrol Boyes salad tongs.

Or am I missing a key point here?

{I know, I bet you are now laughing at my wait at the emergency clinic for plus two hours with an ear infection, clearly I just needed some perspective on that issue to really fully appreciate how fantastic that service was}

My question is:  Are there OGBYNs who practice at government hospitals, so you pay a fee to consult with them – which might be slightly less than the cost of actually just buying a new lung.

Where the OGBYN sees you, and then when you deliver, you deliver in the government hospital he or she refers you to?  And he/she only comes along if there is an emergency?

I tried to phone Karl Bremer and Groote Schuur and the message was very clear: “Fuck off and leave us alone, we are too busy for your suburban problems!”  They did not say that, though the sub-text was clear. They did say they only take referrals for high risk births and then told me to go away.

I have googled the crap out of this, and have not really come to any other conclusion than what I understand above.

Does anyone (who really knows) know any better, or can offer advise on how to circumvent find a better method of working?

Or is this just the way it is, and I best take a chill pill and start cleaning my salad tongs, and boiling the kettle.

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18 Comments

  1. Hi! Sorry I can’t remember if I have left a comment before.. However I am a doctor and work for the state (I know, shoot me now..) but in Gauteng. It probably works about the same in the Cape though. Basically at the clinics low risk patients will be followed by nurses and they will be referred on if there is a complication (to at least a secondary hospital, KB is one as far as I can remember). Really complicated cases will be followed at the tertiary hospitals. At the secondary levels medical officers will be attending and at the tertiary levels there will be medical students, registrars and consultants (qualified specialists who will see really really complicated cases as well as supervise the younger doctors). It is not possible to see these guys any other way, unless they are involved in private wings (some hospitals up here have them too). And that will cost a bit. The situation is really difficult but the fact is there is waaayy to little hands on deck in the state service and really very little incentive for any medical professional to stay there. So low risk patients unfortunately do have to contend with the clinics. If she is in labour though, going to any state hospital will do the trick, here we take ‘walk-ins’ at all hospitals, low risk or high – the ward is stratified as to risk category. The stories I can tell you … For eg, when we were students at a particular hospital up here, we knew the bus from Mamelodi comes by at 10pm and we always expected a few women in labour then – can you even imagine traveling by bus to the hospital while in labour??

    Anyway, that is my experience hope she comes right. Good luck.
    Paula

    Reply
    • reluctantmom

       /  March 26, 2013

      I really do not want her delivering on my lounge floor, or in my car — not because I think it will be an inconvenience, but I really do not want to be putting Priv or her baby at any risk.

      Thanks for your comments though — I think that we worry that something might go wrong, and we worry that something may go wrong — I just don’t want to be a 3 hour wait from someone who can help.

      So many people have given some good suggestions, and I definitely want to look in to those. I want her to have a safe delivery and her baby to be safe …..

      Reply
  2. charliesbird

     /  March 26, 2013

    Mowbray Maternity has a great private midwife run side, where they will refer one onto the non private hospital side if there are complications. The unit has a great reputation.

    Reply
  3. Kristin

     /  March 20, 2013

    I have just gone through a similar ordeal with Euphen. She had a high risk pregnancy – 38 years old and a full term stillborn in 2004 – so was ‘lucky’ enough to be referred to Mowbray Maternity at 32 weeks. She found out she was pregnant at 4 months and couldn’t get decent healthcare at any day clinics. I took her to my private Dr who has a midwife on staff. The midwife did a prenatal checkup and found all to be fine. However, if she was not considered high risk, I hate to think what would have happened.

    I went to see her at Mowbray Maternity and I was extremely impressed. It might be worth giving them a call and seeing if they can help in any way?

    It is apalling and unfortunately I do not know the answer, but I truly hope that you find one.

    Just a thought – a completely ‘out there’ thought – if she is young and healthy, and all is well with the pregnancy, why not hire a midwife and do a homebirth? It’s probably safer and a more controlled environment to birth in by the sounds of it.

