South Africa Unrest: Supporting overstretched health centres and vulnerable communities in the aftermath of the violence

30/07/2021

South Africa

Like other hospitals and clinics in areas affected by the social unrest which was seen in South Africa, the Thelle Mogoerane hospital in Vosloorus saw a spike in trauma cases relating to the unrest. In an effort to help alleviate the stress placed on the healthcare system, Doctors Without Borders dispatched small teams of field workers to support affected hospitals and clinics. Bhelekazi Mdlalose is a nursing activity manager who has been working in the emergency unit of the Thelle Mogoelrane hospital as part of the Doctors Without Borders response to the unrest. © Tadeu Andre/MSF

Over 270 people were reported killed in riots and looting that also disrupted access to crucial healthcare services, food, fuel and other essentials. Trucks, stores and shopping malls were burned and looted, as well as 90 pharmacies and some medical centres. Long-standing inequality, high levels of poverty, an unemployment rate of over 30 per cent and the devastating economic fallout from a year of successive COVID-19 lockdowns, have left millions of South African residents desperate and disaffected.

During the violence, some hospitals and health centres were forced to close while others became unreachable for staff and patients. Many short-staffed hospital emergency departments became overwhelmed by a surge in trauma patients.

Doctors Without Borders / Médecins Sans Frontières (MSF) launched an emergency response to provide emergency support to communities and health facilities affected by the violence.

Philip Aruna, Southern Africa Support

16 July 2021: A SANDF Casspir stands guard outside the Eyethu Mall in Orange Farm. © James Oatway/MSF

In Johannesburg, Doctors Without Borders teams assessed multiple areas affected by the violence and provided nurses with trauma experience to the emergency rooms of a clinic in Alexandra and a hospital in Vosloorus.

Our goal was to enable these overstretched facilities to better cope with the increased volume of trauma cases while some nursing staff where unable to reach the facilities. We expect that as health facilities reopen and a sense of stability returns, an additional wave of patients will go to health centres for treatment they delayed during the unrest as well as to refill prescriptions for chronic conditions, such as HIV, TB, hypertension and diabetes.

Philip Aruna, Southern Africa Support

Doctors Without Borders teams supporting the Alexandra community healthcare centre South Africa July 2021

Doctors Without Borders teams supporting the Alexandra community healthcare centre following social unrest in two provinces of South Africa which has resulted in access for patients and medical staff being blocked. Amidst widespread looting and violence healthcare services have been understaffed whilst seeing an influx of demand for treatment.

The unrest has blocked essential healthcare services. Two Doctors Without Borders medical teams are offering support at understaffed emergency departments of a clinic and hospital outside Johannesburg as more patients seek care in the aftermath of the violence and chaos. © Tadeu Andre/MSF

In KwaZulu-Natal province, in Pietermaritzburg, Doctors Without Borders provided oxygen concentrators on loan to a local hospital from our long-running project in Eshowe to ensure that severe COVID-19 patients were adequately supported.

At this hospital, the competing priorities of simultaneously treating an influx of trauma cases and severe COVID-19 cases put severe strain on the overstretched capacity. Days after the violence many patients were still receiving treatment for violent injuries, thus occupying intensive care unit beds that can not be allocated for critical COVID-19 cases.

In Durban, Doctors Without Borders teams have also been providing support directly to the Briardene informal settlement since 18 July.

Around 250 families lost their homes and belongings in fires that gutted the corrugated iron informal settlement during the week of the unrest. Mothers and young children were forced to sleep in the open, and the community had difficulty accessing food. Many people were unable to reach medical care due to insecurity, or due to the fact that some clinics had closed.

Adeline Oliver, emergency team nurse

In KwaZulu Natal, a Doctors Without Borders team offered medical assistance South Africa July 2021

In KwaZulu Natal, a Doctors Without Borders team offered medical assistance and donated a tent, blankets and other essentials to a community after a fires destroyed their homes in Briardene, Durban. © MSF

Doctors Without Borders team set up a tent to provide emergency shelter in the informal settlement and distributed 600 blankets, 250 hygiene kits, and other essentials. A medical team offered consultations and basic care.

Four of the first ten patients we treated in the informal settlement in Durban had suffered trauma injuries -- three of these injuries were due to violence and we set up a station where we could dress wounds. As we continued working in the community we saw patients affected by smoke inhalation from when the fire was raging and they were trying to salvage their belongings. We also found that there are significant unmet mental health needs in the community.

Adeline Oliver, emergency team nurse

Doctors Without Borders will continue to offer independent and impartial health services in Briardene for the remainder of this week. Our assessment of health gaps in KwaZulu-Natal is ongoing.

The long-term Doctors Without Borders HIV/TB project in Eshowe, King Cetshwayo District, re-opened on 19 July, with clinic, hospital-based and community outreach activities fully reinstated by 21 July. Activities in the Doctors Without Borders -supported COVID-19 ward at Ngwelezana Hospital near Empangeni resumed on 19 July.