Hell from nurses

They anxiously huddle in groups as if seeking comfort from each other, worried that the ever-angry nurse will overhear their sorrowful complaints and deny them medical care. Are our newborn babies alive? They wonder fearfully.

A few minutes later, one of the mothers walks in with tears in her eyes and announces that her newborn baby had died. Silence fills the room as she proceeds to her place in the ward to collect her belongings. Nine months gone down the drain and she will be leaving without her supposed bundle of joy.

A source later disclosed that four newborn babies died in the nursery that Saturday. We could not independently verify if it was due to professional negligence or natural causes.

But the source explained that three were from the high risk section of the special care unit whereas one died in the low risk partition.

The Nation went undercover last week at the Gogo Chatinkha Maternity Wing of Queen Elizabeth Central Hospital (QECH) in Malawi’s commercial city, Blantyre, where we experienced animosity, fear, anger and hatred in a place supposed to offer hope, healing and dignity for patients and their loved ones.

Harsh experiences

Last Wednesday, for example, women were spotted in groups in their wards quietly discussing their harsh experiences during and after delivery of their babies.

At the sound of footsteps in the corridors, they paused as a precautionary measure in case they were overheard and only continued as the authoritative footsteps melted away.

The conduct of one particular nurse came up constantly in the women’s discussions. She, according to the women, had a case with each of them and none of the encounters with her were peaceful.

“She also said that to you? Me too,” so went the discussion.

“Akuti siinu oyamba kubereka ndi siza ndiye ndisawatopetse [She told me I was not the first woman to deliver through Caesarean section, so I should not bother her],” said one, who was visibly in pain.

“Ine ndiye anandiuza kuti 1A inali kale. Musamazione ngati kanthu. [She told me that the paying Ward 1A is no longer the same; hence, do not think you will get special treatment].”

This particular nurse seemed immersed in her own world of creating hell for the women, including those who had their babies in the special care nursery.

Nursery area lacks information

The nursery area was another story altogether with lack of information to mothers on what they should do.

The only instruction nurses do not forget to give is to remove shoes when getting in. The rest, it is assumed, should be obvious to patients and guardians.

One guardian said: “I entered that room and found my baby with a feeding tube… All the help I asked for was responded to in anger and the last straw was when I was told not to bring the baby basin in because it was too big.

“The nurse I found told me big basins were not allowed and I should buy one from her right there at the hospital at K150. Can you imagine that?”

Another guardian said her patient experienced problems with her catheter and when the matter was reported to the nurses, they came four hours later because they were catching a nap.

A catheter is a tube that can be inserted into a body cavity, duct, or vessel usually to allow drainage, administration of fluids or gases, or access by surgical instruments. If not attended to, it causes discomfort to patients.

The guardian said earlier on during working hours, three nurses enjoyed their meals, locked the door and later assembled chairs as beds and had a siesta.

‘We beg for every service’

Said the guardian: “[We beg for every service]. Tests are done, medication given without any communication. Patients are moved about without being given reasons. Everybody works at their own paces.”

QECH has also become an institution where everybody—from cleaners, guards to nurses—seem to have their way with both patients and guardians.

Simple requests for directions or help land either on deaf ears or attract verbal abuse. Everyone visiting the hospital comes out with one vital lesson; never to answer back at whatever cost, let alone exercise your rights.

If you do, you jeopardise your health or that of the person you are guarding or came to see, which for the moment lies in the hands of the medical personnel.

This silence but well applied tactic for survival by patients, guardians and visitors seems deep rooted.

For example, on Tuesday, two security guards, in an open display of their territorial authority, threw away all courtesy and decorum when some visitors attempted to get supplies to their relations during visiting hours.

Instead of politely advising visitors not to wait in the corridors, the instruction came off as a bark followed by name-calling, including accusing some of the visitors of being potential witchcraft practitioners.

‘We will investigate’

QECH chief hospital administrator Themba Mhango said the hospital will investigate the incidents.

He added that the referral hospital relies on a committee that includes the public to report to management for investigation and action.

Said Mhango: “Normally, patients or guardians do not open up when approached by officials. The challenge we have is to track down events that occur after one week. Another challenge is that the committee inspects fortnightly. I will present the matter to the nursing administrator for action.”

He was, however, quick to say that most of the nurses are overworked, working for three days on end without sleep because of the overtime in form of locum.

National Organisation of Nurses and Midwives (NONM) executive director Dorothy Ngoma said patients, guardians or any relation is supposed to be treated with dignity.

“It is all true and these abuses are happening every day. They are not allowed, unacceptable and must not be condoned. That is not how nurses are trained. Mothers in particular become unsettled and anxious because of hormonal changes after birth. Patients or guardians should not be exposed to such kind of treatment,” said Ngoma.

‘There is no excuse’

While acknowledging that some of the behaviour results from exhaustion, she said this should not be an excuse for abusing poor people.

“There is need for sane superintendents and supervisors to go round the wards and check general conduct. Those nurses with psychological stress need to be [identified]. Ideally, their names must be taken and submitted to us so they can be placed under counselling, psychological and spiritual care. If we only revoke their licences, they could get them back at some point and later be integrated back into the system.

“Even a well-trained soldier, if not properly supervised or overworked, turns on innocent civilians. This might be an extreme example, but we cannot leave a troop without a captain. Patients become exposed,” said Ngoma.

She said nurses should not be blamed for joining the locum system because they take orders from their superiors who she said were not to blame either because they are handicapped.

She admitted to things getting out of hand in the nursing profession with nurses and other medical personnel working from hospital-to-hospital and department-to-department to make ends meet through locum, sometimes for two weeks without proper sleep and food.

“I must nonetheless apologise for what happened and what is happening. I am very sorry and it must not happen again. I am embarrassed because we are never trained to become like that. The system has become messed up,” she said.

Adverse effects

Malawi Health Equity Network (Mhen) executive director Martha Kwataine feared that the attitudes at QECH would have the adverse effects of making people, especially expectant mothers, to shun hospitals and resort to delivering at traditional birth attendants (TBAs).

Kwataine noted that problems the workers are facing cannot be sorted overnight, but warned health workers against venting their anger on wrong people.

She questioned the kind of supervision that tolerates recklessness and fails to enforce discipline.

“It is a shame. The sad thing is that all this is done to poor people who have no option for a private hospital. The same nurses and workers behave well at a mission or private hospital. Why can’t they do the same at public institutions?” said Kwataine.