    Reply
    • reluctantmom

       /  March 20, 2013

      Thanks Kristin – so many good ideas, need to do some research and see what I can arrange.
      I really could not live with myself if I just stood by and let the process take it’s course, and something went wrong which a modicum of care could have prevented.

      Reply
  4. Warren

     /  March 20, 2013

    Government needs to react faster in order to keep up with demands, but maybe they “hired” peeps would care more if they were paid adequately, but then they would also have to be experienced, qualified, etc.

    Hey Gov Minister – stop smoking Tic and taking free drugs and start doing your job properly you parasite!

    Reply
  5. Man, this upsetting to read. It is as if they consider people who use their service to not be humans but rather cattle?

    Reply
  6. Jenny

     /  March 20, 2013

    It will probably be worse for her as she is Zimbabwean. But yes, that is the reality for many women in our country. Which so many of us choose to ignore when we judge the moms who have kids in their gardens/taxi’s/queues and then wonder why the babies die? I deal with it daily.

    Reply
    • reluctantmom

       /  March 20, 2013

      Jenny, my eyes have been opened in the last few weeks. I really have not had to deal with government much, so manage to skip through my life thinking my biggest issue is why there is no ice in my ice trays for my glass of wine. I cannot imagine how difficult/impossible it must be for women in this country to get through pregnancy and child birth and not end up dead.

      Reply
      • Jenny

         /  March 20, 2013

        I would first starve to death than give up my medical aid. That’s the truth. Maybe you can rather look into a midwife-led birthing centre but if there are complications be prepared to pay for a c-sec (which is actually not that expensive). Enquire and see if you can afford to take her out that system – I know Zims are treated particularly appallingly – sworn at during birth, made to clean up their own amniotic fluid etc – really not a great start to a baby’s life and then if something does go wrong it’s usually not communicated at all. I often have women tell me their babies died in birth because ‘it was lazy’. Yes, it was indeed just the nurse who was too lazy to call the doc to perform a c-sec. Sigh.

        Reply
        • reluctantmom

           /  March 20, 2013

          I think I just lost all colour from my face, and then my heart fell out of my poop hole ….. cripes ….

          Reply
  7. Wendy

     /  March 20, 2013

    My sister went to KB in the private side, with Dr Lood Labuschagne who is based in Louis Leipoldt. Perhaps he can help – I am sure his Receptionists would be able to give you some info.

    Reply
    • reluctantmom

       /  March 20, 2013

      Thank you for that — I have had several good suggestions, so will definitely investigate a few options.

      Reply
  8. Jimina

     /  March 20, 2013

    It is hell! My Abigail miscarried with twins last year at 24 weeks. First she went to Fish Hoek Hospital where nothing happened and she had to wait 2 days for an ambulance to take her there. She then had to sit at GS for a week while they gave her whatever stuff they give to induce. Never telling her what was happening. Nothing happened. They sent her home and told her to come back Monday. It was a mind fuck. I got hold of the Prof there and eventually told him what I thought of his system. She came back the Monday, they induced again, gave her panado for the pain and she gave natural birth to her dead babies. I fetched her the next day. There are no words as to how kak government hospitals are!

    Reply
    • reluctantmom

       /  March 20, 2013

      Horri – fukn – rific!! I really can’t get my head around how the government/health minister thinks that this is going well. Fortunately I have had little exposure to this process, but the little I have had has really made my head spin!!

      Reply
  9. Appalling!

    Reply
  10. We had a similar situation and as far as I can see there is no solution. I even tried to use my GP but was told that once Isabelle went to see a private doctor there was no getting her back on the government listing. I do know that Bara offers a private birthing ward because I was preggers overseas and thought about coming home to give birth and Bara came highly recommended.

    Reply
  11. Celeste. KB has a private section. That you can go to. I remember 4 years ago it was about R6000 to have you bed booked for the private section, only thing is they will admit you only if you are like seeing the babies head come out. But at least then you don’t have to. Go from clinic to hospital. Will see if I can find the details.

    Sent from my BlackBerry® wireless device

    Reply

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