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PSYCHIATRIC CENTRE OVERCROWDED, HAS ONE PSYCHOLOGIST

By BONGIWE DLAMINI | 2024-08-05

WORKERS at the National Psychiatric Referral Hospital in Manzini have revealed that patients are living under terrible conditions, not fit for humans, let alone patients.

The healthcare facility is also reportedly overcrowded, especially the male wards, with the male acute ward having an average of 90 patients in the past two months.

This is despite that the wards capacity is only 45 patients. In July alone, a total of 112 male patients with acute mental health conditions were admitted at the hospital. The acute mental health illnesses include severe depression, bipolar disorder, schizophrenia, or acute anxiety disorders.

Acute ward are reserved for patients with significant and distressing symptoms of mental illness who require immediate treatment. Ordinarily, patients in this ward need to be provided with intensive medical and nursing support.

Additions

However, in the case of the National Psychiatric Referral Hospital in Manzini, this is almost impossible as in addition to the overcrowding, the patients are also exposed to lice, which are caused by poor hygiene.

The workers at the Manzini hospital added that the male rehabilitation ward, on the other hand, recorded 99 patients in July. As at July 23, 2024, it is alleged that there were 93 admitted patients in the rehabilitation ward.

Meanwhile, the female acute ward is said to have had 65 admitted patients in the months of June and July.

The facility is so overcrowded that patients are believed to be forced to share small spaces, while some sleep on blankets in the hospital corridors, or even on the courtyard within the hospital premises.

“It is a sorry sight, especially because it is winter,” said a source.

Also, the healthcare workers mentioned that with the high volumes of patients admitted at the hospital, some who need psychotherapy, the institution only has one psychologist.

“The psychologist is overwhelmed by the number of patients requiring psychotherapy. Some of the patients, even those with severe depression, end up being discharged without getting the psychologist’s services,” lamented the workers.

In addition to the challenges, workers have expressed their concern over the occasional shortage of treatment for the patients, which they said cause them to relapse. They noted that from time to time, injectable treatment runs out at the institution’s pharmacy, yet it is best for most patients because they take it once a month, unlike the oral medication that they need to take at specific times daily.

Injectable

“With the injectable treatment, patients hardly relapse as the medication remains in their system for about a month. At the same time, their conditions are best controlled with the injectable medication,” said a worker.

On the other hand, the nurses said oral medication sometimes ran out, resulting to patients not being able to take the prescribed medication as recommended. Such medication includes Tegretol CR tablets, which the nurses said are expensive and most patients who are also diabetic cannot afford to purchase them from pharmacies.

These tablets are said to cost about E400 and some patients are sometimes instructed to take 600mg of the tablets twice a day. In a month, patients would have to part with a lot of money for these drugs.

Tegretol (carbamazepine) is an anticonvulsant used to treat bipolar disorder, seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy.

Nurses have also told this newspaper that there was an acute shortage of workers at the psychiatric institution, so much that the ratio of 1:5 ratio of patients to nurses cannot be met. The sources said each patient with acute mental conditions needed to be attended to by five nurses, but at the institution this did not happen. Instead, a maximum of three healthcare workers attend to all the admitted patients, which is overwhelming for them.

“There had been an exodus of at least four nurses who went to the United Kingdom. Government has not hired more healthcare workers to fill these vacancies, yet there were not enough nurses in the first place.

“It is disheartening how government has neglected this hospital when it services patients who desperately need assistance from all over the country. Everyone could be mentally-affected by situations connected to financial challenges, so the institution needs to be amongst government’s priorities. Anyone can find themselves here and one wonders how they’d be assisted if the hospital is neglected this way,” said the workers.

They also expressed their concern that the issues faced by the institution had been reported to the parent ministry numerous times, but nothing had been done. They opined that the overcrowding issue could be addressed if government could have regional institutions, where patients with minor mental health conditions could be treated. They said the main institution in Manzini could be used by patients with acute mental conditions.

“Technically, this institution is not a referral hospital, as most of the patients directly come here for assistance with mental health conditions without being referred,” said a worker.

Patient dies in ward

A patient is alleged to have died recently while getting treatment at the National Psychiatric Referral Hospital.

However, the cause of death could not be immediately ascertained.

The patient is said to have been admitted to the intuition on June 21, 2024 for purposes of treating his bipolar condition.

However, he passed on a few days later. The patient’s family is said to have had concerns about his death, as they claimed to have been denied access to see him a week after he had been admitted. According to reports, the reason for not allowing them to see him was that he had a severe episode on the day.

The family reportedly suspected that their member’s death could be a result of either physical harm inflicted during his stay at the psychiatric referral, or a dosage error in administering medication or an alleged reckless oversight by the hospital staff.

They further alleged that the hospital was unable to provide a complete file documenting the deceased’s care, with medication administered to him and what food he had eaten while there. Therefore, the family demanded answers from the hospital’s administration.

Sources alleged that the death of the patient might be linked to the wards’ overcrowding or shortage of human resource as the nurse, according to the sources, are not able to cope with the overwhelming task of caring for so many patients at once. After the patient’s family launched a complaint, officials from the ministry of health are said to have visited the hospital to

Ministry aware of limited space

THE Ministry of Health has acknowledged the issue of limited space at the hospital.

The visit to the hospital by health officials was confirmed by the ministry’s Communications Officer Nsindiso Tsabedze, although he did not divulge more details about the findings.

The ministry attributed the high bed-occupancy rate at the referral hospital to that some relatives of patients never came for their loved ones when the time for them to be discharged came. Tsabedze said patients of the hospital were not discharged in the absence of their relatives or family members.

Admitted

He cited that admitted patients of foreign origin tended to stay longer at the hospital because the process of repatriating was not easy.

On the other hand, the ministry said it was not aware of all the other challenges cited by the healthcare workers because they had not formally reported them to the ministry.

“No complaints have been received regarding this matter. However, the ministry is aware of the space challenges at the facility, which have been observed during visits there,” stated Tsabedze.

To address the limited space issue, the ministry’s mouthpiece said one of the hospital’s wards was being renovated in order to provide more space for patients. He said there were ongoing renovations to one of the wards that needed to be refurbished, and that this was done to provide additional space for patients.

When asked how much was needed by the referral hospital to address all its challenges so that the institution could be run smoothly, Tsabedze said, “A figure cannot be specified due to the ever-changing needs within the health sector, needs that possibly grow to exceed the budget each year. The ministry of health can never have a budget that would be deemed enough to cater for all needs of the health sector.”

Govt accused of not prioritising health

THE Swaziland Democratic Nurses Union (SWADNU) says it seems as though government is not prioritising the health of citizens.

SWADNU Secretary General Mayibongwe Masangane said one of the ways through which government had shown neglect of the sector was by not hiring healthcare workers to fill vacancies left by those who left for the UK.

Demand

Masangane said government was aware of the high demand for mental health nurses in the UK, and that most of Emaswati nurses showed interest and left. Therefore, he said government was not being truthful when she said she was not aware of the issues faced by healthcare workers at the National Psychiatric Referral Hospital.

“We’ve engaged government on numerous occasions about the shortage of healthcare workers in the country’s health institutions, but nothing has been done so far,” stated Masangane.

On the issue of shortages of working tools for the healthcare workers, the SG said it becomes risky for them as when they improvise, they are risk making mistakes for which government would charge them.

“Despite that nurses stand to leave their families behind when they migrate to the UK, they end up leaving Eswatini they want better pay and conducive working environments,” said Masangane. Further, he concluded that something needs to be done to address the issues faced, not only at the psychiatric hospital, but all health institutions in the country.

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